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382 7th Street TREE 14-00100034 Letter and Inst / A January 28. 2015 V ; Debra Bowser 382 7th St Jacksonville, H. 32233 Re: 382 7th St G BE 9, af- -N S E V�� 1 Big Ben's Tree Service was called out to the above mentioned address to assess the overall health of a large oak tree. It is our findings that the tree in question is hollow throughout the base and limbs. This tree is a serious danger to its surroundings, and needs to be removed to prevent future damage. Thank u r✓ .r .J J rifer G rger, Certified Ar r-ist FL -6338A 09-7�- fiiM C A �,•,'Qe-rr. rr,e4- Big Be 's Tree Service ♦ 2717 St. Johns Bluff Road • Jacksonville. FL 32246 A (904) 641-1 131 ♦ Fax (904) 64.1-1970 bigbenstreesvc s aol.com CERTIFICATE OF LIABILITY INSURANCE Date 1/5/2015 Producer: Plymouth Insurance Agency This Certificate is issued as a matter of information only and confers no 2739 U.S. Highway 19 N. Holiday, FL 34691 rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. 1 (727) 938-5562 Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc. & Subsidiaries Insurer A: Lion Insurance Company 11075 Insurer B: 2739 U.S. Highway 19 N. Insurer C: Holiday, FL 34691 Insurer D: Insurer E: Coverages The policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions, and conditions of such policies. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date Policy Expiration Date Limits (MM/DD/YY) (MM/DD/YY) GENERAL LIABILITY Each Occurrence $ Commercial General Liability Claims Made 11 Occur Damage to rented premises (EA occurrence) $ Med Exp Personal Adv Injury General aggregate limit applies per: Policy ❑ Project ❑ LOC General Aggregate Products -Comp/Op Agg AUTOMOBILE LIABILITY Combined Single Limit (EA Accident) 5 Any Auto Bodily Injury All Owned Autos (Per Person) Scheduled Autos Bodily Injury Hired Autos Non-Owned Autos (Per Accident) Property Damage (Per Accident) EXCESSIUMBRELLA LIABILITY Each Occurrence Occur ❑ Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2015 01/01/2016 X WC Statu- FER Employers' Liability to Limits E.L. Each Accident $1,000,000 Anyproprietor/partner/executive officer/member Disease - Ea Employee $1,000,000 exchYded? NOE.L. If Yes, describe under special provisions below. E.L. Disease -Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations/LocationsNehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 84-65-636 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company": Big Ben's Tree Service Inc. Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s',, while working in: FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or by calling (727) 938-5562. Project Name: FOR BID PURPOSES ONLY ISSUE 07- 1-13 (MT) / REISSUE 08-14-13 (CDF) / REISSUE 09-03-13 (CDF) / REISSUE 10-3-13 (CDF) / REISSUE 11-01-13 (TD)/ REISSUE 12-05-13 (TLD) / Reissued 12/9/13 (SFI) REISSUE 01-03-14 (EP)/ REISSUE 02-11-14 (TLD)/ REISSUE 03-03-14 (TLD) REISSUE 04-02-14 (EP)/ REISSUE 05-01-14 (TLD) REISSUE 06-04-14 (EP)/ REISSUE 7-01-14 (TLD) REISSUE 8-1-14 (AF) REISSUE 09-02-14 (MT)/ REISSUE 09-19-14 (TLD)/ REISSUE 09-22-14 (TLD) REISSUE 10-01-14 (MT) REISSUE 11-03-14 (MT)/ REIS SUE 12-01-14 (TLD) REISSUE 01-05-15 (EP) Bealin Date 12/28/2011 CERTIFICATE HOLDER CANCELLATION Big Ben's Tree Service Inc. Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. 2717 S. St. Johns Bluff Jacksonville, FL 32246 ��� BIGBE-3 OP ID: JI AC RD CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDnYYY) 01/05/2015 THIS C RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Brown & Brown of Florida, Inc. Building 100, Suite 100 10151 Deerwood Park Blvd Jacksonville, FL 32256 Pilar Willis Dixon, CIC CONTACT NAME: PHONE FAX A/C No Ext: A/C No: E-MAIL ADDRESS: INSURE S AFFORDING COVERAGE NAICN INSURER A: Kinsale Insurance Company 38920 INSURED Big Bens Tree Service, Inc. 2717 St Johns Bluff Road Jacksonville, FL 32246-3703 INSURERB:AGCS Marine Insurance Co. 22837 INSURER C: U S Fire Insurance Company INSURER D:Ohio Security Insurance Co. INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFI ATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE A POLICY NUMBER EFF MM/DD/YYYY MLICY ILICYEXP M DD/YYYY LIMITS A GE ERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Ellkt AI/Waiver 0100022047-0 08/02/2014 08/02/2015 EACH OCCURRENCE $ 1,000,00 PRAMAGE TO RENTED— EMISES Ea occurrence) $ 100,0 MED EXP (Any one person) $ EXCLUDE PERSONAL 8 ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN' AGGREGATE LIMIT APPLIES PER: LICY PIFrT RO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ D AUTO MOBILE LIABILITYCOMBINED ANY AUTO LL OWNED SCHEDULED AUTOS X AUTOS X HIREDAUTOS X NON-OWNED BAS(15)88868 08/02/2014 08/02/2015 SINGLE LIMIT 1,000,00 Ea accident _ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ PER ACCIDENT C X MBRELLA LIAR (CESS LIAB X OCCUR CLAIMS -MADE 582-101809-2 08/02/2014 08/02/2015 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 ED I X I RETENTION $ 10000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below / A I WC STATU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ B EquiRment Floater MX193022078 08/02/2014 08/02/2015 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) rr-PTIFIrATF Hr)l nI=R CANCELLATION EVID-01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. EVIDENCE OF COVERAGE Insurance Purposes AUTHORIZED REPRESENTATIVE , Only © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD