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HomeMy WebLinkAboutH&H Utility Excavating 5-1-20 � ® DATE(MM/DDM/YY) A co CERTIFICATE OF LIABILITY INSURANCE 4/16/2019 THIS CERTIFICATE 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 CONTACT NAME: Debbie Hinkes Marsh& McLennan Agency LLC PHONE 262-796-8826 FAC,No):262-785-9753 2725 South Moorland Road _IA/c.No.Ext): _ New Berlin WI 53151 E-MAIL debbie.hinkes@marshmma.com INSURER(S)AFFORDING COVERAGE NAIC k INSURER A:West Bend Mutual Insurance Co 15350 INSURED HHUTIEXCAV INSURER B H & H Utility Excavating, Inc. W4038 Hoffmann Road INSURER C: Plymouth WI 53073 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:441066478 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 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD SUER POLICY NUMBER (MM/DD//YYYY) IMMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY Y A467472 5/1/2019 5/1/2020 EACH OCCURRENCE $1,000,000 DAMAGE CLAIMS-MADE X OCCUR PREMISESO(Ea occu RENTED $200,000 X 2,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO JECT LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY A467472 5/1/2019 5/1/2020 COMBINED SINGLE LIMIT $ (Ea accident) 1.000.000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED - SCHEDULED BODILY INJURY(Per accident) $ HIRED AUTOS X AUTOS X ANONO-OWNED PR Pa RTY DAMAGE(Pe ) A X UMBRELLA LIAB OCCUR A467472 5/1/2019 5/1/2020 EACH OCCURRENCE $6,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $6,000,000 DED X RETENTIONS 0 $ A WORKERS COMPENSATION 0896939 5/1/2019 5/1/2020 X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 A Leased/Rented Equip. A467472 5/1/2019 5/1/2020 $300,000-ACV $1000 dad. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Oshkosh and its officers,council members,agents,employees and authorized volunteers are named as additional insured for general liability,including ongoing and completed operations,on a primary&non contributory basis,and automobile for the named insureds autos,for work performed by the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Oshkosh 215 Church Ave;PO Box 1130 AUT RIZED REPRESENTATIVE Oshkosh WI 54903-1130 C� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD