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HomeMy WebLinkAboutNeyers Communication Services 1-1-20 _____...,„10 ��� 6.a “�-) C�ci l aPJ I( NEYER-1 OP ID: M9 ACORO CERTIFICATE OF LIABILITY INSURANCE DATE 12/18/2018 Y) �i 12/18/2018 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 have ADDITIONAL INSURED provisions or 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 920-725-3232 CONTACT Mary Beth Baribeau NAME: McGlone PHONE 920-725-3232 FAX 920-725-3233 150 Main Street,Ste 300 R.ECEIVEL (Arc,No,Ext): (A/C,No): Menasha,WI 54952-0389 noD"R'Ess:marybeth.baribeau@mcclone.com Troy Carlson 2 0 Z018 INSURER(S)AFFORDING COVERAGE NAIC# DECINSURER A:Middlesex Insurance Co 23434 INSURED Inc.Neyers Communication Services DEPT OF PUHLIC WORKS INSURER B:Sentry Insurance a Mutual Co 24988 Attn: Janet Neyers OSHKOSH. WISCONSIN INSURERC: W9974 Kelly Drive INSURER D: Hortonville,WI 54944 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 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD ,IMM/DD/YYYYI IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS MADE X OCCUR X A0117858004 DMAGE TO RENTED 01/01/2019 01/01/2020 PRREM SES Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 POLICY X PE 9 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER $ COMBINED SINGLE LIMIT 1,000,000 A AUTOMOBILE LIABILITY (Ea accident) $ X ANY AUTO X A0117858001 01/01/2019 01/01/2020 BODILY INJURY(Per person) $ 1-- OWNED SCHEDULED AURTEO�S ONLY AUTOS BODILY BODILY INJURY(Per accident) $ I~— AUTOS ONLY AUTOS ONLY (Per PROPERTY tOAMAGE $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 EXCESS(AB CLAIMS-MADE 'A0117858007 01/01/2019 01/01/2020 AGGREGATE $ 3,000,000 DED 1 X I RETENTION$ 0 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER A0117858006 01/01/2019 01/01/2020 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE NN NIA E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? andatory m NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 lives,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ 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 included as additional insureds as respects to General Liability&Automobile Liability. Thirty(30)day Notice of Cancellation applies. CERTIFICATE HOLDER CANCELLATION OSHKOSI 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 ATTN: DEPT OF PUBLIC WORKS ENGINEERING DIVISION AUTHORIZED REPRESENTATIVE 215 CHURCH AVE, P.O. BOX 1130 Z 164ZIEur. OSHKOSH.WI 54903-1130 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD