Loading...
HomeMy WebLinkAboutAmerican Consulting Services 1-1-19 ____—.....,,, AMERCON-12 AROSS AC' �R� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/19/2018 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 NApMEACT Ann Ross HUB International Mountain States Limited PHONE FAX 245 E.Roselawn Avenue,Suite 31 (A/C,No,Eat):(651)288-5137 (A/C,No):(651)286-0560 Saint Paul,MN 55117-1940 Kiss,ann.ross@hubinternational.com INSURER(S)AFFORDING COVERAGE NAIC If INSURERA:The Phoenix Insurance Company 25623 INSURED AMERICAN CONSULTING SERVICES INC INSURER B:Travelers Property Casualty Company of America 25674 dba AMERICAN ENGINEERING TESTING INC INSURER C:The Travelers Indemnity Company 25658 AM PETROGRAPHIC SERVICE INSURER D:Continental Casualty Company 20443 550 CLEVELAND AVE N ST PAUL,MN 55114-1804 INSURERE: 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 VNTH 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 ADDLJSUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD I WVD IMM/DDM'YYI IMM/DDIYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR X 630539K8896PHX18 01/01/2018 01/01/2019 DAMAGE TO Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 0 GE AGGRE ATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,00GENIIPOLICY II TEf LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000 (Ea accident) $ X ANY AUTO X 810797K914000F18 01/01/2018 01/01/2019 BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTOS AU ONLY _ AUTOS BODILY BODILY INJURY(Per accident) $ __ _ AU Up ONLY A NNUUTOS ONLY (Per accdent)DAMAGE $ $ B X UMBRELLA LIAB X OCCUR EA CH OCCURRENCE J 10,000,000 EXCESS LIAB CLAIMS-MADE CUP3K2260091843 01/01/2018 01/01/2019 AGGREGATE $ 10,000,000 DED X RETENTIONS 0 $ C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN UB9H915101 01/01/2018 01/01/2019 X STATIITF ERH 1,000,000 ANY OFFICER/MEMTBOER/PARTNER/EXEXCLUDED?ECUTIVE N N I A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 II yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ D PROF/POLL LIABILITY ECH254066939 01/01/2018 01/01/2019 PER CLAIM 10,000,000 D RETRO 7-2-87 ECH254066939 01/01/2018 01/01/2019 AGGREGATE I 15,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) RENEWALS:contracts@amengtest.com PROJECT,12/31/19 ACCOUNT#100-0050-4972-00000/ANNUAL RIGHT OF WAY LICENSE I ANNUAL EXCAVATION/WORK IN RIGHT-OF-WAY BOND/V. STREET/SIDEWALK OBSTRUCTION/SIDEWALK LAYERS/CURB CUT CONTRACTORS/WORK IN RIGHT-OF-WAY LICENSES/City of Oshkosh,and its officers,council members,agents,employees and authorized volunteers REFER TO ATTACHED ENDORSEMENTS FOR ADDITIONAL INSURED STATUS. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, City of Oshkosh ACCORDANCE WITH THE POLICY PROVIS ONSCE WILL BE DELIVERED IN Attn:City Clerk PO Box 1130 Oshkosh,WI 54903-1130 AUTHORIZED REPRESENTATIVE R.046•14 gisif OA,. ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD