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HomeMy WebLinkAboutAnderson Brothers 1-1-19 ANDEBRO-01 MWOLF ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 05/22/2018 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 CNTACT NAOME: The Diedrich Agency PHONE FAX 222 Blackburn St (A/C,No,Ext):(920)748-2811 I(MC,No):(920)748-5044 Ripon,WI 54971 ADDRESS: INSURERIS)AFFORDING COVERAGE NAIL N INSURER A:Society Insurance 15261 INSURED INSURER S: Anderson Brothers,Inc INSURER C: 2708 Harrison St INSURER D: Oshkosh,WI 54901 - 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 POUCY EXP UNITS LTR INSD WVD IMM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR BP15038809 01/01/2018 01/01/2019 MEEOENcTuErDra 100,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 _GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY INT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER A AUTOMOBILE LIABILITY (EOMacB dEentSINGLE LIMIT S 1,000,000 ANY AUTO CA15038810 01/01/2018 01/01/2019 BODILY INJURY(Per person) $ OWNED X SCHEDULED AUTOSRE� ONLY AUTOS yyry BODILY INJURY(Per accident) $ X AUTOS ONLY X AUUTOS ONLY (PerP accident)AMAGE .S UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS A WORKERS COMPENSATION X PER AND EMPLOYERS'UABIUTY STATUTE EH R ANY PROPRIETOR/PARTNER/EXECUTIVE N WC15038811 01/01/2018 01/01/2019 500,000 OFFICERIMEMBER EXCLUDED? N N/A E.L EACH ACCIDENT S (MMandatory n NH) E.L DISEASE-EA EMPLOYEES 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Oshkosh THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 215 Chruch Street Oshkosh,WI 54901 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD