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HomeMy WebLinkAboutAT&T / Wisconsin Bell 6-1-19 ' 1 ® DATE(MM/DD/YYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 06/09/2018 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 CONTACT US Centralized Services Marsh USA Inc. NAME: 9664664 FAX 701 Market Street,Suite 1100 (aC No.Extl: (A/C.No): St.Louis,MO 63101 E-MAIL AttCertRequest@marsh.com Attn:ATT. ertRequest@marsh.com ADDRESS: C INSURER(s)AFFORDING COVERAGE NAIL% 018566 GAW-CRT-18 19 X INSURER A:Old Republic Insurance Company 24147 INSURED INSURER B: Wisconsin Bell,Inc. One AT&T Plaza . -� �1 7— • INSURER C: 208 South Akard,Room 1830.06 )I�i J INSURER D: Dallas,TX 75202 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: CHI-007306081-10 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 SUER POLICY EFF POLICY EXP I LIMITS LTRINS!) WVD, POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY)l A X COMMERCIAL GENERAL LIABILITY MWZY313636 06/01/2018 06/0112019 EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ 1,000,030 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 10,003,000 X POLICY JECT PRO- LOC PRODUCTS-COMP/OP AGG S 1,000,000 OTHER: S A AUTOMOBILE LIABILITY MWTB 313635 06/01/2018 06/01/2019 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO MWZX 313637(MI) 06/01/2018 06/01/2019 BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION$ S A WORKERS COMPENSATION MWC31363800 06/01/2018 06/01/2019 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE IYNNI NIA E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Excess Workers'Compensation/ MWXS 313639 (OH,WA) 06/01/2018 06/01/2019 EL Each Accident/EL Disease 1,000,000 Employers'Liability i See Second Page EL Disease-Policy Limit 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Oshkosh SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn:Matthew Nett THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 Church Ave. ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1130 Oshkosh,WI 54903-1130 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _'4_o.' po'•: - L.c, .;fie z ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD