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HomeMy WebLinkAboutCharter 1-1-19 A��a DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/29/2017 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 Marsh USA Inc. NAME: PHONE FAX 701 Market Street,Suite 1100 tA/C.No.Est): I(A/C,No): St.Louis,MO 63101-1830 E-MAIL Attn:StLouis.CertRequest@marsh.com Fax:212-948-0811 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC M INSURER A:Commerce&Industry Insurance Company 19410 INSUREDCharter Communications,Inc. INSURER B:National Union Fire Ins Co Pittsburgh PA 19445 400 Atlantic Street INSURER C:New Hampshire Insurance Company 23841 Stamford,CT 06901 INSURER D:ACE Property and Casualty Insurance Company _ 20699 INSURER E:Insurance Company State Of Pennsylvania 19429 INSURER F: _ COVERAGES CERTIFICATE NUMBER: CHI-008870727-02 REVISION NUMBER: 0 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 SUER TYPE OF INSURANCE ADDL ER POLICY EFF ' POLICY EXP LIMITS LTR INSD WV➢ POLICY NUMBER (MM/DDYYYI IMM/DD/YYYY] A X COMMERCIAL GENERAL LIABILITY 3629906 01/01/2018 01/01/2019 EACH OCCURRENCE $ 2,000,000 DAMAGE CLAIMS-MADE I X 1 OCCUR PREMISESO(EaENTED occur occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY PRO JECT LOC PRODUCTS-COMP/OP AGG $ 2,000.000 OTHER $ B AUTOMOBILELIABILITY 1921838(AOS) 01/01/2018 01/01/2019 COMBINED SINGLE LIMIT $ 2,000,000 Ea accident B X ANY AU I O 1921839(MA) 01/01/2018 01/01/2019 BODILY INJURY(Per person) $ B OU E ONLY SCHEDULED 1921840(VA) 01/01/2018 01/01/2019 BODILY INJURY(Per accident) $ AX HIRED x NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ D X UMBRELLA LIAB X OCCUR G28119616 003 01/01/2018 01/01/2019 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ C WORKERS COMPENSATION 014122399(AOS) 01/01/2018 01/01/2019 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER E ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N 014122396(MA,WA,ND,WI,WY) 01/01/2018 01/01/2019 E.L EACH ACCIDENT $ 2,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 If yes,describe under See Additional Page 2,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ B Excess Workers Compensation 4595566(OH) 01/01/2018 01/01/2019 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ,RECEIVED JAN082018J CITY CLERiK s t3 ! CERTIFICATE HOLDER CANCELLATION CITY OF OSHKOSH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: CITY CLERK THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 CHURCH AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. OSHKOSH,WI 54901 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _MaLUJaei►� �3+4-.._tc.•a.A.4u- 1 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD