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Home My WebLink AboutDan V Binder Construction 10-15-19 DANVBIN-01 SCLARK ,a►coRo" CERTIFICATE OF LIABILITY INSURANCE DATE 10/02/DD YYYY) 0/02/2018 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 Shelly Clark NAME: Richards Insurance of Oshkosh, LLC PHONE FAX PO Box za2a (A/C,No,Bay(920)235-1980 (Nc,No(920)235-1982 48 North Oakwood Road E-MAIL ADDRESS: Oshkosh,WI 54903 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:West Bend Mutual Insurance 15350 INSURED INSURER B: Dan V Binder Construction Inc INSURER C: ATTN Diane Binder 1224 W South Park Ave INSURERD: Oshkosh,WI 54902-6642 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 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 INSD WVD IMM/DD/YYYYI IMM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR S 2131920 10/15/2018 10/15/2019 DAMAGE TO RTE 300,000 X PREMISE (Ea ENoccurrDence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PELT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 , OTHER $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) X ANY AUTO X 2131920 10/15/2018 10/15/2019 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSE ONLY AUTOSpp BODILY INJURY(Per accident) $ AUTOS ONLY PROPERTY DAMAGE HIRED ONLY NON-OWNED ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE X 2131920 10/15/2018 10/15/2019 AGGREGATE $ 2,000,000 • DED RETENTION$ $ 2,000,000 A WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER 2131921 10/15/2018 10/15/2019 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OCtRo/ry9nM BEREXCLUDED? N/A -- E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 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) CARPENTRY-INTERIOR OR EXTERIOR The City of Oshkosh,and its officers,council members,agents,employees and authorized volunteers are listed as Additional Insured on ISO form CG 2010 07 04 and CG 2037 07 04.30 day cancellation provision provided per company language by endorsement WB213. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF OSHKOSH Attn: City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. 215 CHURCH AVE PO BOX 1130 OSHKOSH,WI 54903-1130 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD