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HomeMy WebLinkAboutD R Hansen Plumbing 1-1-19 DRHANSEOPC MMURKEN coR0 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYW) 04/05/2018 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 Nsri ACT Mary Murken,CIC Murken Insurance LLC t PO Box Insurance 306 (A/C No,Ext):(920)651-1500 FAX Ne):(866)218-6850 Oshkosh,WI 54903-3062olilzss:mmurken@murkeninsurance.com INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A:Secura Insurance 22543 INSURED INSURER B: D.R.Hansen Plumbing LLC INSURERC: -- 55 Knapp Street INSURER D: Oshkosh,WI 54902 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!NM N/ POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR !NM (MM(DDNYYY1 (M YYYY M/DO/ I A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE X OCCUR TC3247152 01/01/2018 01/01/2019 DAMAGE TO RENTED 100,000 X PREMISES(Ea occurrencel S MED EXP(Any one person) S 5,000 PERSONAL&ADV INJURY S Included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: COMBIND A AUTOMOBILE LIABILITY Ea acciden SINGLE LIMIT S 1,000,000 X ANY AUTO A3247153 01/01/2018 01/01/2019 BODILY INJURY(Per person) S OWNED SCHEDULED AUTOSgE� ONLY AUTOS yy BODILY INJURY(Per accident) S AUTOS ONLY AUOTOS ONE PROPERTY accident)DAMAGE S A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 5,000,000 EXCESSLIAB CLAIMS-MADE CU3247155 01/01/2018 01/01/2019 AGGREGATE E 5,000,000 DED X RETENTIONS 10,000 S A WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE OTH- ER WC3262007 01/01/2018 01/01/2019 1,000,000 ANY AFFICER/MIMBER EXCLUDED?PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT S (Mandatory n 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 $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Oshkosh,and its officers,council members,agents,employees and authorized volunteers are named as additional insureds under general liability form#ILE1037(11/05). Notice of cancellation in favor of the same under form#ILE0550(11/01). 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. PO Box 1130 Oshkosh,WI 54901-4747 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD