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HomeMy WebLinkAboutEmcor Facilities Services 10-1-19V AC O DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 06/04/2019 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 1166 AVENUE OF THE AMERICAS IA/C.No.Extl: 1A yNo): NEW YORK,NY 10036 E-MAIL Phone.866-966.4664 ADDRESS: Emcor.Certrequesl@marsh.com/Fax: 203-229-6787 INSURER(S)AFFORDING COVERAGE - NAIC A 176537-EFSVi-W/WC-18-19 INSURER A:Continental Casualty Company 20443 INSURED INSURER B:American Casualty Company of Reading,PA 20427 EMCOR FACILITIES SERVICES,INC. - 9655 READING ROAD INSURER C:Transportation Insurance Co 20494 CINCINNATI,OH 45215 INSURER D:N/A N/A INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-010668352-02 REVISION NUMBER: 5 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 EFF POLICY EXP LIMITS LTR INSD,WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) A X COMMERCIAL GENERAL LIABILITY X GL 6072246207 10/01/2018 10/01/2019 EACH OCCURRENCE $ 2,000,000 DAMAGE RENTED _ CLAIMS-MADE X OCCUR PREM SESO(Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ 25,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 6,000,000 POLICY X JE a LOC PRODUCTS-COMP/OP AGG $ 14,000,000 OTHER: A AUTOMOBILE LIABILITY X BUA 6072246269 10/01/2018 10/01/2019 COMBINED SINGLE LIMIT $ 2,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS x HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY —� AUTOS ONLY (Per accident) - Auto Physical Damage $ Included UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WC 6072290921(AOS) 10/01/2018 10/01/2019 X PER oTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N WC 6072336019(CA) 10/01/2018 10/01/2019 E.L.EACH ACCIDENT $ 1,000,000 C OFFICER/MEMBEREXCLUDED? N N/A WC 6072378738(AZ,OR,WI) 10/01/2018 10/01/2019 (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 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) RE:ANY AND ALL JOB SITES ADDITIONAL INSURED FOR ALL LIABILITY ARISING OUT OF PROJECT WORK UNDER ALL POLICIES(EXCEPT WORKERS COMPENSATION&EMPLOYERS LIABILITY)WHERE REQUIRED BY CONTRACT:CITY OF OSHKOSH,AND ITS OFFICERS,COUNCIL MEMBERS,AGENTS,EMPLOYEES AND AUTHORIZED VOLUNTEERS. 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 AVE ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 1130 OSHKOSH,WI 54903-1130 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee -24.-aAA-00 - ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 176537 LOC#: Norwalk A CORCP ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED "'MARSH USA INC EMCOR FACILITIES SERVICES,INC. 9655 READING ROAD POLICY NUMBER CINCINNATI,OH 45215 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Auto Physical Damage Comp I Coll Deductible$500 In the event of cancellation or material change that reduces or restricts the insurance afforded by this Coverage Part(other than the reduction of aggregate limits through payment of claims as applicable),Insurer agrees to mail prior written notice of cancellation or material change to:Certificate Holder Schedule 1.Number of days advance notice.For any statutorily permitted reason other than non-payment of premium,the number of days required for notice of cancellation as provided in paragraph 2 of either the Cancellation Common Policy Conditions or as amended by the applicable state cancellation endorsement is increased to the lesser of 60 days or the number of days required in a written contract. For non-payment of premium,The greater of(1)the number of days required by state law or(2)the number of days required by written contract. 2.Name Notice will be mailed to•Certificate holder ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GL 6072246207 CG 2010 10/93 Carrier: Continental Casualty Co Effective date: 10/01/2018 - 10/01/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED , OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: ALL PERSONS OR ORGANIZATIONS FOR WHOM YOU ARE REQUIRED BY CONTRACT TO ADD AS AN ADDITIONAL INSURED BUT ONLY IF THE PERSON OR ORGANIZATION DOES NOT QUALIFY AS AN ADDITIONAL INSURED WITH RESPECT TO WORK PERFORMED BY OR FOR YOU PURSUANT TO THAT CONTRACT ON ANOTHER ADDITIONAL INSURED ENDORSEMENT ATTACHED TO AND FORMING A PART OF THIS POLICY. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED(Section II)is amended to include as an insured the person or organization shown In the Schedule,but only with respect to liability arising out of your ongoing operations performed for that insured. CNA Countersigned by Authorized Representative EMCOR GROUP, INC POLICY NUMBER: GL 6072246207 EFFECTIVE DATE: 10-1-2018-10-1-2019 COMMERCIAL GENERAL LIABILITY CG20370704 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): PERSONS OR ORGANIZATIONS FOR WHOM YOU ARE REQUIRED BY CONTRACT TO ADD AS AN ADDITIONAL INSURED FOR COMPLETED OPERATIONS COVERAGE BUT ONLY IF THE PERSON OR ORGANIZATION DOES NOT QUALIFY AS AN ADDITIONAL INSURED FOR COMPLETED OPERATIONS ON ANOTHER ADDITIONAL INSURED ENDORSEMENT ATTACHED TO AND FORMING A PART OF THIS POLICY Location(s)Of Covered Operations AS PER THE WRITTEN CONTRACT OR WRITTEN AGREEMENT, PROVIDED THE LOCATION IS WITHIN THE"COVERAGE TERRITORY"OF THIS COVERAGE PART Section II — Who Is An Insured is amended to the location designated and described in the schedule include as an additional insured the person(s) or of this endorsement performed for that additional organization(s) shown in the Schedule, but only with insured and included in the "products-completed respect to liability for "bodily injury" or "property operations hazard." damage" caused, in whole or in part, by"your work" at CG 20 37 07 04 Copyright, ISO Properties, Inc.,2004 Page 1 of 1