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HomeMy WebLinkAboutMeyer Services 5-20-19 CFO DATE(MM/DD/YYYY) AC�REP CERTIFICATE OF LIABILITY INSURANCE 8,27/201$ 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 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 NAME: Ansay&Associates, LLC. FV PHONE Patti VandenBosch FAX 4351 W College Ave (NC.No,ex* 920-560-7000 (A/C.No):920-560-7078 Suite 310 E-MAIL patti.vandenbosch@ansay,com Appleton WI 54914 INSURER(S)AFFORDING COVERAGE NAIC aK INSURERA:Secura Insurance A Mutual Company 22543 INSURED MEYESER-01 INSURER B: Meyer Services, Inc. INSURER C N1004 Tower View Drive - Greenville WI 54942 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1504461472 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 EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER .(MM/DD/YYYY) (MM/DD/YYYY) A GENERAL LIABILITY CP3238325 5/20/2018 5/20/2019 EACH OCCURRENCE $1,000,000 X DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $500,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1.000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X JECOT- X LOC $ A AUTOMOBILE LIABILITY A3238326 5/20/2018 5/20/2019 COMBINED SINGLE LIMIT (Ea accident) $1.000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE I ^ HIRED AUTOS ,_ AUTOS (Per accident) A X UMBRELLA LIAR X OCCUR CU3238328 5/20/2018 5/20/2019 EACH OCCURRENCE $8,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $8,000,000 DED I X RETENTION$10,000 $ A WORKERS COMPENSATION WC3238327 5/20/2018 5/20/2019 X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 A Equipment Floater CP3238325 5/20/2018 5/20/2019 Leased/Rented 200.000 A Professional Liability CP3269084 5/20/2018 5/20/2019 Errors&Omissions 1,000,000 E&O Deductible 5,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) City of Oshkosh and its employees are provided Additional Insured status on the general liability per form#ILE 1037 on a primary and noncontributory basis in regard to work performed by insured if required in a written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Oshkosh Division of Insurance Services ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1130 215 Church Avenue AUTHORIZED REPRESENTATIVE Oshkosh WI549031130 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD