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Home My WebLink AboutO'Brien & Gere Limited 6-1-19 CERTIFICATE OF LIABILITY INSURANCE DAT119YYY) ACOl2a 04/1 aa11 1202o1s THiS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS J 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 p REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. co IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION 1S WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this za certificate does not confer rights to the certificate holder in Ilea of such endorsement{s). m PRODUCER CONTACT 4 NAME: Aon Risk Services Central, Inc. i(.LCEj PHONE (g66) 283-7122 FAX (800) 363-0105 `a) Philadelphia PA office V�L; (NC,No.Ext): (NC.NO.): V one Liberty Place -MAILADDRESS: 0 1650 Market street - I Suite 1000 APR 2 6 2019 Philadelphia PA 19103 USA INSURER(SI AFFORDING COVERAGE NA1C# INSURED DEPT OF j J INSURER A: Greenwich insurance company 22322 p'erien & Gere Limited 'L LfC �' INSURERB: XL specialty Insurance Co 37885 333 W Washington Street OSHKOSj-j ii,'j ..ji, PO Box 4873 SCONS1� INSURERC: Indian Harbor Insurance Company 36940 -- Syracuse NY 13221-4873 USA INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570075915385 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- Limits shown areas requested INSR ADDL SUER; POLICY EFF POLICY EXP LIMITS _LTR TYPE OF INSURANCE INSD WWI POLICY NUMBER µM10D MM/D '"'I A X COMMERCIAL GENERAL LIABILITY CG0740917705 `—'�51[7 �b701j 9 EACH OCCURRENCE $1,000,000 DAMAGE 10 CLAIMS-MADE X OCCUR PREMISES(Ea REoc�uD renoe) $300,000 MED EXP(Any one person) S10,000 PERSONAL&ADV INJURY S1,000,000 2 mi GEWL AGGREGATE LIMI-APPLIES PER: GENERALAGGREGATE T 53,000,000 'n POLICY X PRO- 1 1rOC PRODUCTS-COMP/OPAGG $3,000,000 ti J=_CT 0 j OTHER: N. B AUTOMOBILE LIABILITY CAH740917805 01/01/2018'.06/01/2019 COMBINED SINGLE LIMii S1,000,000 v) (Ea accident) %.ANYAUTO BODILY INJURY(Per person) ZO OWNED SCHEDULED BODILY INJURY(Per occident) ai AUTOS AUTOS ONLY NON-OWNED PROPERTY DAMAGE u hIREDAUTDS (Per accident) — ONLY 'AUTOS ONLY i Comprehensive Deduct 't—+ Si,000 d B X UMBRELLA LIAB , X OCCUR TUS00064561L118A ,01/01/2015 O6/01/2019 �OH OCCURRENCE S5,000,000 V EXCESS LIAR CLAIMS-MADE AGGREGATE $5,000,000 • pen X'RETENTION 510,000 B WORKERS COMPENSATION AND cWD740917606 01/01/2019 06/01/2019 x PER STATUTE OTTH- EMPLOYERS'LIABILITY YIN 18-19 Work Comp - ADS ANY PROPRIETOR)PARTNER/''EXHCUTNE E-L.EACH ACCIDENT S1,000,000 B OFF10ERIMEMBER EXCLUDED? NIA Cw0740965001 D1/01/2019 06/01/2019 (Mandatory In NH) 18-19 work comp - WI E.L.DISEASE-EA EMPLOYEE S1,000,000 If yyes,describe under E L.DISEASE-POLICY LIMIT Si,000,000 DESCRIPTIOS DF OPERATIONS below III 1 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) ^Z-2. city of Oshkosh, and its officers, council members, agents, employees and authorized volunteers are included as Additional insured in accordance with the policy provisions of the General Liability and Auto Liability policies. General Liability and Auto Liability policies evidenced herein are Primary and Non-Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. See attached for Additional Named insureds. i4 ti■ •CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE a- EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISONB. City of Oshkosh AUTHORIZED REPRESENTATIVE Attn: City Clerk 215 church Avenue `�� LAG e! eh- PO Box 1130 Oshkosh WI 54903-1130 USA fd '� OZ�1 _ )1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD