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HomeMy WebLinkAboutRadtke Contractors 1-1-19 - DAT E(MM/DD/YYYY) A`aRO CERTIFICATE OF LIABILITY INSURANCE 07/31/2018 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 ,,=45 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). .c PRODUCER CONTACT LI NAME: — Aon Risk Services Central, Inc. PHONE (920) 437-7123 FAX (920) 431-6345 `li Green Bay WI Office (NC.No.Ent): (A/C.No.): _ .0 111 N. Washington Street, Suite 300 E-MAIL p P. 0. Box 23004 ADDRESS: _ Green Bay WI 54305-3004 USA INSURERIS)AFFORDING COVERAGE NAIC# INSURED INSURERA: Navigators Specialty Insurance Company 36056 RADTKE CONTRACTORS INC INSURER B: The Travelers Indemnity Co. 25658 Po Box 6000 WINNECONNE WI 54986 USA INSURER C: The Phoenix Insurance Company 25623 INSURERD: The Travelers Indemnity Co of CT 25682 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570072493500 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 are as requested 1NSR ADM-SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD ‘AND POLICY NUMBER (MMIDDIYYVY1 IMM/DD/YYYY)) LIMITS C X COMMERCIALGENERALLIABILITY DT-CO-5G477527-PHX-18 b1/01/2018 01/01/2014 EACH OCCURRENCE $1,000,000 CLAIMS-MADE n OCCUR GENERAL LIABILITY DAMAGEIORENTED S300,000 PREMISES(Ea occurrence) X AGGREGATE PER PROJ MED EXP(Any one person) S10,000 X CONTRACTUAL LIAB PERSONAL&ADV INJURY $1,000,000 g GEN'L AGGREGATE LIMIT APPLIES PER r� . GENERALAGGREGATE S2,000,000 POLICY I I PECOT- n LOC PRODUCTS-COMP/OP AGG S 2,000,000• AT OTHER o n B AUTOMOBILELIABILITY DT-810-5G477527-IND-18 01/01/2018 01/01/2019 COMBINED SINGLE LIMIT $1,000,000 'n BUSINESS AUTO (Ea accident( X ANY AUTO BODILY INJURY(Per person) 0 OWNED SCHEDULED BODILY INJURY(Per accident) W AUTOS ONLY AUTOS X HIRED AUTOS x NON-OWNED PROPERTY DAMAGE 0 ONLY —AUTOS ONLY (Per accident) w 0 tu B X UMBRELLALIAB X OCCUR DTSM-CUP-SG477S27-IND-18 01/01/2018 01/01/2019 EACH OCCURRENCE E5,000,000 0 UMBRELLA AGGREGATE 55,000,000 EXCESS LIAB CLAIMS-MADE DED RETENTION 0 WORKERS COMPENSATIONAND DTDTSE-UB-SG47752-7-18 01/01/2018 01/01/2019 " PER OTH- EMPLOYERS'LIABILITY YIN WORKER'S COMPENSATION STATUTE ER ANY PROPRIETOR I PARTNER/EXECUTIVE E.L.EACH ACCIDENT E 500,000 OFFICER/MEMBER EXCLUDED' N NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 5500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S500,000- A Env Contr Poll CH16ECP3062081C 01/01/2016 01/01/2019 Occurrence S1,000,000 POLLUTION LIABILITY Deductible S25,000 Aggregate S1,000,000 n DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) it ADDITIONAL INSURED ON THE GENERAL LIABILITY AND AUTO CITY OF OSHKOSH AND ITS OFFICERS, COUNCIL MEMBERS, AGENTS, EMPLOYEES, AND ie AUTHORIZED VOLUNTEERS AS RESPECTS TO THE WORK BEING DONE PER BLANKET ADDITIONAL INSURED ENDORSEMENT, AS REQUIRED BY WRITTEN CONTRACT. ENDORSED POLICIES WILL INCLUDE A 30 DAY NOTICE OF CANCELLATION/NONRENEWAL FOR ANY REASON OTHER THAN NONPAYMENT OF MI PREMIUM, PROVIDED TO THOSE PARTIES INDICATED IN THE WRITTEN CONTRACT. Ei CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE zA EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF OSHKOSH AUTHORIZED REPRESENTATIVE .J ATTN: CITY CLERK PO BOX 1130 Ble OSHKOSH WI 54903 USA r�/J `��cCt zAalid Vaf1.E��t/f?Ct M �/�b I. ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD