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HomeMy WebLinkAboutAlliance Construction & Design 9-10-18 AC�® DATE(MM/DD/YYYY) C CERTIFICATE OF LIABILITY INSURANCE 5/10/2018 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 CONTACT NAME: Mary McLennan Spectrum Insurance Group GB PHONE FAX 303 Packerland Dr., Ste C (A/C.No.Ext1:920-884-2850 (A/C,No):920-884-2851 Green Bay WI 54303 ADDRESS: mary.mdennan@spectruminsgroup.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Sentry Insurance _ INSURED ALLIA-4 Alliance Construction&Design INSURERS: 1050 Broadway Street _INSURER C: Wrightstown WI 54180 INSURER D: _ INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:683987403 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 W ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR VD POLICY NUMBER (MM/DD/YYYY1 (14MIDD/VYYYI A X COMMERCIAL GENERAL LIABILITY A0084994005 9/10/2017 9/102018 EACH OCCURRENCE $1,000,000DAMAGE CLAIMS-MADE X OCCUR PREM SESO(EaENTED occurrence) $500,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY X TCOT- X LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY A0084994001 9/10/2017 9/10/2018 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) Comp/Coll deductible $500 A X UMBRELLA LIAB OCCUR A0084994008 9/102017 9/102018 EACH OCCURRENCE $6,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $6,000,000 DED X RETENTION$0 $ A WORKERS COMPENSATION A0084994007 9/102017 9/10/2018 X STATUTE EORH _ AND EMPLOYERS'LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? 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 Rented/Leased Equip A0084994003 9/10/2017 9/10/2018 Limit $250,000 Deductible $1,000 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.On the Commercial General Liability Policy,the additional insured coverage must include Products-Completed Operations equivalent to ISO form CG 20 37 for a minimum of 2 years after acceptance of the work.This does not apply to Workers Compensation Policies. 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 ACCORDANCE WITH THE POLICY PROVISIONS. 215 Church Ave PO BOX 1130 AUTHORIZED REPRESENTATIVE Oshkosh WI 54903-1130 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD