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HomeMy WebLinkAboutBadger Laboratories & Engineering 1-1-18 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11/13/2017 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). CONT PRODUCER NAMEACT Shannon Kraut. CISR CIC Ansay 8 Associates, LLC. FV INC.No.Ext):920-560-7000 PHO FAX No):920-560-7079 Suite 31 College Ave E-MAIL ansa com 310 n$ Y• Appleton WI 54914 INSURER(S)AFFORDING COVERAGE NAIC N INSURER A:Cincinnati Insurance Company 10677 INSURED BADGLAB-01 INSURER B:Nautilus Insurance Co 17370 Badger Laboratories& Engineering Inc INSURERC: 501 West Bell Street INSURER D: Neenah WI 54956 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:841445504 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 EPP 0172582 1/1/2017 1/1/2018 EACH OCCURRENCE $1,000,000 X DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $1,000,000 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 —I POLICY X Of LOC $ A AUTOMOBILE LIABILITY EBA 0172582 1/1/2017 1/1/2018 COMBINED SINGLE LIMI r 1 000,000 (Ea accident) $ X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X PROPERTY DAMAGE NON (Per accident)AUTOS-OWNED A X UMBRELLA LIAB X OCCUR EPP 0172582 1/1/2017 1/1/2018 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED X RETENTION$10,000 $ A WORKERS COMPENSATION EWC 0291946 1/1/2017 10/1/2017 WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Prof Pollution CCP200306616 7/1/2017 7/1/2018 Prof Pollution Liab 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Worker's Compensation Policy Cancelled Effective 10/1/2017. City of Oshkosh, and its officers, council members, agents, em ployees and authorized volunteers are listed as additional insured per form CA-233. 30 days notice of cancellation is included with the exception of 10 days for cancel of nonpayment. CERTIFICATE HOLDER r- iECu\'.D CAP CELLATION City of Oshkosh NOV 1 6 2017 TH�ULD ANY OF EXPIRATIIONTHE DATEABOVE THE EOF, NOTIICE POLICIES WILL CANCELLED DELIVERED IN City Clerk ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1130 CITY CLERK'S OFF ICE Oshkosh WI 549031130 AUTHORIZED REPRESENTATIVE USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD