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HomeMy WebLinkAboutCorevac LLC 1-1-18 A��EP CERTIFICATE OF LIABILITY INSURANCE DATE YYY) 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 Linda Famularo NAME: R&R Insurance Services Inc IA1C0 No.Eat): (262)953-7227 IaC.No),(262)953-1325 1581 E Racine Avenue E-MAIL linda.famularo@rrins.com ,ADDRESS, _ PO Box 1610 INSURER(S)AFFORDING COVERAGE NAIC r Waukesha WI 53187-1610 INSURER A:The Phoenix Insurance Company 25623 INSURED INSURERB:The Travelers Indemnity Company 25682 Corevac LLC INSURER c:The Travelers Property Casualty 25674 W2385 County Road A South INSURER D: INSURER E: • Oostburg WI 53070 INSURERF: COVERAGES CERTIFICATE NUMBER:17/18 Carts 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 IMMIDD/YYYY).IMM/DDIYYYY) GENERAL LIABILITY 1 EACH OCCURRENCE $, DAMAGE TO RENTED 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 300,000 A CLAIMS-MADE X OCCUR C09D297717 1/1/2017 1/1/2018 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $ 2,000,000 —1 POLICY 7 I PE- LOC $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ 1,000,000 B X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 8109D297717 1/1/2017 1/1/2018 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X PROPERTY DAMAGE $ NON-OWNED (Per accident)AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 7,000,000 C EXCESS LIAB CLAIMS-MADE AGGREGATE $ 7,000,000 DED X RETENTIONS 10,000 CUP9D297717TIL 1/1/2017 1/1/2018 $ B WORKERS COMPENSATION YIN X WC STI LIMIT OTH- AND EMPLOYERS'LIABILITY TORY S ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N NIA 1/1/2017 1/1/2016 (Mandatory In NH) EUB9D29771 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 A Installation Floater Co9D297717 1/1/2017 1/1/2018 $100,000 Limit$1000 Dad Leased/Rented Equipment ��CCam�++,,, S194.000 Per Item Limit DESCRIPTION OF OPERATIONS/LOCAIONS/VEHIOLES._taua rACORD 101,Additional Remarks Schedule,if more space is required) MAR 2 12017 CITY CLERK'S OEFICEI CERTIFICATE HOLDER CANCELLATION ekarl@ci.oshkosh.wi.us 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 Avenue PO Box 1130 AUTHORIZED REPRESENTATIVE Oshkosh, WI 54903 ` `J William Katzfey/C220 ��-- -��/' -- ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r?mnnsr ni This arnaIl nnmm and Inns aro ranichardari mark,,of amp l