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HomeMy WebLinkAboutCrafts 5-1-18 DATE(M M/DD/YYYYI A CERTIFICATE OF LIABILITY INSURANCE 04/07/2017 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 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 w this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). .c PRODUCER CONTACT 7:14) NAME: Aon Risk Services Central, Inc. PHONE (920) 437-7123 FAX (920) 431-6345 m Green Bay WI office (A/C.No.Ext): (A/C.No.): v 111 N. washi ngton Street, Suite 300 E-MAIL 0 P. 0. Box 23004 ADDRESS: _ Green Bay WI 54305-3004 USA INSURER(S)AFFORDING COVERAGE NAIC B INSURED INSURER& ACUITY, A Mutual Insurance Company 14184 Crafts, Inc- INSURERB: P.O. Box 190 Manitowoc WI 54221 USA INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570066091420 REVISION NUMBER: 1 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 INSR ADDL SUER POLICY EFF POUCY EXP LTR TYPE OF INSURANCE INSD WVD POUCY NUMBER 1MMIDDIYYYY11 JMM/DD/YYYY UNITS A X COMMERCIAL GENERAL LIABIUTY Z67218 105/01/2017 05/01/2018 EACH OCCURRENCE $1,000,000 PACKAGE - COMMERCIAL DAMAGETOREN1ED $300,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) X AGGREGATE PER PROJ. MED EXP(Any one person) $10,000 X CONTRACTUAL LIAB. PERSONAL&ADV INJURY S1,000,000 N GENII AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 m POLICY X JEa I X I LOC PRODUCTS-COMP/OP AGG S3,000,000 o o OTHER: 0 N- LU A AUTOMOBILE LIABILITY z67218 05/01/2017 05/01/2018 COMBINED SINGLE LIMIT $1,000,000 N PACKAGE - COMMERCIAL (Ea accident) X ANY AUTO BODILY INJURY(Per person) 0 OWNED SCHEDULED BODILY INJURY(Per accident) m AUTOS ONLY AUTOS X HIRED AUTOS x NON-OWNED PROPERTY DAMAGE U ONLY AUTOS ONLY (Per accident) E- A X UMBRELLA LIAB X OCCUR Z67218 05/01/2017 05/01/2018 EACH OCCURRENCE $5,000,000 U EXCESS LIAR CLAIMS-MADE PACKAGE - COMMERCIAL AGGREGATE $5,000,000 SIR applies per policy terns & conditions DED X RETENTION A WORKERS COMPENSATION AND z67218 05/01/2017 05/01/2018 X PER OTH- EMPLOYERS'LIABILITY Y/N PACKAGE - COMMERCIAL STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED, I N I N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 II yns descnhe under .--L..- DESCRIPTION OF OPERATIONS below E. DISEASE-POLICY LIMIT $500,000— DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is requiredRECEIVED pi- APR 1 0 2017 T - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE C EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE _7 POLICY PROVISIONS. �4,C CITY OF OSHKOSH AUTHORIZED REPRESENTATIVE 11+... CITY CLERK'S OFFICE P.O. BOx 1130 �y OSHKOSH WI 54902-1130 USA e._.-.C `;��,� ,�n� id Ofy - ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD