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Home My WebLink AboutDan Welhouse and Sons Inc 3-2-18 DANWELH-01 GOJE ACORO MM/D(DATE D/YYYY) CERTIFICATE OF LIABILITY INSURANCE MM/D17 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 (920)766-5511 Valley Insurance Associates Inc. PHONE FAX (A/C, 200 E 2nd Street,Ste 1A E-MAILNo,Ext): (A/C,No): E-M Kaukauna,WI 54130 ADDRESS: INSURERS)AFFORDING COVERAGE NAIC N _ INSURER A:Liberty Mutual INSURED Dan Welhouse and Sons Inc. INSURER B: N177 Speedway Lane INSURER C: Kaukauna,WI 54130 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 INS SUBR W D POUCY NUMBER POLICY EFYT POUCY EXTY LIMITS (MM/DD/YYYYI (MMlDD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE X OCCUR Y N BKS55371534 3/2/2017 3/2/2018 PREMISES(Ea occurrence) $ 300,000 MED EXP(Any one person) $ 15,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO Y N BAS55371534 3/2/2017 3/2/2018 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS - NON-OWNED PROPERTY DAMAGE S HIRED AUTOS _ AUTOS (Per accident) S UMBRELLA LIAB OCCUR EACH OCCURRENCE S 2,000,000 A EXCESS LIAB CLAIMS-MADE N N US055371534 3/2/2017 3/2/2018 AGGREGATE S 2,000,000 DED RETENTION 5 S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y A ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A N WC8900000 3/2/2017 3/2/2018 E.L.EACH ACCIDENT S 500,000 OFFICER/MEMBER EXCLUDED? --- - - - (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 RICCrrCrlirD DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attachedr� space Is required) JAN022018 : J CITY CLE►ci:''UFFICE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Oshkosh and its officers, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN council members,agents,employees and authorized volunteers ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1130 Oshkosh,WI 54902- AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD