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HomeMy WebLinkAboutDowling Construction Inc 1-23-18 AC�� DATE(MMIDD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 01/25/2017 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). PRODUCER CONTACT Andrew T.Ballard NAME: Andrew T Ballard PHONE .Exn: 920-233-4902 FAX Na): 920-233-4902 tAtc1091 South Washburn Street ADDRESS: aballard@ruralins.com Oshkosh,WI 54904 INSURER(S)AFFORDING COVERAGE NAIC• INSURER A: Rural Mutual Insurance Company INSURED INSURER B: Dowling Construction Inc. INSURER C: 3596 Stearns Dr. INSURER D: Oshkosh WI 54904 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. !N SW. INSD LTR INSD R TYPE OF INSURANCE WVD ADDL SUER POLICY NUMBER (MMIDD/YYYY) (MM DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO R CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $ MED EXP(Any one person) $ 5,000 A BOP9116906 01/23/2017 1/23/2018 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PR LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: i $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED X SCHEDULED BAP2239993 01/23/2017 1/23/2018 BODILY INJURY(Per accident) $ AUTOS X HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ X AUTOS (Per accident) $ I X UMBRELLA LIAB - OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE BOP9116906 01/23/2017 1/23/2018 AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION ,AND EMPLOYERS'LIABILITY X STATUTE ER PER Ii ANY PROPRIETORIPARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 100,000 A OFFICER MEMBER EXCLUDED? Y NIA WRKGO80187 01/23/2017 1/23/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,00E If yes,describe under 500,00E DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 . 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD tot,Additional Remarks Schedule,may be attached if more space Is required) 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 J PO Box 113E AUTHORIZED REPRESENTATIVE Andrew T Ballard Oshkosh,WI 54903-1130 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD