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HomeMy WebLinkAboutE.D. Chase Company Inc 10-1-18 Aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY( 9/11/2017 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 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME:CONTACT Tiffanie Courtney M3 Insurance Solutions, Inc. PHONE 920-455-7102 FAX E� 480 Pilgrim Way, Suite 1230 JA/c.No, : (A/C.No): E-MAIL DRESs;_tiffanie.courtney@m3ins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER a:Acuity Insurance Company 14184 INSURED INSURER B: E.D. Chase Company Inc. INSURERC: 5001 Green Valley Road - - INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 571665408 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 7GDDL SUBR, POLICY EFF POLICY EXPDI LIMITS LTR INSD WVD POLICY NUMBER (MM/DYYYY) (MM/DDIYYYY) A x COMMERCIAL GENERAL LIABILITY Y Y X79632 10/1/2017 10/1/2018 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $250,000 MED EXP(Any one person) $10,000 PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY I X JECT X LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER $ A AUTOMOBILE LIABILITY Y Y X79834 10/1/2017 10/1/2018 COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) A UMBRELLA LAB X OCCUR Y Y X79632 10/1/2017 10/1/2018 EACH OCCURRENCE $5,000,000 X EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I X I RETENTION$0 $ A WORKERS COMPENSATION X79632 10/1/2017 10/1/2018 X PER OTH- •AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED") N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 H yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Oshkosh and its officers, council members, agents, employees and authorized volunteers are additional insureds with respects to General Liability, Automobile Liability, and Umbrella Liability where required by written contract. RECID CERTIFICATE HOLDER CANCELLATION SEP i S ZQ17 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cty: CityClerk CITY CLERK'S'OF I t THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cityof Oshkosh L---- ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1130 Oshkosh WI 54903-1130 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD