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HomeMy WebLinkAboutTurnkey Network Solutions 1-1-18 I UhiNK-4 UP ID:Cbt CORD DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/23/2016 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 PAUL S BUITEN BUITEN & ASSOCIATES, LLC 5738 FOREMOST DRIVE,SE IA/C.ONo.E,n:616-949-0490 FAX C No): 616-949 0433 GRAND RAPIDS, MI 49546 E-MAIL PAUL S BUITEN ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:TRAVELERS INS CO 25615 INSURED FIBER OPTIC MANAGEMENT LLC INSURER e:ACCIDENT FUND INS CO OF AMER 10166 DBA TURNKEY NETWORK SOLUTIONS INSURER C:ALTERRA AMERICA INSURANCE CO 7020 SOUTHBELT DR SE CALEDONIA, MI 49316 INSURER D:HANOVER INSURANCE COMPANY 22292 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 W POLICY NUMBER M/ ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD VD (MDDIYYYYI (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DT-0005G866698 01/01/2017 01/01/2018 DAMAGE TO RENTED 200,000 PREMISES(Ea occurrence) $ X XCU COVERAGE MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: EMP BEN. $ 1,000,000 AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO DT8105G866698 01/01/2017 01/01/2018 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accident) X HIRED AUTO PHY DAMAGE $ 75,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE DT CUP 5G866698 01/01/2017 01/01/2018 AGGREGATE $ 5,000,000 DED X RETENTION$ 10000 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WCV6087646 12/31/2016 12/31/2017 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) INCL: GAIN IL MI MO WI E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A RAILROAD CGD316 DT CO 5G866698 01/01/2017 01/01/2018 AGG/OCCUR 1000/2000 A RAILROAD PROTECTIV DT-SPS-4G458380 02/03/2016 02/03/2017 AGG/OCCUR 1000/2000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ADDITIONAL INSURED ON ALL LIABILITY POLICIES ARISING OUT OF PROJECT WORK SHALL BE THE CITY OF OSHKOSH AND ITS OFFICERS, COUNCIL MEMBERS,AGENTS, EMPLOYEES AND AUTHORIZED VOLUNTEERS. 30 DAY NOTICE OF CANCELLATION PER THE CONDITIONS AND PROVISIONS. 10 DAYS FOR NON-PAYMENT OF PREMIUM. CERTIFICATE HOLDER CANCELLATION OSHKOSH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF OSHKOSH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: CITY CLERK 215 CHURCH AVENUE AUTHORIZED REPRESENTATIVE PO BOX 1130 PAUL S BUITEN OSHKOSH,WI 54903 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD