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HomeMy WebLinkAboutFischer Ulman Construction Inc 2-20-18 �..—N,N FISCULM-01 KADAMJK AC'oRO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/VYW) 4...------ 2/1/2017 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 C2NTACT Willis Towers Watson Certificate Center NAME: Willis of Wisconsin,Inc. c/o 26 Century Blvd (a"c°°,No,Est):(877)945-7378 I FAX No):(888)467-2378 P.O.Box 305191 ADDRESS:Certificates@Willis.com Nashville,TN 37230-5191 INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:SECURA Insurance,A Mutual Company 22543 INSURED INSURER B: Fischer Ulman Construction Inc INSURER C: 915 S Midpark Dr INSURER D: Appleton,WI 54915 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 ADDL SUBR W POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD VD IMM/DD/YYYYI (MMIDDIYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 20-CP-003122476-7 02/20/2017 02/20/2018 DAMAGE TO RENTED 100,000 X PREMISES(Ea oaurrencal S MED EXP(Any one person) $ 10,000 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 S 2,000,000 OTHER $ COMBINED A AUTOMOBILE LIABILITY Ea accident SINGLE LIMIT $ 1,000,000 X ANY AUTO 20-A-003122477-7 02/20/2017 02/20/2018 BODILY INJURY(Per person) $ AUTEOS ONLY AUTOS SSyWNEDUyLNED BODILY INJURY(Per accident) $ AUTO$ONLY AUOTOS ONLY (Perr aPcEciidentDAMAGE $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 8,000,000 EXCESS LIAB CLAIMS-MADE 20-CU-003122479-7 02/20/2017 02/20/2018 AGGREGATE S 8,000,000 DED X RETENTIONS 10,000 S A WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER 20-WC-003122478-7 02/20/2017 02/20/2018 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N N/A 100,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 1 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Commercial General Liability includes Additional Insured Wrap Endorsement ILE1037 11 05. This endorsement includes Additional Insured When Required by Written contract including Completed Operations when Required in the Written Contract;Primary and Noncontributory when required in a written contract or written agreement;Waiver of Transfer of Rights of Recovery Against Others to Us included(when required in a written contract or agreement)and Amendment-Aggregate Limit of Insurance(Per Project). Re:Sidewalk Layers/Curb Cut Contractors License The City of Oshkosh,it's employees and officers are Additional Insured's under the Commercial General Liability. CERTIFICATE HOLDER CANCELLATION e IYED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ` ACCORDANCE WITH THE POLICY PROVISIONS. MAY2$ 2U17 AUTHORIZED REPRESENTATIVE City of Oshkoshayit- "S 0 'CL 'r 215 Church Avenue �_'� fl:� x rNailgL•- Oshkosh.WI 54903 - I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD