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HomeMy WebLinkAboutH&H Utility Excavating 5-1-18 A CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY( 4/27/2017 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 Debbie Hinkes _ Marsh& McLennan Agency LLC PHONE F:ry.262-796-8826 FAX 2725 262 785-9753 2725 South Moorland Road E-MAIL New Berlin WI 53151 AnnRFCS•debbie.hinkes@marshmma.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:West Bend Mutual Insurance Co 15350 INSURED HHUTIEXCAV INSURER B: H & H Utility Excavating, Inc. INSURERC: W4038 Hoffmann Road Plymouth WI 53073 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:359202560 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. IR TYPE OF INSURANCE ,• • POLICY NUMBER • POLICY LTR .• LIMITS LT DAMAGE TO- • CLAIMS-MADE OCCUR PREMISESoccurrence) •+ ••0 • •00• OTHERGEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- • _ COMBINED SINGLE LIMIT $ CLAIMS-MADE (Ea accident) 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ I—ALL OVVNED — SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS „ NON-OVVNED PROPERTY DAMAGE X HIRED AUTOS A AUTOS (Per accident) OCCUR EACH OCCURRENCE $6,000,000 EXCESS LIAB 000••0 A WORKERS COMPENSATION 0896939 TH- PER •ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A ACCIDENTE.L.EACH „ 100 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.•ISEASE-EA EMPLOYEE $600,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.• • •+ A Leased/Rented Equip. 0.05825 5/1/2017 5/1/2018 $300,000 +••ded DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) City of Oshkosh and its officers, council members, agents,employees and authorized volunteers are named as additional insured for general liability, including ongoing and completed operations, on a primary&non contributory basis, an/ -Tamed-insureds autos, for work performed by the named insured. RE Fl + 2018 EiticS(WPM!. CERTIFICATE HOLDER CANCELLATION 4 - ....�...! SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Oshkosh THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 Church Ave;PO Box 1130 ACCORDANCE WITH THE POLICY PROVISIONS. Oshkosh WI 54903-1130 AUT RIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD