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HomeMy WebLinkAboutJones Sign Company Inc 8-1-18 Page 1 of 2 A`ORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDlYYYY) DE/28/2017 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 CONTACT NAME: Willis of Minnesota, Inc. PHONE FAX c/o 26 Century Blvd (A/C.No.Extl 1-877-945-7378 (NC No): 1-888-467-2378 E-MAILcertificatesewillis.com P.O. Box 305191 ADDRESS: Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAICS INSURER A: Liberty Insurance Corporation 42404 INSURED INSURER B: Liberty Mutual Fire Insurance Company 23035 Jones Sign Company, Inc. Attn: Bonnie Vann INSURERC: 1711 Scheuring Road INSURER D• _ De Pere, WI 54115 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:W3110084 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 POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE 1 X OCCUR PREMISES(Ea occurrence) S 1,000,000 A MED EXP(Any one person) $ 10,000 Y N TB7-Z91-467682-047 08/01/2017 08/01/2018 PERSONAL dADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JE LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER. _ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) S B OWNED SCHEDULED Y N AS2-Z91-467682-037 08/01/2017 08/01/2018 BODILYINJURY(Peraccident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION$ $ WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE ER Y!N 1,000,000 N/A B ANYPROPRIETOR/PARTNER/EXECUTIVE N E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? WC2-Z91-467682-027 08/01/2017 08/01/2018 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 B Workers Compensation (CA) N N WC2-291-467682-067 08/01/2017 08/01/2018 Each accident: $1,000,000 & Employers Liability Disease-policy limit: $1,000,000 Per Statute Disease-ea. employee: $1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Oshkosh, and its officers, council members, agents, employees or authorized volunteers are included as Additional Insureds as respects to General Liability and Auto Liability. SEE ATTACHED CERTIFICATE HOLDER �Fi.C�`� CANCELLATION p I �Pt t o% NIB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE i`► THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ,{r F ACCORDANCE WITH THE POLICY PROVISIONS. City of Oshkosh 4'q Attn: City Clerk . 215 Church Avenue AUTHORIZED REPRESENTATIVE Po Box 1130 A ,l Oshkosh, WI 549031130 1- r/r,ei` ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 14887117 BATCH: 398064