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HomeMy WebLinkAboutMcKinstry Essention LLC 1-31-18 �.MIN MCKICO.-01 MJOHNSON ,4��Ro CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/27/2017 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 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 I CONTACT NAME: Hub International Northwest LLC PHONE No,Ext):(425)489�500 FAX 12100 NE 195th Street,Suite 200 ( lac,No):(425)485$489 Bothell,WA 98011 E-MAILSS:now.info@hubinternational.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:The Travelers Indemnity Company 25658 INSURED INSURER B:Travelers Property Casualty Company of America 25674 McKinstry Essention,LLC INSURER C:National Union Fire Insurance Company of Pittsburgh,PA 19445 PO Box 24567 INSURER D:The Travelers Indemnity Company of America 25666 Seattle,WA 98124-0567 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. ILTRR TYPE OF INSURANCE ISR NSD ISIN/D POLICY NUMBER POLICY EFF POLICY EXP 1MM/DD IMM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 2,000,000 EACH OCCURRENCE $ CLAIMS-MADE X OCCUR VTC2KCO-5643B901-IND-17 01/31/2017 01/31/2018 DREMISAMAGE ES(TO EREaNTEDoccurrence) S 300,000 P MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GE AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 N1 POLICY X LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER _ $ B COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) $ 1,000,000 X ANY AUTO VTC2JCAP-5643B913-TIL-17 01/31/2017 01/31/2018 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(PeracadenQ $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) $ $ C UMBRELLA UAB X OCCUR EACH OCCURRENCE s 2,000,000 X EXCESS LIAB CLAIMS-MADE BE28189072 01/31/2017 01/31/2018 AGGREGATE y 2,000,000 DED X RETENTION$ 0 $ D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N VTH-UB-5D739674-17 10/01/2017 10/01/2018 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ FFICER/MEMBEER EXCLUDED? N N IA (Mandatory m NH) E.L.DISEASE-EA EMPLOYEES 1,000,000 If yes describe under E.L.DISEASE-POLICY LIMIT $ 1,000+000 I DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I 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 AN* AUTHORIZED VOLUNTEERS ARE ADDED AS ADDITIONAL INSUREDS. RECEIVED ) OCT 2 2017 CITY CLERK'S OFFIC CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF OSHKOSH ATT: CITY CLERK THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 1130 OSHKOSH,WI 54903 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD