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HomeMy WebLinkAboutMichels Civil 2-1-18 ® CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 03/10/20 7 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. (Arc NO ExT) 877-945-7378 (vr.No). 888-467-2378 P. O. Box 305191 E-MAILDD ADDRESS certificates@willis.com Nashville, TN 37230-5191 INSURER(S)AFFORDING COVERAGE NAIC# _ INSURER A: Greenwich Insurance Company 22322-001 INSURED INSURER B:National Fire and Marine Insurance Compan 20079-001 Michels Civil, A Division of Michels Corporation 817 W Main Street INSURERC:XL Specialty Insurance Company 37885-901 Brownsville, WI 53006 INSURERD:XL Specialty Insurance Company 37885-001 INSURERE: Zurich American Insurance Company 16535-501 I INSURER F: COVERAGES CERTIFICATE NUMBER:25281171 REVISION NUMBER:see Remarks 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 NUMBER POLICY EFF POLICY EXP LIMITS 1 TR Ns!) UIHn (MMInfrfYYY) (MM/f1f71YYYY) A X COMMERCIAL GENERAL LIABILITY Y CGD7409553 2/1/2017 2/1/2018 EACHOCCURRENCE $ 1,000,000 gg ELATED CLAIMS-MADE X OCCUR K a occurence) E 300,000 MED EXP(Any one person) $ PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y CAD7409554 2/1/2017 2/1/2018 Ea OMacciBINdenEDt)SINGLELIMIT $ 2,000,000 ( X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ B UMBRELLA LIAB X OCCUR Y 42XSF10013904 2/1/2017 2/1/2018 EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION$ $ C WORKERS COMPENSATION CWD7409551 2/1/2017 2/1/2018 X PER OTH- AND EMPLOYERS'LIABILITY STATl17E ER D ANY PROPRIETOR/PARTNER/EXECUTIVE NN N/A CWR7409552 2/1/2017 2/1/2018 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 E CPP354784016 2/1/2017 2/1/2018 Installation Floater Per Occurrence 2,000,000 Temporary Storage Per Occurrence 2,000,000 Transit Per Occurrence 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 3/7/2017 WITH ID: 25273394 Project Name/#/Description: Public Works Contract No. 17-07, South Park Basin Retrofit. Project Address/Location: South Park Basin Retrofit. Coverage for Contractual Liability is provided under General Liability policy. CERTIFICATE HOLDER CANCELLATION II SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MAR 13 2017 NCEION WITHDATE THEREOF,THE POLICY PROVISIONS. WILL BE DELIVERED IN ACCORDA City of Oshkosh i i - CITY CL-'. Attn: City Clerk '<- . _-1r_ICE AUTHORIZED REPRESENTATIVE 215 Church Avenue ___�_� I PO Box 1130 Oshkosh, WI 54903-1130 5Ctf -g^ , e' " - Coll:5045290 Tp1:2130405 Cert:25281171 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD