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HomeMy WebLinkAboutMidwest Engineering Services Inc 10-1-18 ATE ACc RIJ CERTIFICATE OF LIABILITY INSURANCE D09/20/201/7DiYYYY) 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 Marsh USA Inc. NAME: PHONE FAX 500 Dallas Street,Suite 1500 IA/C.No.Exf: IA/C,No):- — Houston.TX 77002 EMAIL Attn:Houston.Certs@Marsh.com ADDRESS: _, INSURER(S)AFFORDING COVERAGE _ NAIC# 905863-PSI-PrPo-17-18 INSURER A:Zurich American Insurance Company 16535 INSURED INSURER B:Greenwich Insurance Company 22322 'MIDWEST ENGINEERING SERVICES,INC. ATTN:MARK WEILAND INSURER C:American Guarantee&Liability Ins Co 26247 1901 S.MEYERS ROAD;SUITE 400 INSURER D:XL Specialty Insurance Company 37885 OAKBROOK TERRACE,IL 60181 42307 INSURER E:Navigators Insurance Company INSURER F: COVERAGES CERTIFICATE NUMBER: HOU-003127487-07 REVISION NUMBER: 3 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 SUER POLICY EFF POLICY EXP W LIMITS LTR INSD VD POLICY NUMBER (MM/DD/YYYY] (MM/DD/YYYY] A X COMMERCIAL GENERAL LIABIUTY GL0541569304 10/01/2017 10/01/2018 EACH OCCURRENCE $ 5,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 5,000,000 GENT AGGREGATE LINT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 X POLICY PRO JECT LOC PRODUCTS-COMP/OP AGG $ 5,000,000 OTHER $ B AUTOMOBILELIABIUTY RAD943781301 10/01/2017 10/01/2018 COMBINED SINGLE LIMIT $ 1,000,000 Ea ccident) X ANY AUTO BODILY INJURY(Per person) $ X OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS x HIRED x NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ C X UMBRELLA LIAB X OCCUR AUC541569404 10/01/2017 10/01/2018 EACH OCCURRENCE $ 6,000,000 EXCESS LIAB CLAIMS-MADE Excess of General Liability AGGREGATE $ 6.000,000 DED RETENTION$ Auto and Employers Liability $ D WORKERS COMPENSATION RWD300119301(AOS) 10/01/2017 10/01/2018 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER D ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N RWR300119401(WI) 10101/2017 10l01l2018 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? N N/A (Mandatory in NH) Et.DISEASE-EA EMPLOYEE $ 1,000,000 If yes describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ E Excess Liability CH17EXR8547521V 10/01/2017 10/01/2018 Each Occurrence 4,000,000 Excess of Auto and Employers Dab. General Aggregate 4,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space is required) RE Soil borings:2014 City of Oshkosh Capitol Improvement Projects City of Oshkosh,and its officers,council members,agents,employees and authorized volunteers are additional insureds for general liability and automobile liability per Ila policy includes the general liability,automobile liability and employers liability in the schedule of underlying insurance. RECEIVED SEP262017 i CIAY CLED 'S CFFic_F, CERTIFICATE HOLDER CANCELLATION City of Oshkosh SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn:City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 Church Avenue ACCORDANCE WITH THE POLICY PROVISIONS. P.O.Box 1130 Oshkosh,WI 54903 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. John Shahidi . I ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD