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HomeMy WebLinkAboutNorthcentral Construction Corp 1-1-18 NORCO-1 OP ID:A7 ,d►corzor CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/13/2017 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 McGlone-Fond du Lac PHONE Ann Linzmeyer FAX 885 Western Avenue Suite 100 (A/C,No.Ext):920-929-8243 (A/C,No): 920-921-6142 Fond du Lac,WI 54935-3874 ADDRESS:ann.linzmeyer@mcclone.com Patrick McClone INSURER(S)AFFORDING COVERAGE NAIC I _ INSURER A:Cincinnati Insurance Company 10677 INSURED NORTHCENTRAL CONSTRUCTION CORP INSURER B: 631 S Hickory St INSURER C: Fond du Lac,WI 54935-5502 INSURER D: 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. INSRL TYPE OF INSURANCE IN SD Syy D POLICY NUMBER BR POUCY EFF POLICY EXP UNITS (MM/DD/YVYY) (M MIDDM'YY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X EPP 0169944 01/01/2017 01/01/2018 DAMAGE TO RENTED , 500 000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY X JERCT LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: S AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO X EBA 0169944 01/01/2017 01/01/2018 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X PROPERTY DAMAGE $ NON-OWNED (Per accident) AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 7,000,000 A EXCESS LIAB CLAIMS-MADE EPP 0169944 01/01/2017 01/01/2018 AGGREGATE S 7,000,000 DED X RETENTIONS 10000 $ • WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N A ANY PROPRIETOR/PARTNER/EXECUTIVE WC 0414001 01/01/2017 01/01/2018 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 • DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) D The City of Oshkosh,and its officers,council members,agency,employees, CEalvE and authorized volunteers shall be Additional Insureds. Thirty days notice of cancellation(except in the event of non-payment of premium and then ten 3 2011 days notice)applies. SEP 1 y OFFICE CITY CI'E CERTIFICATE HOLDER CANCELLATION OSHKOSI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN CITY OF OSHKOSH ACCORDANCE WITH THE POUCY PROVISIONS. 215 CHURCH AVENUE P.O. BOX 1130 AUTHORIZED REPRESENTATIVE OSHKOSH,WI 54902-1130 Patrick McClone ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD