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HomeMy WebLinkAboutNorthwest Cable Construction Inc. 1-1-18 DATE(MM/DD/YYYY) AFRO® CERTIFICATE OF LIABILITY INSURANCE 3/21/2017 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 Carol Gau NAME: Marsh& McLennan Agency LLC PHONE 262-796-8829 FAX 262-785-9753 2725 South Moorland Road (A/C.No,Est). (A/C.Nor. New Berlin WI 53151 ADpRIEg$;carol.gau@marshmma.com INSURER(S)AFFORDING COVERAGE NAIC I INSURER A:West Bend Mutual Insurance Co 15350 INSURED NORTHCABLE3 INSURER B: Northwest Cable Construction Inc. INSURER C: 1017 North Main Street - Mayville WI 53050 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1915917695 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 W M/ LIMITS LTR INSD VD POLICY NUMBER (MDD/YYYY) (MM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY 2302924 1/1/2017 1/1/2018 EACH OCCURRENCE $1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) 5200,000 MED EXP(Any one person) 510,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X FE o- X LOC PRODUCTS-COMP/OP AGG 52,000,000 OTHER: $ A AUTOMOBILE LIABILITY 2302924 1/1/2017 1/1/2018 (Ea accl ED)INGLE LIMB $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED - NON-OWNED PROPERTY DAMAGE AUTOS ONLY X AUTOS ONLY (Per accident) $ A X UMBRELLALIAB X OCCUR 2302924 1/1/2017 1/1/2018 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$0 $ A WORKERS COMPENSATION 2048956 1/1/2017 1/1/2018 X PER ERH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT 51,000,000 OFFICER/MEMBER EXCLUDED? N N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 H yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A Rented/Leased CE 2302925 1/1/2017 1/1/2018 $200,000 Installation Floater $300,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) If required by written contract,the following are included additional insured for general liability with regard to work performed by the named insured and for automobile liability with regard to_the named insured's owned autos: City of Oshkosh, its officers,council members,agents, employees and authorized volunteers. RECL APR 0 7 2017 1 CERTIFICATE HOLDER CI I Y t L�1` CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Oshkosh THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 Church Street ACCORDANCE WITH THE POLICY PROVISIONS. Oshkosh WI 54901-0000 AUT RIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD