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HomeMy WebLinkAboutPHD Roof Doctors Inc 5-31-18 A�® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/YYYY) 5/31/2017 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 Linda Famularo NAME: R&R Insurance Services Inc PHONE (262)953-7227 FAX (262)953-7227 IA/C.No.Extl: IAlC,Noj: 1581 E Racine Avenue EMAIL ADDRESS:linda.famularo@rrins.com PO Box 1610 INSURER(S)AFFORDING COVERAGE NAIC a Waukesha WI 53187-1610 INSURER A:Continental Casualty INSURED INsuRERB:Argent- A Division of West Bend PHD Roof Doctors Inc INSURERC: 340 S Milwaukee Ave INSURERD: INSURER E: Fredonia WI 53021 INSURER F: COVERAGES CERTIFICATE NUMBER:17/18 Certs REVISION NUMBER: M 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 INSR VD POLICY NUMBER (MMIDD/YYYYI (MDDr'YYYI X COMMERCIAL GENERAL LIABILITY 2090323806 EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED A CLAIMS-MADE X] OCCUR PREMISESO(Ea occurrence) $ 500,000 Blkt AI PNC/CNA75079XX 5/31/2017 5/31/2018 MED EXP(Any one person) $ 15,000 Per Proj Agg/Blkt WOS PERSONAL 8.ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: CNA74705XX GENERAL AGGREGATE $ 2,000,000 POLICY X JECOT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY 2084964409 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED AUTOS AUTOS Blkt AI PNC/CNA71527XX 5/31/2017 5/31/2018 BODILY INJURY(Per accident) $ X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per - - $ X UMBRELLA LIAB X OCCUR 2090323854 EACH OCCURRENCE $ 7,000,000 A EXCESS LIAB CLAIMS-MADE I Blkt Al PNC/CNA75504XX AGGREGATE $ 7,000,000 DED X RETENTIONS 10,000 i 5/31/2017 5/31/2018 $ WORKERS COMPENSATION X PER 0TH- AND EMPLOYERS'LIABILITY STATUTE ER Y!N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 MFME N/A B (Mandatory EXCLUDED? N ( ry�n NH)) 1852152 5/31/2017 5/31/2018 E.L.DISEASE-EA EMPLOYEES 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Leased/Rented Equipment 2090323806 5/31/2017 5/31/2018 $175,000 $2,500Ded Installation Floater $275,000 $1,000Ded DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Oshkosh, and its officers, council members, agents, employees and authorized volunteers are additional insureds for General Liability including completed operations per form CNA75079XX(1-15) , Auto Liability per form CA2048 (2/99) , and Umbrella per form above all as required by written contract. 30 days notice of cancellation applies in favor of the City Clerk - City of Oshkosh for General Liability, Auto Liability and Umbrella. RECEIvEn CERTIFICATE HOLDER CANCELLATION JUN 0 5 2017 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Oshkosh _ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: City Clerk CITY CLERK',SOF . ACCORDANCE WITH THE POLICY PROVISIONS. 215 Church Avenue PO Box 1130 AUTHORIZED REPRESENTATIVE Oshkosh, WI 54903-1130 __ - Brad Stehno/C220 —_ -- �� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)