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HomeMy WebLinkAboutR.J. Albright Inc. 1-1-18 ,lac7.1:)xe,74° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDM'YY) 12/22/2016 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. Zil If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on 47:. this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). c CONTACT d PRODUCER - _ HONNAME: _ _ — .Aon Risk Services Central, Inc. P@ (920) 437-7123 FAX (920) 431-6345 d Green Bay WI Office (A/C.No.Eat): (A1C.No.): 13 111 N. washington Street, Suite 300 E-MAIL o P. O. Box 23004 ADDRESS: _ Green Bay WI 54305-3004 USA INSURER(S)AFFORDING COVERAGE NAIC a INSURED INSURER A: ACUITY, A Mutual Insurance Company 14184 R. J. Albright, Inc. INSURERB: 5711 Green valley Road INSURER C: Oshkosh w7 54904 USA INSURER D: INSURER E: INSURER F. COVERAGES CERTIFICATE NUMBER:570064832952 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. Limits shown are as requested INSR AWL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INS° WVD POLICY NUMBER 11MM/DDI YYYI, IMM(DD/Y YY) LIMITS A X COMMERCIAL GENERAL LIABILITY L74803 71/01/7017 al/0171018 EACH OCCURRENCE 51,000,000 CLAIMS-MADE X OCCUR GENERAL LIABILITY DAMAGE TORENTED 5250,000 PREMISES(Ea occunence) • MED EXP(Any one person) S10,000 PERSONAL d ADV INJURY S1,000,000 ,rN GENII AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S3,000,000 r POLICY I X I I PE I X I LOC PRODUCTS-COMP/OP AGG S3,000,000 i OTHER ll 110 A AUTOMOBILE LIABILITY L74803 01/01/2017 01/01/201R COMBINED SINGLE LIMIT S1.000,000 AUTO LIABILITY IEaaccMenll -- X ANY AUTO BODILY INJURY(Per person) 0 Z OWNED —SCHEDULED BODILY INJURY(Per accident) W AUTOS ONLY AUTOS fa A HIRED AUTOS X NON-OWNED PROPERTY DAMAGE oNIY —AUTOS ONLY (Per accident) w 1= e) A X UMBRELLALIAB X OCCUR L74803 01/01/2017 01/01/2018 EACH OCCURRENCE 55,000,000 f..) UMBREL LA AGGREGATE S5,000,000 EXCESS LIAR CLAIMS-MADE DEDI 'RETENTION A WORKERS COMPENSATION AND L74803 01/01/2017 01/01/2018 X PER OTH- EMPLOYERS'LIABILITY YIN WORKERS COMPENSATION STATUTE ER ANY PROPRIETOR I PARTNER I EXECUTIVE E,L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED', ( I N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S100,000 If yes,descnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S500 0 RECEIV F 1 DESCRIPTION OF OPERATIONS(LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) I 20 li APR07 E K'S U `_- CERTIFICATE HOLDER CANCELLATION g SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE C EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, t••I aa CITY OF OSHKOSH AUTHORIZED REPRESENTATIVE !U PO BOX 1130 OSHKOSH WI 54903-1130 USA r 1M ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD