Loading...
HomeMy WebLinkAboutRaiserite Concrete Lifting Inc 1-1-18 ��....4 RAISCON-01 BBRUSS AC 0RIf) CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYV) kii..------- 05/31/2017 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 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 Jeffrey Cardenas NAME: Vizance,Inc. 1320 Walnut Ridge Dr.Ste.200 (A/C,,No,Ext):(262)367-8611 302 (A C,No) Hartland,WI 53029 E-MAIL ADDRESS:I 4cardenasn vizance.com _. INSURER(S)AFFORDING COVERAGE _NAIC S INSURER A:Acuity 14184 INSURED INSURER B:Wilson Mutual 19950 Raiserite Concrete Lifting Inc RaiseRite Foundation Pier INSURER C: Systems,Inc. 1025 E.Albert Drive INSURER D: Manitowoc,WI 54220 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRINSD WVD (MM/DD/YYYY1 IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE X OCCUR X86313 01/01/2017 01/01/2018 DAMAGES) RENTED 100,000 X PREMISES(Ea occurrenpel � 5,000 MED EXP(Any one person) S 1 PERSONAL 8 ADV INJURY S 1,000,000 GEN'L AGGREGATE UMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY X JERCT LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER Emp Ben. i 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) S X ANY AUTO X X86313 01/01/2017 01/01/2018 BODILY INJURY(Per person) SO _ AUTOS ONLY ONLY SCHEDULEDUOWN BODILY INJURY(Per accident) S ., AUTOS ONLY _ AUTOS ONES' (P r acEcidTY ntDAMAGE S i A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 5,000,000 EXCESS LIAB CLAIMS-MADE X86313 01/01/2017 01/01/2018 AGGREGATE i 5,000,000 • DED X RETENTIONS 0 s B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY _ STATUTE ER Y/N 3200605040 01/01/2017 01/01/2018 500,000 ANY OFFICER/MEMBER/EXCLUDED?ECUTIVE Y N/A E.L.EACH ACCIDENT S (Mandatory in H) E.L.DISEASE-EA EMPLOYEE S 500'000 If yes,describe under 500,000 (DESCRIPTION OF OPERATIONS below _ E L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) The City of Oshkosh,its officers,council members,agents,employees and authorized volunteers shall be named additional insureds with regard to the General Liability and Auto Liability,as required by written contract.General Liability is on a primary and non-contributory basis,including iiangl1r�t`n completed operations coverage. A 30-day Notice of Cancellation applies. �l-�— MAY (-ITN'CLERICS 01F1FICE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Oshkosh THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 215 Church Ave P.O.Box 1130 Oshkosh,WI 54903-1130 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) < ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD