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HomeMy WebLinkAboutSpeedy Clean Inc 6-29-18 r■C� DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 6/26/2017 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 s e Ga lligan h Glli an NAME: g g Hierl Insurance, Inc INCPHONE No. (920)921-5921 lA/C No): (920)921-6239 325 Trowbridge Drive ADDRIe55:agalligan@hierl.com P. O. BOX 949 INSURER(S)AFFORDING COVERAGE NAIC# Fond du Lac WI 54937 INSURER A:Cincinnati Insurance Company 10677 INSURED INSURER B:Society Insurance Speedy Clean, Inc. INsuRERC:Rockhill Insurance Company 1380 Earl Street INSURERD: INSURER E: Menasha WI 54952 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1762601393 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 I LIMITS LTR INSD YN/D, POLICY NUMBER (MM/DO/YYYYI (MM/DD/YYYY] X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE J $ 1,000,000 A CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES 500,000 PREMISES(Ea occurrence) X EPP0081072 6/29/2017 6/29/2018 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS X EPP0081072 6/29/2017 6/29/2018 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accident) Underinsured motorist $ 1,000,000 X UMBRELLA LIAR _ OCCUR EACH OCCURRENCE $ 6,000,000 EXCESS LIAR A CLAIMS-MADE AGGREGATE $ 6,000,000 BED I X RETENTION$ 0 EPP0081072 6/29/2017 6/29/2018 $ WORKERS COMPENSATION X PER OTH- ,AND EMPLOYERS'LIABILITY STATUTE ER Y f N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A B E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? Y (Mandatory in NH) WC408703 6/29/2017 6/29/2018 E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ 500,000 C Contractors Pollution Liab ENVP014003-02 6/29/2017 , 6/29/2018 Aggregate Limit $2,000,000 Each CPL Condition Limit $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: 2016 Sanitary and Storm Sewer Main and Lateral Televising. City of Oshkosh, and its officers, council members, agents, employees and authorized volunteers are listed as an additional insured and primary and non contributory with respects to the above named insureds general liability and automobile coverage. applies but only as their interest applies. A 30 day cancellation notice applies. 1 RECaE L 1`... r CERTIFICATE HOLDER CANCELLATION .IIJI 1 4 2017 ttaylor@ci.oshkosh.wi.us SHOULD ANY OF THE ABOVE DES PN ( P BEFORE City of Oshkosh THE EXPIRATION DATE THERE ' ¢v�T(CE WfhL • 1�:RED IN Attn: City Clerk ACCORDANCE WITH THE POLICY PROVISIONS. 215 Church Avenue — P.O. Box 1130 AUTHORIZED REPRESENTATIVE Oshkosh, WI 54902-1130 —� S Smeaton, CIC, CRM/A ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)