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HomeMy WebLinkAboutStorm Companies Inc 2-1-18 ----Rill AFRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/19/2017 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 Andrew T.Ballard NAME: Andrew T Ballard (AG N.exq: 920-233-4902 ice,No): 920-233-8944 1091 South Washburn Street ADDRESS: aballard@ruralins.com Oshkosh,WI 54904 _ INSURER(S)AFFORDING COVERAGE NAIC a INSURER A: Rural Mutual Insurance Company INSURED INSURER B: Storm Companies Inc. INSURERC: 4553 CTY Rd.E INSURERD: P.O. Box 3385 INSURER E: _ Oshkosh,WI 54903 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 POLICYPOLICY TYPE OF INSURANCE ADDL SUBR EFF EXP LTR INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000.000 CLAIMS-MADE I X OCCUR PREMISESO(Earrence) $ 50,000 MED EXP(Any one person) $ 5,000 A CPPG021136 02/01/2017 02/01/2018 PERSONAL BADVINJURY $ 1,000,000 i GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY L 1 E a I_- I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED •,/ SCHEDULED BAPG019861 02/01/2017 02/01/2018 BODILY INJURY(Per accident) $ AUTOS ONLY /• AUTOS _ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) X Hired Autos X Non-owned $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 A EXCESS LIAB CLAIMS-MADE CPPG021136 02/01/2017 02/01/2018 AGGREGATE $ 4,000,000 DED I RETENTIONS $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY A YIN ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBEREXCLUDED? Y N/A WRKG093344 02/01/2017 02/01/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 It yes,descnbe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101,Additional Remarks Schedule,may be attached if more space is required) I JAN O 2 2018 CERTIFICATE HOLDER CANCELLATION CITY MOWS 04111CIE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Oshkosh ACCORDANCE WITH THE POLICY PROVISIONS. 215 Church Ave PO Box 1130 Oshkosh WI 54903 AUTHORIZED REPRESENTATIVE Andrew T Ballard ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD