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HomeMy WebLinkAboutVanco Construction 4-30-18 I:Jill R Schultz AU PWCAM FaxID:Johnson Insurance Date.4/20/2017 12:44:47 PM Paoe2 of 2 VANCCON-01 JSCHULTZ ACORO' DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 4/20/2017 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 NAME: Jill R.Schultz,AU, PWCAM Johnson Insurance Northeast PHONE 920 445-7401 F 877 254-8586 318 South Washington Street fac,No,Ext): ) (NC,No): Green Bay, E-MAIL WI 54301 ADDRE55:1sc ischultz@johnsonins.com ohnsonins.com INSURER(S)AFFORDING COVERAGE NAIC U INSURER A:West Bend Mutual Ins Co 15350 INSURED INSURER B: Vanco Construction Inc. INSURER C W1988 Twilight Trl INSURER D: Seymour,WI 54165 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER (MM/UDD�YY) (MMl FF POLICY , LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X 0572630 04/30/2017 04/30/2018 DAMAGE TO NTE PREMISES(EaRE occurrenceD 100) $ ,00O MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 POLICY X PECOT- LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY , COMBINED SINGLE LIMIT $ 1,000 000 (Ea accident + A X ANY AUTO 0572630 04/30/2017 04/30/2O18 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAIMS-MADE 0572630 04/30/2017 04130/2018 AGGREGATE s 3,000,000 DED X RETENTION$ O $ WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE OTH- ER N A ANY PROPRIETOR/PARTNER/EXECUTIVE ('- -1 NIA 0048105 04/30/2017 04130/2018 E.L.EACH ACCIDENT 4 100,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Addldonal Remarks Schedule,may be attached If more space Is required) City of Oshkosh,and its officers,council members,agents,employees,and authorized volunteers are included as Additional Insured with respect to General Liability,30 day written notice of cancellation for reason other than nonpayment is applicable. RCCE$V APR . 2017 CITE'Cl CERTIFICATE HOLDER CANCELLATION - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Oshkosh CityClerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, PO Box 1130 Oshkosh,WI 54902-0113 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. 25(2014/01) The ACORD name and logo are registered marks of ACORD ACORD g