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HomeMy WebLinkAboutViking Tree Service LLC 4-29-18 DATE(MM/DD/YYYY) ACRD® CERTIFICATE OF LIABILITY INSURANCE 4/10/2017 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 Jeff Bet NAME: g _ __ Dave Wittmann Insurance PHONE (920)788-1000 FAx (920)798-9390 (A/C.No.Extl: (A/C.Not 300 PATRIOT DRIVE ,mm :jeffb@Wittaanninanrance.com STE A _ INSURER(S)AFFORDING COVERAGE NAIC• LITTLE CHUTE WI 54140 INSURER A:Weat Bend Mutual Ins 15350 INSURED INSURER B: Viking Tree Service, LLC INSURERC: — PO Box 693 INSURERD: _INSURER E: _ Oshkosh WI 54903 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1741001004 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 -ADDL-SUM POLICYEFF POLICYEXP LTR TYPE OF INSURANCE 1NSn NND POLICY NUMBER IMM/DD/YYYY1 IMM/DD/YYYY) UMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AGE TO A CLAIMS-MADE X OCCUR PREM SES(EaENTED ocuerence) $ 100,000 X A151011 4/29/2017 4/29/2019 MED EXP(My one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GEM_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 --- - ---- — OTHER: Adj for Pdct/Completed $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULEDAUTO AUTOS BODILY INJURY(Per accident) $ H REDSAUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Par accident) — i $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER _ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A -- (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CITY OF OSHKOSH, IT'S EMPLOYEES AND OFFICERS ARE NAMED AS ADDITIONAL INSURED. 30 DAY NOTICE OF CANCELLATION. RECEIVED [4:T_E-! 202017 CERTIFICATE HOLDER _.. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF OSHKOSH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY CLERK ACCORDANCE WITH THE POLICY PROVISIONS. 215 CHURCH AVE. PO BOX 1130 AUTHORIZED REPRESENTATIVE OSHKOSH, WI 54903 Jeff Bergum/JBE � �—� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INCn9c nnnnnl l