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HomeMy WebLinkAboutVinton Construction Company 3-1-18 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/26/2017 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 NAME: Tiffanie Courtney M3 Insurance Solutions, Inc. PHONE FAX 480 Pilgraim Way, Suite 1230 (A/C No.E:t):920-455 7102 ,(A/C,No): E-MAIL Green Bay WI 54304 ADDRESS: tiffanie.courtney@m3ins.com PRODUCER CUSTOMER!DM V INTCON-01 INSURER(S)AFFORDING COVERAGE NAIC INSURED INSURER A:zuriCh American Insurance Co. 16535 Vinton Construction Company INsuRERB:American Guarantee 6, Liability 26247 2705 North Rapids Road PO Box 1987 INsuRERc:starr Indemnity and Liability Manitowoc WI 54220-1110 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:335649664 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 LTRINSR WVD (MM/DD/YYYY) (MM!DD/YYYY) A GENERAL LIABILITY GLO-5948754-03 3/1/2017 3/1/2018 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED X 300,000 COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR MED EXP(Any one person) 510,000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X jeT X LOC A AUTOMOBILE LIABILITY BAP-5948753-03 3/1/2017 3/1/2018 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) NON-OWNED AUTOS S B X UMBRELLA LIAB X OCCUR AUC-5948802-03 3/1/2017 3/1/2018 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DEDUCTIBLE S X RETENTION SO S B WORKERS COMPENSATION WC-5948756-03 3/1/2017 3/1/2018 X WC STATU- TORY EMPLOYERS'LIABILITY TORY LIMITS ER Y N ANY PROPRIETOR/PARTNER/EXECUTIVE / N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S1,000,000 C Leased/Rented Equipment ITC100070588617 3/1/2017 3/1/2018 Leased/Rented 665,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) City of Oshkosh, its officers, council members, agents, employees and authorized volunteers are included as Additional Insured on the General Liability per the policy forms, conditions and exclusions. 30 day Notice of Cancellation, to the Certificate Holder, is included on the policy CERTIFICATE HOLDER CANCELLATION ` .. LI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED EFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED City of Oshkosh JULw Lno�� ACCORDANCE WITH THE POLICY PROVISIONS. 215 Church Avenue dV o PO Box 1130 Oshkosh WI 54 90 3-113 0 (, — UTHORIZED REPRESENTATIVE QrSUlart ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD