HomeMy WebLinkAboutWisconsin Technology Networking LLC 11-11-18 .,��'..'1 MOINV-3 OP ID:JK
,AFRO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDII17
1 Or27/2017
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(les) 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: Brent Jetton,AAI,CIC
Silverstone Insurance Services PHONE FAX
Jetton &Assoc Ins Svs Inc No,Est): 909-980-4211 (AIC,No): 909-9804785
P.O. Box 1200(LIc#0004829) E-MAILADDFtE s:
Rancho Cucamonga„ CA 91729-1200 Brent Jetton,AM,CIC INSURER(S)AFFORDING COVERAGE NAIC!
INSURER A:Federal Insurance Company 20281
INSURED Wisconsin Technology INSURER B:Great American E&S Ins Co 37532
Networking, LLC INSURER C:Underwriters Lloyds London IL 15792
660 Newport Center Dr.#200
Newport Beach,CA 92660 INSURER D:
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.
INSR TYPE OF INSURANCE R'yy Bp POLICY NUMBER POLICY EFF POLICY EXP LIMITS
(MMIDOM'YY) (MMIDD/YYYV)
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY X X 36036868 11/11/2017 11/11/2018 DAMAGE TO RENTED
PREMISES(Ea occurrence) $ 1,000,000
CLAIMS-MADE X_ OCCUR MED EXP(Any one person) $ 5,000
PERSONAL&ADV INJURY $ 1,000,000
CONTRACTUAL LIAB GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000
POLICY n JECT LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
(Ea accident) $
A X ANY AUTO X X 73591570 11/11/2017 11/11/2018 BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUTOS
X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $
_ AUTOS (PER ACCIDENT)
$ _
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
A EXCESS LIAB CLAIMS-MADE 79897229 11/11/2017 11/11/2018 AGGREGATE $ 5,000,000
DEC RETENTION $ _ $ Follow Form
WORKERS COMPENSATION X TORY LIM 5 ER
AND EMPLOYERS'LIABILITY
A ANYPROPRETOR/PARTNERIEXECIJTIVE Yf N 71749062 11/11/2017 11/11/2018 EL.EACHACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N Ni A
(Mandatory In NH) E L.DISEASE-EA EMPLOYEE $ 1,000,000
It yes,describe under —DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ 1,000,000
B Pollution Llab PRE315985702 11/11/2017 11/11/2018 EaClmJAgg 5,000,000
C Professional Llab PMOB1000916-1 11/11/2017 11/11/2018 EaClm/Agg 5,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more apace is required)
*30 Days NOC to the City Clerk.
City of Oshkosh, and its officers, council members, agents, employees and
authorized volunteers are named additional insured per attached
endorsements.
CERTIFICATE HOLDER CANCELLATION
CITOSHK
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
Oshkosh,WI 54901 AUTHORIZED REPRESENTATIVE
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01988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD