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HomeMy WebLinkAboutFrank Contractors LLC 08-27-20 AC CERTIFICATE OF LIABILITY INSURANCE °"9;4,0°'9"" 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 tho certificate holder is an ADDITIONAL INSURED, the pollcy(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: Sue Zoromski,CISR Ansay&Associates,LLC. FV PHONE — FAX - -- 4351 W College Ave Ne,extk 920-560-7019- 1(AIC,Not 920-560-7078 Suite 310 "wows!:esue_zoromsloeensay.com Appleton WI 54914 PP INSURERS)AFFORDING COVERAGE NAIL I--_ INSURER A:Socie1y Insurance A Mutual Insurance Cornpany 15261. INSURED FRANCON.01 INSURER B:SeCUra InSUranCe A Mutual C 22543 Frank Contractors LLC Pam —3045 Sheldon Drive INSURER C Oshkosh WI 54904 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:1190968951 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 --_ (ADDS SUdR -- _�...-'...POLICY EFF POLICY EXP - - --------.—. LTR TYPE OF INSURANCE INSR yyVO POLICY NUMBER fMMIDDIYYYYI IMMIDOIYYYYI LIMITS B GENERAL LIABILITY Y Y CP3292175 8272019 8127R020 EACH OCCURRENCE___ PREMISES SES S 1.000.000 X COMMERCIAL GENERAL LIABILITY DAMAGES t RENTED MIfEaoccurrence) 5250,000-__._-- . -__4__-.I CLAIMS-MADE I X 'I OCCUR MEDEXP(Anyoneperson) $10,000 _---.-_.--_-_ PERSONALS AOV INJURY $1,000,000 .___ __ GENERAL AGGREGATE 33.000,000-_.—_-- BENLAGGREGAIE LIMIr API>LIESPER- PRODUCTS-COMPIOPAGO S 00000000_ l POLICY I X 18 hoc _____ -_ _ ____ 13 AUTOMOBILE LIABILITY A3292176 1 8127r1019 ER7/2020 COMBINED SINGLE LIMIT -- (Ea scc4809 _-__-S.1.009.0D2-----___-- ANY AUTO BODILYINJURY(Perperson) S __ ALL OWNED I x I SCHEDULED AUTOS j BODILY INJURY(Per acnderd) S .. NON-OWNED PROPERTY DAMAGE -- -- ----- X HIRED AUTOS x AUTOS (PerscOdMyt _ S --'ems B X UMBRELLA LIAR I X OCCUR CU3292177 BI272019 8/272020 EACH OCCURRENCE S 1,000,000 _---- EXCESS — EXCESS LIAB CLAIMS-MADE AGGREGATE 51,000,000 BED 1 I RETENTIONS I S A •WORKERS COMPENSATION VP18018583 5222019 52272020 I WC STATU-TORY LIMITS Ix__1 T AND EMPLOYERS'LIABILITY - ---.-- '-••ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N I E L EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? NIA -- ------ -- ! (Mandatory In NH) E L DISEASE-EA EMPLOYEE S 1, 0°000.0 II yes,daunt*under ... __._- --_._._._.- --—._. ... DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY UMIT S 1,000,000 U Leased Equipment CP3292175 6/27I2019 8272020 Leased Equip 25.000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,It mots spats is required) The City of Oshkosh,and its officers,council members,agents,employees and authorized volunteers are listed as Additional Insured on a Primary and Non Contributory basis with respects to the general liability policy including ongoing&completed operations per forms CG2010 and CG2037. Waiver of Subrogalion is inducted. 30 Day Notice of Cancellation is also included. CERTIFICATE HOLDER CANCELLATION 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. Attn: City Clerk 215 Church Ave AUTHORIZED REPRESENTATIVE Oshkosh WI 54903-1130 j,c,..c_.g. // (71;3:rL4Y�S k, ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD