HomeMy WebLinkAboutFluor Bros./Certificate of Limited Liability Ins. 2009DATE (MM�DD�YY)
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_: �_ •... ���_.� 07/13/09
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Aon Risk Services Central, Inc.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Green Bay WI Office
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
111 N. Washington Street, Suite 300
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. O. Box 23004
Green Bay WI 54305 -3004
COMPANIES AFFORDING COVERAGE
COMPANY Harleysville Insurance Company
PHONE - (920) 437 -7123 FAX- (920) 431 -6345
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INSURED
COMPANY
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Fluor Brothers Construction Co., Inc.
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203 Otter Avenue
P. 0. Box 1216
COMPANY
Oshkosh WI 54903 -1216 USA
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o
COMPANY
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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. LIMITS SHOWN ARE AS REQUESTED
CO
IT - TYPE OF INSURANCE POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DD /YY) LIMITS
• GENERAL LIABILITY 872419
10/31/08 10/31/09 GENE RAL AGGREGATE $2,000,000
PACKAGE POLICY
)( COMMERCIAL GENERAL LIABILITY
PRODUCTS - COMP /OP AGG $2,000,000
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CLAIMS MADE FX OCCUR
PERSONAL & ADV INJURY $1, 000, 000
OWNER'S & CONTRACTOR'S PROT
EACH OCCURRENCE $1,000,000
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X Agg pe r P r oj ect Endt
FIRE DAMAGE(Anv one fire) $300,000
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MED EXP (Any one person) $5,000
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• AUTOMOBILE LIABILITY _. 872419
10/31/08 10/31/09
COMBINED SINGLE LIMIT $1, 000,000
X ANY AUTO BUSINESS AUTO
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ALL OWNED AUTOS
BODILY INJURY
U
SCHEDULED AUTOS
( Per person)
J( HIRED AUTOS
BODILY INJURY
X NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
ANY AUTO
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
• EXCESS LIABILITY 832419
10/31/08 10/31/09 EACH OCCURRENCE $5,000,00
X UMBRELLA FORM UMBRELLA
AGGREGATE $5,000,00
OTHER THAN UMBRELLA FORM
Retained Limit Amoun $10,00
• WORKER'S COMPENSATION AND 832419
10 31 O8 10 31 09 X CRY SL OTH_ "
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L1 TORY LIMITS ===
EMPLOYERS' LIABILITY WORKER'S COMPENSATION
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jJ 1� EL EACH ACCIDENT
� � � ((�, s10u, 000
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THE PROPRIETOR/ INCL
PARTNERS/EXECUTIVE
I
L �� _._) I� I L- EL DISEASE- POLICY LIMIT $S00,000
OFFICERS ARE: EXCL
I EL DISEASE -EA EMPLOYEE $100,000
JUL 14 09
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DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLES/SPECIAL ITEMS
BEAGH AWPI '
. J i §
- LIABILITY,
: AE ' ITHEATER. CONTRACT` AMOUNT 780. '
D I I DON 'T GE E ME THE CITY OF
.. $82:�
YAME6�A '6�OVE' " PETT 'B'LANKET ADDIT AL INS URED „ _ , _
OSHKOSH 'AS RESPE M .0 I �I ON - EN MENT.
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE
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CITY OF OSHKOSH
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
215 CHURCH AVENUE
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
P.O. BOX 1130
OSHKOSH WI 54903 -1130 USA
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
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OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.,
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AUTHORIZED REPRESENTATIVE � 22
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