Agreement - MPAC-POTO Chandelier Support - A&D Contractors LLC

Home Browse Search

AC[7R©0 CC) CERTIFICATE OF LIABILITY INSURANCE DATE (MM)ODIYYYY) 08/07/2017 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 LIC #01329370 1-205-581-3330 Edgewood Partners Insurance Center (EPIC) [Alabama Branch - Branch ID 154911 2901 2nd Avenue South., Suite 200 CONTACT Y PAle Kell Cha NAME; PHONE FAX c No Ext: 205-581-3340uc"N205-250-1173 E-MAIL kell cha le@e icbrokere.com ADDRESS: Y• PP P INSURER 5 AFFORDING COVERAGE NAIL # INSURER A: TRAVELERS IND CO 25658 Birmingham, AL 35233 INSURED INSURER B; TRAVELERS CAS INS CO OF AMER 19046 Sterling Boiler & Mechanical, LLC INSURER G: NAVIGATORS INS CO 42307 A & D Constructors, LLC P.O. Box 8004 INSURER D! AMERICAN GUAR & LIAB INS 26247 INSURER E INSURER Ft Evansville, IN 47716 COVERAGES CERTIFICATE NUMBER: 50552818 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 LTR TYPE OF INSURANCE N DL SUER POLICY NUMBER MM DONYYY MMIab YYYY LIMITS A X COMMERCIAL GENERALLIAB14ITY X X VTKC05794B34617 06/02/17 06/02/18 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1XI OCCUR MA PREM SES Eaoccur ence $ 300,000 MED EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L POLICY LJ JECT LOC PRODUCTS - COMPIOP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY X X VT.7CAP5794B33417 06/02/17 06/02/18 COMBINED SINGLE LIMIT £a accidentU___ $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED AUTOS NON -OWNED AUTOS C X UMBRELLA LIAS X OCCUR X X GA16EXC865917IV 06/02/17 06/02/18 EACH OCCURRENCE S 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE PEP I I RETENTION $ $ A WORKERS ANDEMPLOYER'LIAT1oN YIN AND EMPi.OYERS' LIABILITY ANY PROPRIETORIPARTNERlEXECUTIVE OFFICERIMEMBER EXCLUDED? NI X VTRHUB8751X35A17 06/02/17 06/02/18 ERH _X _STATUTE E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEd $ 1, 000, 000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Excess Liability AECO11503902 06/02/17 01/02,111 Per Occ/Agg 20,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Additional Remarks Schedule, maybe attached If more space is requiradi *See Attached Wording* 1�7iNJ ■iw'J.�►1 City of South Bend Department of Public Works 1316 County City Building South Bend, IN 46601 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE LrSA YA�__ ©1988-2014 ACORD CORPORATION. All rights reserved, ACORD 25 (2014/01) KChapple 50552818 The ACORD name and logo are registered marks of ACORD