Opening of Proposals - Water Works Utility Service Line Repair Program - Bob Frame Plumbing Inc

Home Browse Search

ACOR-1 0 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) I 07/1212018 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, EXTENT) OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW- THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 endorsements . PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 OWATONNA, MN 55060 NAME: CT CLIENT CONTACT CENTER PHONE CNn Ex1 : 888-333-4949 arc No : 507-446-4604 ao EL.: CLIENTCONTACTCENTER FEi)INS.COM INSURER(S) AFFORDING COVERAGE NAIC h1 INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 264-429-2 INSURER 8: FEDERATED SERVICE INSURANCE COMPANY 28304 INSURER C: BOB FRAME PLUMBING SERVICES INC 2442 JACLYN CT SOUTH BEND, IN 46614-3700 INSURER -: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 22 REVISION NUMBER: L 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. INSRLTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY Err MMIDDIYYYY POLICY EXP MMIDDIYYVY LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR Y N 9403507 04/01/2018 04/01/2019 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person) EXCLUDED PER SONAL& ADVMJURY $1,000,000 GEN'L X GENERAL AGGREGATE $2,000,000 AGGRFGATE LIMIT APPLIES PER: POLICY U PRJEGT O ❑ LOC OTHER: PRODUCTS - COMPIOP AGO $2,000,000 B AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS NON -OWNED HIRED AUTOS ONLY AUTOS ONLY N N 9403507 04101l2018 0410112019 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) — PROPERTY DAMAGE Per accident _ BJE�XIC15FL]IIAII�3T�CLAIIIS-MADE X UMBRELLA LEAS X OCCUR N N 9403508 04/01/2018 0410112019 EACH OCCURRENCE $2,000,000 AGGREGATE $2,DD0,000 R A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY yl ry ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDE-. (Mandatory in NH) II yes, describe under DESCRIPTION OF OPERATIONS below NIA N 9403509 04/01/2018 04/01/2019 X PER STATUTE 07H- ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached ii more space is required) THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. 264-429-2 CITY OF SOUTH BEND 227 W JEFFERSON BLVD SOUTH BEND, IN 46601-1830 CANCFI I ATION 22 2 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 tV IUUU-ZU 10 HI:VKU VVKKVKyi I IVIV. I'M nynia Iced—, ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD