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W BKE NG I-02 iM@)iL
<br />DATE(MM/ DNYYY)
<br />ID
<br />E (MMD/YY
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />1019
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERSmmmmmmmmmmmmmmmmmmmIT NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,
<br />EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />.. ............................ ..........
<br />_......_......
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer ri0hts to the certificate holder in lieu of such endorsement(s).
<br />....... ......... ._
<br />PRODUCER
<br />CONTACT
<br />NAME"L•_
<br />Insurance A enC ,Inc.
<br />Northwest 625
<br />NA
<br />47-1200CorkIIl
<br />AIC,NoEatI, (847 758 000 p).(8
<br />kgntd.,Ste
<br />Ela60t
<br />certs corkill)nsurance.com
<br />�20508c
<br />_ — �
<br />_ INxURER�A Valley Forge Insurance Company
<br />INSURED
<br />INsuRER B eThe Contmen,tal lnsu,rance Company 35289
<br />WBK Engineering LLC
<br />INSURER C ; Continental Casualty. Company 20443 ,
<br />116 Main Street Suite 201
<br />INSURER .0 : Trumbull Insurance Company 27120
<br />St. Charles, IL 60174
<br />INSURER E
<br />111111INSURER
<br />F :
<br />COVERAGE wwCERTIFICATE NUMBER:
<br />...... REVISION NUMPE, .:_ . ....,....... ........
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE
<br />BEEN REDUCED BY PAID CLAIMS.
<br />BR[
<br />INSR ADDL�S N
<br />TYPE OF INSURANCE POLICY NUMBER
<br />POLICY EFF POLICY EXP LIMITS
<br />A
<br />1,000,000,
<br />X COMMERCIAL GENERAL LIABILITY
<br />EACHOCCURRENCE $
<br />CLAIMS -MADE J X eI OCCUR 6024988798
<br />..._.
<br />,.........
<br />10/15/2019 10/15/2020 DAMAGE TO RENTED 300,000
<br />FIhSi.(FrJGl��ren.) $
<br />10,000
<br />MED EXP (Any, one person) $
<br />PERSONAt. & ADV INJURY S 1,000,000
<br />MITAPPLIES PER: ,,..
<br />LIMIT
<br />GE,NERAI.
<br />,GEN POLICY EOAT
<br />X T LOC
<br />2,OUU,000
<br />PRGDUCTS,e,COMP/OPAGG $
<br />B _J�Iqa .. . ..........
<br />AUTOMOBILE LIABILITY
<br />........
<br />COMBINED SINGLE LIMIT $ 1,000,000
<br />X ANY AUTO 6075560886
<br />Eue dr �11.
<br />10/15/2019 10/15/2020 BODILY INJURY (Per person),
<br />OWNED SCHEDULED
<br />TOS
<br />AUTOS ONLY....a...
<br />OILY INJURY (Peraccident),
<br />ryryT� vryr
<br />X NRV-
<br />X... AUTOS
<br />� 'CY c t�AMAGE $
<br />ONLY �3N(.
<br />e „ .
<br />...................................................
<br />....,.,,,.....
<br />.,
<br />UMBRELLA LIA
<br />X +OCCUR.,
<br />,......
<br />10,000,000
<br />$
<br />EXCESS LAB CLAIMS -MADE 6074584137
<br />7
<br />.�..
<br />GRO�RENCE
<br />10/1512019 10/15/2020 AG�10 000 000
<br />DEIX RETENTION$ 70�000
<br />,,..,.,-,.-.......,. ___ . .......... ..._........
<br />D WORKERS COMPENSATION
<br />....... ................ .._. ..........PER OTH
<br />X STATUTE ER
<br />.AND EMPLOYERS' LIABILITY
<br />83WECIC2654
<br />............ ....... a ,,...... m®
<br />10/15/2019 1011512020 1,000,000
<br />!ANY
<br />EXCLUDE/EXECUTIVE (
<br />R EXCLUDED NIA
<br />/MEMry
<br />;L EACH,ACCIDENT 8 �. ,--
<br />eardat in��R
<br />11000,000
<br />L DISEASE_ - EA EMPLOYEE $
<br />If yes, describe under
<br />DESCRIPTION OFOPERATIONSbelow _ __....._____...
<br />1,000,000
<br />E.I. DISEASE -POLICY LIMIT $m.......................
<br />C,,,
<br />AIEW Professnl E&O AEH591914061
<br />10/15/2019 10115/2020 Per claim 2,000,000
<br />C AEH591914061
<br />10/15/2019 10115/2020 Aggregate 4,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />Proofof Insurance,
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />For Informational Purposes Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />P y ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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