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HomeMy WebLinkAbouthigh fac contr a-20150709160716.pdf ACo CERTIFICATE OF LIABILITY INSURANCE °ATE(MM'°°,YYYY' �� 4/14/2011 THIS CERTIFICATE 1S 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 CONTACT Debbie KiPP ola NAMES. PHONE (607)257-9760 FAX (607)257-9761 Olver and Associates A!C No Ext: A/C No: E-MAIL debbie@olverinsurance com 414 East Upland Rd ADDRESS. PRODUCER 00001033 Suite CCUSTOMERID9 Ithaca NY 14850 INSURER(S)AFFORDING COVERAGE NAIC# INSURED - INSURER A:Peerless Insurance- INSURER B:Zurich American Ins. Co. Shisler Electrical Contracting Co. , Inc. INSURERC: 408 Second Street INSURERD: INSURER E: Ithaca NY 14850 INSURERF: COVERAGES `CERTIFICATE NUMBER:CL1012700409 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 OFSUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR'. ADDL SUBR POLICY EFF POLICY EXP - LIMITS LTR TYPE OF INSURANCE - -IN SR WVD. POLICY NUMBER ' MMIOD MIDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTEp 300,000 X COMMERCIAL GENERAL LIABILITX- PREMISES(Ea occurrence) $ A CLAIMS-MADE X�OCCUR X CCP8102316 12/31/2010 12/31/2011 MED EXP(Any one person) $ 15,000 PERSONAL&ADV'INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY' X PRO- Lod $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED AUTOS A8104216 12/31/2010 12/31/2011 BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ X UMBRELLA LIAB i X OCCUR - - EACH OCCURRENCE $ 5.,000,0:00 '..EXCESS LIAB CLAIMS-MADE. - AGGREGATE $ 51000,000 DEDUCTIBLE _ $ A X RETENTION $ 101 000 CU8104916 12/31/2010 12/31/2011 $ A WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN - T IMIT R ANY PROPRIETORMARTNERIEXECUTIVE❑'..N l A EL EACH.ACCIDENT $ 100,000 OFFICE-MEMBER EXCLUDED? C8104516 _. 12/31/2010 12/31/2011 (Mandatory in NH) . E.L DISEASE-EA EMPLOYE. $ 100,000 -If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 5O0 OOU B NYS DISABILITY 1561593 2/31/201012/31/2011 STATUTORY A OCP-Owners Contractors Pr To Be Assigned /01/2012 O5/Ol/2011 OS DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate holder is listed as additional insured with respect 'to general liability. Contract #4 - Electrical Project - Proposed Highway Garage, 475 Enfield Maim Road, State Rt 327, Ithaca, NY 14850 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Enfield 168 Enfield Main Road Ithaca, NY 14850: AUTHORIZED REPRESENTATIVE � 1y Neil 'Olver/DAK ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights'reserved. INS025(2009D9) The ACORD name and logo are registered marks of ACORD