HomeMy WebLinkAboutWilson Construction Co.,4c40RO® CERTIFICATE OF LIABILITY INSURANCE FDAT4YY;
�� 0512912025/29/2024
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(les) 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 CONTACT NAME: Lisa Vincent 205-583-9534
_
McGriff Insurance Services, LLC PHONE 1-800 476-2211 FAX
2000 Intemaficnal Park Drive LAIC, No Ext); �_INC, No):
Suite 600 E-MAIL
Birmingham, AL 35243 ADDRESS: Ivincent@mogdff.com
INSURED
Wurypn Construction Co.
1190 N.W. Third Avenue
Canby, OR 97013
INSURERIS) AFFORDING COVERAGE _
I,"f nrt .
INSURER A :American Contractor$ Insurarim CRmA4AY_ Rlj y
NAIC X
12300
19984
INSURER B :ACIG Insurance Company
.'
INSURER C :
INSURER D
INSURER E :
INSURER F :
COVFRAGFS CFRTICIr ATF M1111ARCQ• CTVrJn7on
or ancrr�u wrusrs.
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 AGDL SU$ POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MWDDIY1'YY LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
GL24AO0093
GL24B00093 (GL Excess)
GL24C00093 (GL Excess)
O610112024
06/01/2025
EACH OCCURRENCE
$ 10,000,000
MAGETO-RERT
PREMISES Ea occurrence),$
_
100,000
X
MED EXP (Any one person)
Stop Gap - ND, OH, WA, WY
$ 5,000
PERSONALS ADV INJURY
$ 10,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
POLICY E] PRO- LOC
JECT
GENERAL AGGREGATE
$ 10,000,000
PRODUCTS-COMPIOP AGG
$ 10,000,000
$
OTHER:
I
A
AUTOMOBILE
LIABILITY
AL24000038
06/01/2024
IWW112025
COMBINED SINGLE LIMIT
Eaacddant
$ 5.000,000
X
BODILY INJURY (Per person)
ANY AUTO
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
I
BODILY INJURY (Per acddent)
$
X
PROPERTY DAMAGE
Per accident
S
$
UMBRELLALW9
OCCUR
EACH OCCURRENCE
$
AGGREGATE
EXCESS LIAB
CLAIMS -MADE
$
DIED RETENTIONS
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y r N
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
NIA
WCA000030124 AZ, CA, ID, NV,
(
NM, OR
WCA00(69924 (AK, AR, CT, FL, HI,
MI, MT, NY, NC, PA, TX, UT, VA}
O6lD112024
06/01/2025
PER orH
X STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,DDD
E.L. DISEASE - EA EMPLOYEE
(Mandatorydescr In NH)and
It s, descritne under
DESCRIPTION OF OPERATIONS below
WCA000033224 (MN)
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
$
$
S
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached if more space Is required)
The City of Caldwell is included as an Additional Insured on a primary and noncontributory basis for ongoing and completed operations by the General Liability policy, and
the Automobile Liability policies if required by written Contract.
� F%1 I1-1.e I�nv�uc r% GANULLLAI IUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Caldwell
411 Blaine St AUTHORIZED REPRESENTATIVE
P.O. Box 1179
Caldwell, ID 83605
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