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Home My WebLink AboutEnvirogen . \.'.O ì íC ~1T«iIiì I ;1\'" I1ij \ U \}. FEB 0 3 2003 \.-"'1'1 CLERK'S OFFICE City Attorney's Office Phone: (920) 236-5115 Fax: (920) 236-5090 http;/Iwww.cLoshkosh.wi.us January 30, 2003 Kris Baran - Project Environmental Specialist Envirogen Inc. 790 Marvelle Lane Green Bay, WI 54304 RE: Privilege in Street Permit/City of Oshkosh Sec. 66.045, Wis. Stats. Gentlemen: On January 28,2003, by resolutiow#03-19, the City of Oshkosh Common Council approved your request for a privilege in street permit subject to certain conditions that are made a part of the approval resolution. In order for the permit to be valid, each one of these conditions must be satisfied. To that end, please find enclosed for your signature an Agreement releasing, and holding the City harmless, from all liability arising from your use of the permit. This, along with the insurance filing requirements ($200,000/$500,000 limits) are part of state law that enables the City to allow you this use. Kindly return to this office the signed Agreement along with your proof of insurance, either a separate policy or naming the City as an additional insured on your policy. Please execute and return to us as soon as possible. These conditions of approval must be met before YQ1! exercise the privilege in the street. If not, the city is empowered to shut down any activities undertaken before the paperwork is [mished. Direct any questions about insurance and liability releases to this office. Any other questions concerning the remaining conditions should be directed to the Public Works Department at 236-5065. Thank you very much for your timely cooperation in these matters. Sincerely, CITY OF OSHKOSH cc: Pamela R. Ubrig--City Clerk Dave Patek, Dir. of Public Works Matt Tucker, Community Dev. nfV1 - v: ~U.':; ~'.V Lynn A. Lorenson Asst. City Attorney ,... AGREEMENT (~ WHEREAS, the City of Oshkosh has granted to the undersigned a privilege to place an obstruction within the street right-of-way as follows: Installing a monitoring well within the right-at-way at Pierce Avenue, between 944 and 951 Pierce Avenue, per the attached Exhibit (Resol. 03-19 with attachment). WHEREAS, State law provides that by its acceptance of this privilege the undersigned shall become primarily responsible for damages to per$On or property by reason of the granting of the privilege; NOW, THEREFORE, in consideration of the City of Oshkosh, a Municipal Corporation granting permission to the undersigned to place an obstruction within the street right-of-way, the undersigned agrees that he/she/it is solely responsible for his/her/its activities under this agreement. The undersigned hereby releases the City of Oshkosh from all debt, claims, demands, damages, actions and causes of action whatsoever which may result from the placement of an obstruction in the street right-of-way by the undersigned. Further, the undersigned agrees to protect and hold the City of Oshkosh harmless against all actions, claims and demands of any kind or character whatsoever which may in any way be caused by the activities under this privilege by the undersigned or agents or employees. Further, the undersigned agrees to indemnify and refund to the City all such sums which the City may be obligated or adjudged to pay, including the City's attorney fees and costs, on such actions, claims or demands within 30 days after written request for such indemnification. The undersigned agrees that this paragraph is to be liberally construed in favor of the City of Oshkosh, in consideration of the privilege granted by the City under this agreement. This agreement and the privilege cannot be assigned without the written consent of the City of Oshkosh. The privilege is subject to all terms and conditions contained in any authorizing resolution adopted by the City of Oshkosh Common Council, which is incorporated by reference as if fully recited within this document. By executing this agreement and by using the privilege, the undersigned agrees to fully abide by such terms and conditions, including revocation upon written notice for noncompliance with the authorizing resolution and this agreement. Datedthis ..çí?daYOf:14,2003. :~v~ 7f~ Name & Title: rYln'tiew ¡< tJ¡erj~ Name & Title: P/,f 7?' ¡ cr/'rl Çf P It ~ e'T' And: STATE OF WISCONSIN) ) SS. WINNEBAGO COUNTY) / /. Persona!Jy came before me this :5J7f day of ~¡ , 2003, the above-named 1'f/fJ//IEW 1'(. ~ ..and - . to me known to be the (name & title)~677?/"T #ó,f'. (name & title) ~~~~~~~d~~~ ~~~C:~~~~hO executed the fOregOic~ °,i1~ROGEN INC. and Notary Public: ~AJ Co., Wiscon;in ".--- MyCommlsslon:_U<il :;:', 2¿:JCJ6"' - ¡rÖ) œ ~ ~ ~ W ~ íf1ìl' Attachment: Resol. #03-19 andattàchments dated 1/28/03 of the Oshkosh Common Council IIJ Ll FEB 1 3 2003 I!dJ I I CITY CLE~~'S OFFICE II ',' II II , , , .. , " I II II ., , , , , . , ,'..,' JANUARY 28, 2003 03-19 RESOLUTION (CARRIED 7- 0 LOST LAID OVER WITHDRAWN PURPOSE: GRANT PRIVILEGE IN STREET/ PIERCE AVENUE INITIATED BY: ENVIROGEN INC., PETITIONER PLAN COMMISSION RECOMMENDATION: Approved w/conditions WHEREAS, Envirogen Inc. has requested the Common Council to grant them the privilege of installing a monitoring well within the right-of-way of Pierce Avenue, between 944 and 951 Pierce Avenue, per the attached; and WHEREAS, Section 66,0425, Wis. Stats., provides for the granting of a privilege in a right-of-way; and WHEREAS, the Plan Commission has approved of this request with conditions. NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that the proper City officials are hereby authorized and directed to grant Envirogen Inc, the privilege of installing a monitoring well within the right-of-way of Pierce Avenue, between 944 and 951 Pierce Avenue, per the attached, contingent upon the following: 1) 2) The monitoring well be installed in a manner that is approved by the Dept. of Public Works. If no longer needed, the monitoring well be properly abandoned and removed in accordance with City standards and under the direction of the Dept. of Public Works. Any problem which may arise as a result of the installation of the monitoring well be the responsibility of the petitioner/owner to correct in coordination with the Dept. of Public Works. All appropriate permits be obtained prior to the start of boring or excavation work. The monitoring well be modified or removed immediately upon the request of the City. The petitioner/owner secures and submits to the City Clerk a separate insurance policy which names the City as an additional insured with a minimum coverage of $200,000 per person and $500,000 in general ag9regate. It is the responsibility of the petitioner/owner to file in a timely manner a new insurance certificate with the City Clerk upon expiration of an existing certificate. Failure to do so will result in the revocation of the privilege in street upon 10 days notice. The petitioner/owner execute a hold harmless agreement with the City. 3) 4) 5) 6) 7) 8) It " It OENVIROGEN II " II , II , , II , , , l1li , II II , I ^.. 790 Marvelle Lane Green B.y, WI 54304 Tel: 920/497-8910 Fax: 920/497-8065 www.envirogen.com December 23, 2002 Mr. Darryn Burich Department of Community Development P,O. Box 1130 Oshkosh, Wisconsin 54903cl130 RECEIVED DEC 26 2~O2 DEPARTMENT OF COMMUNI1Y DEVELOPMENT Re: Lakeside Marina 902 Taft Avenue Oshkosh, Wisconsin 54901 ~ COMM No. 54901-3459-02 BRRTS No. 03-71-200194 Dear Mr. Burich: Envirogen, Inc. (Envirogen) has been retained by Lakeside Marina to continue the remediation at the above referenced property, To complete site remediation at the above- mentioned property the Department of Commerce (COMM) has requested that a monitoring well be instaIled to the west of the subject property in the Pierce Avenue right-of-way. The monitoring well will be installed per the WDNRNR 141 requirements, The monitoring well will include a 9 inch flush mounted well cap to prevent damage to the road and monitoring well. The monitoring well will be installed to a depth of approXÙllate1y 14 feet below land surface, . The monitoring well will be installed as 'soon as all proper permits have been received, Groundwater samples will be collected from the monitoring well on a quarterly basis and analyzed for contaminant constituents, Once site closure has been received from COMM the monitoring well will be properly abandoned, It is estimated that the monitoring well will be in place for approximately 1.5 years, A figure illustrating the location of the proposed monitoring well has been attached along with the application and application fee of $100, Ifyoú should require any further information, please contact me at (920) 497-8910, Sincerely, ~,~ KrisBaran . Project Environmental Specialist L: \Pro j2 002 \020227\1 e!lelS Ikkb87 Cost effective leadership for a cleaner environment -v . ,: v , ~ ~~! ~1 ~~ , ~ ~ ~$ h ! ~1 n ' Q ..~3 , 1~ i Ji j~ J~ ~! ~¡'i '-3d ~ j & d h hEE r- "1'it~ ~ ~ t $J jj;1 .I~.H z~ ~idì.i ! i '~ h h il iiJ=~~ a. hUll! ! II Ii Ii! !!!~~! H iU ! ~JZ] ~,' 4~ @~ ~~hH I I i II I 1?2 ~ ¡¡ . ", w ~ ::> i< C> Z ü: '~g¡~ ¡¡:z8 !~~ Qr.:t CI)~CI) ~'"'~ jð:ið 0 ~ ~ ¡ x ~ 0' g; I! 0. ~ ;;; ~ . iü i . '~ . (f) I ~ n ~! (') ,Z Õ ...J 5 m II J , " -- ¡----'---- , --1) .. j I . ~ .'-Q " JÌ ~~ 'i;..t II ' (- :f ~ ' --," '-'-'-'-'j'-{"-'-,-,-, ~ ,4 J l~ . ~ " i ,., ~ i J . J I , I , , I ,~~ . /' ,~. 1,' . 'I '-.",' ". '-<i'l '. I, -. ,J' '"'" ",j. " I , r' ""'";:"'~" " 2.~ i~1 /"",-< """-'-'-'-'-'-'-'-'-'-'-:- 1 'I ]X"" ""'~ " ,].,""'" S -f "",,"1 'I ", ~ i,',',' .; § I I ¡g , . 1 I ~ . i ~ I, 'Æc;:¡ 1 I 'W~ I, '~!!! 1 I 1","- I, :~ !.~ ~ I : .: '~~ ' 945 ~ ìere-e. /we.- 00 ,..-< '-0 ~ ~ DISCLAIMER Close Up View Pierce Ave. . OJHKOfH 120 TH'Fëët Thl, map b neitb" a '.gally "'O"" map no, a '.my and It 10 not lot.od.d to b. .... " on., Tblo '"wlng 10 a ,ompllatlon of ",o,d" 'a" and Inrn'matlon 1o.".' In mlo., cIty, ,onnty and ,tat. nm,.. and 0"" oom" aff,,"ng tb. am obown and it 10 to b. .... fo' "f",.o< p.'p"" oDly, Tb. City ofo.bko,b b DOt ,.. ,ponolbl. fo, ony ID",.",I" b",ID ,0D"'D"', If d"""P'D"" m fo.Dd, pI.... ,0Dtad tb, CIty of "'bko,b, City of Oshkosh Wisconsin Community Development 0 60 60 , (ftDt- fo s ecJe \. C"atedby- VR ADA N A 1-2-03 ACORD. CERTIFICATE OF LIABILITY INSURANC~r~~~ A' DATE (MMIDD/VY) 12/10/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE InterContinental Ins Brks, LLC HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 21 Custom Bouse St., Suite 700 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW, Boston MA 02110-3527 Phone: 617-439-0107 Fax:6l7-330-7877 INSURERS AFFORDING COVERAGE INSURED INSURER A' Commerce & Industrv-A++ INSURER B' National Union Fire Ins. A++ Envirogen, Inc. INSURERC, Granite State Ins. Co. A++ t~~~eg~~~Îf~~ig~eof~~~ INSURER D' INSURER E' COVERAGES THE POLICIES OF INSURANCE LlSTEO BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOR THE POLICY PERIOO INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN, THE INSURANCE AFFORDEO BY THE POLICIES DESCRIBEO HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCEO BY PAlO CLAIMS, 'L~ TYPE DF INSURANCE FOLICY NUMBER ~~ifiMmB~' í\'..tt~~.rrló=N GENERAL LIABIUTY - A ~ ~~ERCIALGENERALLIABILITY GL4l78980 - -.-I CLAIMS MADE [!] OCCUR X PD Deductible AUTO ONLY. EAAOODENT $ EAACC $ AGoG $ $ 10,000,000 $10,000,000 $ $ $ X I f'ó'R~'ù'~WS I IU~~ $ 500,000 E,L,DISEASE-EAEMPLOYE $ 500,000 ELDISEASE.PDLlCYLIMIT $ 500,000 02/22/01 EACH OCCURRENCE 02/22/03 FIREDAMAGEIA,yo,efi"l MED EXP IA'Yo" ""'001 PERSONAL & ADV INJURY $2S,OOO PER OCCURRENCE ~'L AGGRE~ ,LIMIT AP~S PER' I POLICY I X I ~,\'& I I LOC ~OMOBILE LIABILITY A - />NY AUTO ALL OWNED AUTOS - ..!.. SCHEDLILED AUTOS ..!.. HIRED AUTOS ~ NON-OWNED AUTOS X Compo $1000 ded X ColI. $1000 ded. hRAGE LIABILITY ÏÎ />NY AUTO EXCESS LlABIUlY B tfjOCCUR 0 ClAIMS MACE h DEDUCTIBLE Ix1 RETENTlON $ 10000 GENERAL AGGREGATE PRODUCTS. CDMP/DP AGG CA5054514 02/22/02 COMBINED SINGLE LIMIT 02/22/03 (Eaaooide"1 BODILY INJURY (pel peæo,) BODILY INJURY (Pel oodde") PROPERTY DAMAGE (Pel aoo"'oo') OTHER THAN AUTOONLY, BE1394557 02/22/02 EACH OCCURRENCE 02/22/03 AGGREGATE WORKERS COMPENSATION AND C EMPLOYERS' LIABILITY WC5362981 07/23/02 07/23/03 ELEACHACCIDENT OTHER A Pollution & Prof. COPS 761-93-31 Liab.-Claims Made RETRO DATE: 7/1/88 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT,sPECIAL PROVISIONS City of Oshkosh, its employees and officers, council members, agents and authorized volunteers are included as additional insureds with respect general liability and automobile liability with respects work performed by or on behalf of the Named Insured. Insurance hereunder shall be primary. 02/22/01 02/22/03 Per Claim Aaareaate CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTE'" OSBKOOI CANCELLATION UMITS $ 5,000,000 $ 50,000 $5,000 $ 5,000,000 $5,000,000 $5,000,000 $1,000,000 $ $ $ $5,000,000 $5,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POUOIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ..3.0- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMFOSE NO OBLIGATION OR LIABILITY OF ANY KlNDUFON THE INSURER, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE Albert P Everts II ~..tAJ. #. City of Oshkosh, Wisconsin ACORD 25-S íl/97) @ACORDOORPORATlON1~ f OENVIROGEN 790 Marvelle Lane Green Bay, WI 54304 Tel: 920/497-8910 Fax: 920/497-8065 www,envirogen,com March 17,2003 City of Oshkosh City Clerks Office Attn: Penny 215 Church Avenue P,O, Box 1130 Oshkosh, Wisconsin 54903-1130 Re: Lakeside Marina Privilege in Street Permit 902 Taft Avenue Oshkosh, Wisconsin 54901 COMM No. 54901-3459-02 BRRTS No. 03-71-200194 Dear Madam: Envirogen Inc, (Envirogen) has obtained an annual work in right-of-way bond as required by the City of Oshkosh and an updated insurance certificate, These items were requested in our discussion on March 17,2003, regarding the privilege in street permit for the installation of a monitoring well in the right of way of Pierce Avenue, It is my understanding that Envirogen now has submitted all information requested to obtain a right of way work permit and to obtain the permit Envirogen must contact the city engineers office, If you should require any further information, please contact me at (920) 497-8910, Sincerely, ¿~ Kris Baran Project Environmental Specialist L:\Proj2002\020227~etters\kkb I 06 Cost effective leadership for a cleaner environment 02/1V2003 TUE 11,19 FAX 920+236+s039 CITY dF ÓSHKÓSB I4J 004/005 ~ ',' ANNUAL WORK IN RIGHT-OF-WAY BOND pRINCIPAL(S)(Legal name(s) and business addressees)) Envirogen, Inc. . 4100 Quakerb ridge Road Lawrenceville, NJ 08648 Surety(ies) (Name(s) and business addressees)~ Travelers Casualty & Surety Company 2~Êo~~Sh Uw'[Hn Ave. Penal Sum of Bond: $5000,00 Type oforg!U1ization: - individual - partnoxship ...x... c_oration State of Incorporation Bond Number: 103790726 OBLIGATION: We, the Principal(s) and Surety(ies), are firmly bound to the City of Oshkosh in the above penal sum. For payment of the penal sum, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, CONDITIONS: The Principal contemplates performing work within the right-of-way area(s) within the City of Oshkosh from time to time during the calendar year shown below. The Principal desires that all of those projects be covered by a single bond rather than a separate bond for each contract. The Principal shall faithfully perform all work done in the City of Oshkosh with proper care and skill; obey all laws of the State of Wiscon~in and ordinances of the City of Oshkosh in connection with such work performed alid with the employment of labor; properly replace and restore any area within the right-of-way to as good a condition as it was in prior to Principal's activities; and pay to the City of Oshkosh any amounts due for services or materials furnished in connection therewith within one week of invoice, The Principal shall for a period t3'eginning on the date of issuance of this bond through a two' (2) year period from the expiration date of the annual license save, defend, and hold harmless the City of Oshkosh from and against any and all claims, damages, costs, and expenses of any kind or character arising out of or resulting, however remotely, from the work performed by the Principal under the attached license, including but not limited to, all accidents and damages caused by any failure to erect and maintain sufficient barriers or lights at the place where licensee has placed obstruction or performed work, or by failure to guard against injury to persons passing UpOr:1 the street or sidewalk, or by failure to promptly remove all tools, implements, refuse and unused materials from said right-of-way, The Principal shall indemnify and refund to the City of Oshkosh all sums which it may become obligated to pay, including without limitation, damages, punitive damages, attomey feès and court costs, within 30 days of written demand for payment. It is understood and agreed by the Principal(s) and Surety(ies) that this bond supplements, but does not take the place of any liability insurance required to be carried by said Principal(s) herein by the City of Oshkosh policies or ordinances, TERM OF BOND: T.he pfóiod 6'& time covered by this Bond shall be" for a three (3) year period from De ce mD e r , 2 2 (Date of Issuance) to December 31, 20~, (Bond must cover work performed through a period extending for 2 years beyond the expiration of the annual license.) SIGNATURES/SEALS: :~~~/~~O, ""1"'1- jJ/l.-fS, t) i,,¡ -r-- Title For the Surety: Travelers Casualty & Surety Coo ~ x[--;td~ Attorney in Fact Title 21 Custom Rouse St., Boston, MA 02lW Address Any person signing in a representative capacity (e.g., an attorney-In-fact) must fumish evidence of authority if that representative is not a member of the firm or partnership or an officer of the corporation involved, Annoal wo.. In the Right-of-Way Bond 11-27-02 ,~, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY FARMINGTON CASUALTY COMPANY Hartford, Connecticut 06183-9062 i- POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)-IN-FACT KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford, County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed, and do by these presents make, constitute and appoint: Thomas E. Sleeper, Theresa M, Farrell, Anne S. Walgreen, James J, Aiken, Ruth M, McAllister, Nancy N. O'Connor, of Boston, Massachusetts, their true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States, the following instrument(s): by his/her sale signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking and any and all consents incident thereto and to bind the Companies, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Companies, and all the acts of said Attorney(s)-in-Fact, pursuant to the authority herein given, are hereby ratified and confinned. This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are now in full force and effect: VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts ofindenmity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her. VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary. VOTED: That any bond, recogniZance, contract of indenmity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary, or (b) duly executed (under seal, if reqnired) by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a vmtten delegation of authority, This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed) under and by authority of the following Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, which Resolution is now in' full force and effect: VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in-Fact for pwposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future ",ith respect to any bond or undertaking to which it is attached. (11-00 StandMd) 03-17-2003 04:29PM FROM-I NTERCONT I NENTAL INSURANCE +1-6174237541 T-1S4 P 002/002 H88 ....--..-. ....-. . ... .-... - -. -.. - - - - - n"_____", ""VL"-L V~,-"V~ PRODuceR THIS CERTIFICATE IS ISSUED A$ A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ceRTIFICATE In~erContinenta~ Ins Brks, LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 175 Federa~ Street, Suite 725 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. Boston MA 02110-2202 INSURERS AFFORDING COVERAGE phone,6~7-439-0107 Fax,G17-423-7853 INSURED INSURERk Commerce & Industrv-A++ INSURERS, Nationa~ Union Fire Ins. A++ ~ï~å""23¡~~r~~Îd e Road INSURER c, Granite state Ins. Co. A++ INSURER D' ~awrencevi~~e N908648 INSUAEA E' 'COVERAGES r THE POLICIES OF INSURANce LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FoR THE POLICY PERIOD INDICATED. NOTWITHSTANDING I ~~~ ~~~¥Á~~,~~fiN\~~~EC~F~~~~ ~A~~ ~~~~~ DEO:c~~l~ ~;E~~~u~~~~6~8_\1~ =:~~r~~~~~~ ~~g~~~egF ~~CH ¡ POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 11'f". lYPE OF INSURANce PDLICY NUIIOER DAYE MMJOii~' PQ I D LIMITS DATE MMIOD I A ~NERAL LIARDJlY EACH occuRReNCE . 5 000,000 r..!.~MMeRcIAL GENERAL uABILI1Y GL4178980 02/22/0~ 04/22/03 FlAE DAMAGE (fW¡ 00. ,'O) :50,000 ¡ ---1 CLAIMeMAOe œ DCCUR MEO EXP lAo, - ,alaon) .5,000 X PD Deductib~e S2S.000 .£It .""""""."" PEAeCN"" UDV INJUAY 05,000,000 . GENERALAGGAeGATE 05,000,000 ñ'L A""':ri;l ;:.~: APF"~t,PeR' PAODUCTS - COMP/OP AGG 05,000,000 POLICY X JOCT LOO ~=>MOOß.E LlA.'LI'IV COMBINED SINGlE UMIT >1,000,000 'A '- ANY AUTO CA50S4514 02/22/02 04/22/03 (E. "'idenl) I-- All. CWNeD AUTOS SDD"V INJURY ~ SCHË!""."O AuTOS ".r..~'n) 0 ~ I'IIAEDAUTDS BODILY INJuRY ~ NON-DWN.O AUTOS (?oIa'o1"n~ S X Compo $1000 ded PAOPEAlY DAMAGE X Coll. $1000 ded. ,PM ""idenl) : RRAGE LIAOILI'IV AUTO ONLY..A Ar;c¡D-NT 0 ANY ALfI'O DTI<ER THAN EAACO: AUTOONLV, AßG . exC"ss LlABILnY eACH OCCUAAeNC. olD 000,000 B tfj'OCCUA D CLAIMS MADE B£2131241 02/22/03 02/22/04 AGGREGAT- . ~O,OOO,OOO 0 ~ DËDUCTISLE . X A""'NTION . 10000 : WORIŒR. COMPENBATIOH AHD X I ~A~'6'.:.urS I lo¿~ C "MPLO,,"RS' lIABlUlY WC53G2981 07/23/02 07/23/03 e.L. eACH ACCIDENT .SOO,OOO E.L, Dle""eE. SA EMPLOYE. 0 SOD 000 E,L, DISEA'E - POLICY LIMIT . 500 000 OTH"A A Pollution {o Prof. COPS 761-93-31 02/22/01 04/22/03 Per Claim $5,000,000 Liab.-Claims Made RETRO DATE' 7/1/88 Aaa:r:eaate S5000,OOO DESCRIPTION OF DPERA TIONS/LOCATlONSN5HIClESIEXCWSIDNS ADOED OY eNDOReEMENTlSpeClAL PRDVISIOH. City of Oshkosh, its employees and officers, council members, agents and authorized volunteers are included as addi~iona~ insureds with respect general ~iabi~ity and automobile ~iahili~y with respects work performed by or on behalf of the Named Insured. Insurance hereunder sha~l be primary. CERTIFICATE HOLDER I N I ADOIT1ONAL ,"SURIiD; INSUReR LETTER: CANCEL1.ATlON OSBKO01 SHOULJ> ANV OF THE AB',,", oæCAIlED PouelES BE CANCeU"D BEFORE TH" EXPIRATIoN oATe THeAEOF, TH" ISSUINO IN.uReR WILL ENDEAVOR TO MAIL ...z.!L. DAyS WßrnëN City of Oshkosh, Wisconsin NOTICE TO THe CEATlFlCATE HDLCER NAMED TO TN" LI1FT, BUT FAILURE TO DO SO SHAU IMPQ.EHO .OLIOATIONOR UABILlTYoFANY KIND UpoN THE INSURER, ITS AOENTSOR REPRE5ENTATIVES. AUTHOR"'¡O "¡PAESENTATIVE ~-t:d ð Alhert P Everts II ACORD 25.S (1/97) @ACORØCO~ORA~ON1~