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CERTIFICATE OF LIABILITY INSURANCE D;~~~~7::~
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTIER THE COVERAGS AFFORDED BY THE POUCIES BELOW.
INSURERS AFFORDING. COVERAGE
PRODUCER
Insurance Services, Inc.
200 E Washington St
PO Box 877
Appleton, WI 54912-0877
INSURED
City of Oshkosh
POBox 1130
Oshkosh, WI 54902-1130
INSURER A: Lea
INSURI(¡R EI:
INSUR5R c:
INSURER iiI:
íNSURI\!R.:
COVERAGES .. ...." .., . .
THIi: POLICIES OF INSURANCE LJSTt¡t¡> 6 ELOW HÀVE BEeN ISSUËO TO THE IN$UR~ NAMEPABÒ\(5 I"øft THE Pouçy ØeïRIOQ'IN[)!CATftD. NQTvvITHSTANDING
Am RttQUIREMEN'T. TtRM OR coNØtTtôN Q'F ANY CONtRAetoF\ O'Ì1i~ OÖCUM~NTWlTJi! Ft¡¡¡-$PI£CT 1GWHjêHrHts êERTlf~CATi MAY BE .1$Suè:O @R
MAY pêRTAIN, rHË INSURANCËÉ Àf'.FORQËiDBY THE POt.ICIÊSOè:$CRla~DHI!ÉI!æ1NI$ $UBJËCT 1(1) ALL Ti'Ii!! 'fiRMS. ÈXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGG~ATâLIMtTS SHOWN MÂYIllAVE BE.EN RÊDUCEOav prAIO CLAIMS. .. . .
INSR TVPEØP:lN$\JrtANef! - -.I!'ØUøv.HU~IIiE'" --.- ",ø.YEf!$-'V¡;
GENERAL. UABIUTY
A X COMMERCIAl. G~ERAllJABIUTY 1026$
~IMS ~~ [i] ()CC~
X Public OffiCials I & ø
X Employee Benefit lIabilit
GEN'L AGGREGATE LIMIT APPUi;S PÈR:
POliCY PRQ-. Vi>'.' -..
AUTOMOBILEUABIllTY
A X ANY AUTO
02101/2004
02101/2005
LIMITS
70266
02/0112004
021011200$
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOs
BPDlLYINJURY
(Per pelsØA)
$
BP01LY INJURY
(Per aØcii!lent)
$
GARAGE LIABILITY
ANY AUTO
-I'~---'
PJroMERTY DAMAGE
(Per¡!!l!íident)
AUT'ØONlY - lEA ACCIDENT
OtNE- THAN eA ACC
AUi'O ONLY: AGG
$
EXCESS UABILITY
OCCUR D CLAIMS MADE
~O(¡i;C~e¡NCÈ
AGGREGATE
DEDUCTiBlE
R.IITEN1'1ON
$
WORKERS COMPENSATION AN!)
EMP/.,OYERS'UABRJTY
OTHER
DESCRIPTION OF OpERA TlONSILOCA TlONsMHlCteSJÉ)(CLUSIGNS ADDED IiYENDORtlEME
JAN 2 4 2005
CITY CLERK'S OFFICE
CERTIFICATE HOLDER
ADDITIONAL I~URED. INSUQR lE'TTEJR:
CANCiLLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAll~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TODG SO SHALL
IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESE A TlveS.
. .
AUTHORIZED REPRESENTATIVE
Advocap Inc.
Terri Sterns
Winnebago County Nutrition Program
19 W 1st Street
Fond Du Lac, WI 54936-1108
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ACORD 25-S (7/97)