HomeMy WebLinkAboutOshkosh Truck/05-06
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID K~ DATE (MM/DDNYYY)
90SHTRK OS/23/05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Hays Companies of WI HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1200 N. Mayfair Road Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Milwaukee WI 53226
Phone:414-443-0000 Fax:414-259-B44B INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: ScottsdaJ.e Insurance Company
INSURER B:
Oshkosh Truck co~oration INSURER C:
2307 oreaon St'j 0 Box 2566 INSURER D:
Oshkosh I 5490 -2566
INSURER E:
COVERAGES
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, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
LTR NSR
TYPE OF INSURANCE
GENERAL LIABILITY
f--
X COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE ~ OCCUR
POLICY NUMBER
PJÃ,;!ffJ~rJ¡f~E p~k~Cl(~rlb~~N
A
X
RBSOOO04B7
04/01/05
EACH OCCURRENCE
04/01/0 6~~~~'Es (Ea occurence)
MED EXP (Anyone person)
PERSONAL & ADV INJURY
I--
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
I--
GEN'L AGGREGATE LIMIT APPLIES PER:
I::=i n PRO- n
IX I POLICY JECT LOC
AUTOMOBILE LIABILITY
I--
COMBINED SINGLE LIMIT
(Ea accident)
I--
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY
(Per person)
I--
I--
SCHEDULED AUTOS
HIRED AUTOS
BODILY INJURY
(Per accident)
I--
I--
NON-OWNED AUTOS
-
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
==¡ ANY AUTO
EXCESs/UMBRELLA LIABILITY
~ OCCUR D CLAIMS MADE
I D,EDU,CTIBLE
I RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OTHER
AUTO ONLY - EA ACCIDENT $
EAACC $
AGG $
$
$
$
$
$
OTHER THAN
AUTO ONLY:
EACH OCCURRENCE
AGGREGATE
I~',-, f? ff~ ~¡f\V7, -- rf5,~.I'~'\
0" \...::1. '" l5 u \~ :...'":1, ') !,
, .,' ¡'-----" -------
- " ..
'LTU,L_~A) 2 5 200~.j! :~J-,. j
I
c:rrv ClJ:RV :;~_: {H:¡;:'f': î
TTORY LIMITS I IU¿~-
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
,-...-. ""'" ,"~ -". .._,'
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE: Application - communications conduit being installed under W Waukau
Avenue in two locations at the 370 W Waukau Avenue property owned by Oshkosh
Truck Corporation. City of Oshkosh is included as an additional insured but
only with respects to liability arising out of Oshkosh Truck Corporation's
operations subject to the policy terms, forms, conditions & exclusions
CERTIFICATE HOLDER
CANCELLATION
LIMITS
$1,000,000
$ 500,000
$
$ 1,000,000
$5,000,000
$2,000,000
$
$
$
$
City of Oshkosh
City Clerk-City of Oshkosh
Attn: Angela Joeckler
215 Church - POBox 1130
Oshkosh WI 54903
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR ,LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
OSHKOS
REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE,'
Daniel J. Sa iro
(, .
Z{~
@ACORD CORPORATION 1988
ACORD 25 (2001/08)