HomeMy WebLinkAbout501-509 N Main St
OP 10 K DATE (MM/DDIYYYV)
INLCOM2 05 26 06
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA.TION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ACORDN
CERTIFICATE OF LIABILITY INSURANCE
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.
J~~\,~"'-~" TYPE OF INSURANCE POLICY NUMBER
GENERAL LIABILITY
PRODUCER
~lwaukee Office
Frank F. Haack & Associates
P. O. Box 26997
~lwaukee WI 53226-0997
Phone:414-475-1100 Fax: 414-475-1833
INSURED
~~~a~tJ~a~~~~~ St., Ste. 400
~lwaukee WI 53202
COVERAGES
A
x . COMMERCIAL GENERAL LIABILITY
8:4 ~~''''":' 11<]:"R
GEN'L AGGREGATE LIMIT APPLIES PER:
-:JPOUCY jr8i LOC
AUTOMOBILE LIABILITY
K44165
A
K44165
A
CLAIMS MADE
K44165
$0
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
A ANY PROPRIETOR/PARTNER/EXECUTIVE
, OFFICER/MEMBER EXCLUDED?
I If yes, describe under
1 SPECIAL PROVISIONS below
OTHER
K44165
A Property Section
K44165
INSURE~_ Acui 1::Y_~___
INSURER
INSURER C:
INSURER D:
INSURER E:
LIMITS
$ 1 {.S!Q.9.,..99.9_.
_UJ>.QLQQ9____. ..
~,.i>"QQ_~..~ .
$ 1 ,90 OLO..9Q____
$ 2 L~~9_9_L(LOQ.__
_~_1.L900LQO(L._n
l EACH OCCURRENCE
1"DAlJlAGETtJREN~-"
~'_E....R.'EM~S.E..s,'(..E..a. o.c..c..ure n.c.e1...
. MED~~(p,ny one pe~~_.
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
---"_.- -
05/31/06
I COMBINED SINGLE LIMIT 1 ()OO 000
05/31/07 ' (EaaCc~dent)~__ $, ,
~ODIL Y INJURY $
. . ..... (Per person)
~__~__._~___ ~._~_ ..L. _-'--"-.
BODILY INJURY I
, (Per accident) $
PROPERTY DAMAGE
(Per accident)
rf\~!~_~~LY.~~6!,cCI~!=_N.fc~~;.~'c..- .
'iOTHERTHAN EA ACC $
i AUTO ONLY: AGG $
EACH OCCURRENCE _ $ 5.t'QQQ.,..9_()9...
05/31/07 [,,="--__t~O~69~-
I $
! X I WC STATU- I JOTH-
05/31/07~. ~~~:~I;;~:E~ _ER 1$- 100000~.._n
_~1 E.L. DISEASE - EA EMPL~ 100000
EL DISEASE - POLICY LIMIT $ 500000
05/31/06
05/31/07
$145,000
Pers Prop
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
City of Oshgosh, its officers, council members, agents, employees,
authorized volunteers are named as Additional Insureds. Location 0
Property: Webster Building; 501-509 N. Main Street, Oshkosh, WI 549
re (Ct~ ~ Vi Ji~
~ '. -- '\\ \\
MAY 3 1 200~~
CERTIFICATE HOLDER CANCELLA liON
CITOF01 SHOULD ANY OF THE ABOVE DEseRIB
DATE THEREOF, THE ISSUING INSURER
CITY OF OSHKOSH
215 CHURCH AVENUE
OSHGOSH WI 54903-1130
ACORD 25 (2001/08)
@ ACORD CORPORATION 198!