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Home My WebLink AboutGrand Opera House/06 ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE 05/02/2006 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Brehmer Agency, Inc. (262) 781-3714 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 12800 W. Silver Spring Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 0498 INSURERS AFFORDING COVERAGE Butler WI 53007- INSURED INSURER A: STARNET INSURANCE COMPANY Alltech Elevator, Inc. INSURER B: ACUITY 309 Wilmont Drive INSURER C: LIBERTY MUTUAL INSURANCE CO. INSURER D: Waukesha WI 53189- 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 MA'( 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. INSR TYPE OF INSURANCE POUCY NUMBER Pg.i~~:~~~8~f Pg~~l(~'gi~~N UMITS LTR A GENERAL LIABILITY / / / / EACH OCCURRENCE $ 1,000,000 ~ 100,000 X COMMERCIAL GENERALLIABIUTY FIRE DAMAGE (Anyone fire) $ I CLAIMS WoADE ~ OCCUR JMSOOO018700 05/01/2006 05/01/2007 MED EXP (Anyone person) $ 10,000 --'------ X PER ELEVATOR-AGGREG. PERSONAL & ADV INJURY $ 1,000,000 / / / / GENERAL AGGREGATE $ 3,000,000 ~'L AGGR@ElIMIT AFlES PER: PRODUCTS.COM~OPAGG $ 1,000,000 POLICY X ~~g;: LOC / / / / ~UTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 - B ALL OWNED AUTOS K28455 05/01/2006 05/01/2007 BODILY INJURY - SCHEDULED AUTOS (Per person) $ - X HIRED AUTOS / / / / BODILY INJURY - ~ NON.OWNED AUTOS (Per accident) $ X Compo Oed. $250 / / / / PROPERTY DAMAGE X Col.lision Oed. $500 (Per accident) $ ~RAGE UABILfTY AUTO ONLY. EA ACCIDENT $ ANY AUTO / / / / OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS lIABILITY / / / / EACH OCCURRENCE $ :J'OCCUR D CLAIMS MADE AGGREGATE $ $ ==i DEDUCTIBLE / / / / $ RETENTION $ $ WORKERS COMPENSATION AND WC1-34S-382720-016 / / / / X TWCSTATU-} 10TH. EMPLOYERS' LIABILITY TORY LIMITS ER ~.l. EACH ACCIDENT $ 100,000 C 05/01/2006 05/01/2007 E.l. DISEASE. EA EMPLOYEE $ 100,000 C EC~U\'it= 500,000 OTHER ~ / / / DESCRIPTION OF OPERA TlONSlLOCA TlONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS f toY IWsAof.,2,9ll,6"B · · RE: THE GRAND OPERA HOUSE, 100 HIGH AVENUE, OSHKOSH, WI. ADDITIONAL INSURED OPERA HOUSE, TO GENERAL LIABILITY ONLY. --- ... ~lTY CLERK1S OFFICE~ CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLE[I BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT - CITY OF OSHKOSH FAILURE TO DO SO SHALL IMPOSE NO OBLIGA7R LIABILITY OF ANY KIND UPON THE ATTN: DON LAFONTAINE INSURER, ITS AGENTS OR REPRESENTATIVES. . . A 215 CHURCH AVENUE AUTHORIZED REPRESENTATIVE ---;If/~''J4./~ 7L ;:l "',-r,/l' OSHKOSH WI 54901 ACORD 25-S (7/97) @ACORD CORPORA~1988 tfcTM-INS025S (9910}m ELECTRONIC LASER FORMS, INC. . (800)327-0545 Page 1 of2 OSHKOSH-01 ACORQ.. CERTIFICATE OF LIABILITY INSURANCE KOMA PRODUCER Insurance Services, Inc. 122 E College A ven ue PO Box 877 Appleton, WI 54912-0877 DATE (MM/DDIYY) 01/25/2006 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOR.MATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOI::S NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO fH~IN$VRE:[) NAIvlE:D A'El9Y~ FORJ'H~F~~19YF>~fCm It',jBIQAJED. t',jQTWi'r'HsIANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHE:g [)()CUIvlE:Nf WITI-fR.ES'PE;CT TOWHIQR T81$~~RfIFr(';ATE MAYBEIS$Ut::R QR MAY PERTAIN, THE INSURANCE AFFORDED BY THE PO~IQIES DESCRIBEp HE:R~IJI.1fSSUBJECttO ALL Tl-fETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE ElEEN REDUCED BY pAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY $ 02/01/2007 $ $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS-COM~OPAGG $ Public Officials E & 0 COMBINED SINGLE LIMIT $ INCLUDED 02/01/2007 (Ea accident) BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) (920) 739-7711 INSURERS AFFORDING COVERAGE --..- - - --. ~ INSURED City Of Oshkosh : ATIN:. Don LaFontaine POBox 1130-- Oshkosh, WI 54903-1130 INSURER A: Lea ue of WI Municipalities Mutual Insurance INSURER B: INSURER C: INSURER D: INSURER E: A X COMMERCIAL GENERAL LIABILITY 70266 CLAIMS MADE [iJ OCCUR X Public Officals E & 0 X Emplovee Benefits Liab 02/01/2006 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- LOC AUTOMOBILE LIABILITY A X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON-OVVNEDAUi'OS .... 70266 02/01/2006 GARAGE LIABILITY ANY A.lJXO AUTO ONLY - EA ACCIDENT $ EA ACC $ AGG $ $ $ $ $ $ E.L. EACH ACCIDENT OT~ bTHERTHAN AUTO ONLY: EXCESS LIABILITY OCCUR D CLAIMS MADE EACH OCCURRENCE AGGREGATE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS D ~ [JAN 27 2006 CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION ''', r\ 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Grand Opera House Foundation 215 Church Avenue Oshkosh, WI 54901- ."". ACORD 25-S (7/97) '\'