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Home My WebLink AboutAlltel ACORDm CERTIFICATE OF LIABILITY INSURANCE OP 10 A~ DATE (MM/DDNYYY) ALLTE-8 12/28/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAT~ON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Rebsamen Insurance Inc(LR) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1500 Riverfront Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Little Rock AR 72202 Phone:501-661-4800 Fax:501-666-9592 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Cincinnati Ins CO INSURER B: Liberty Insurance Corp* ~pleton-Oshkosh-Neenah MSA INSURER c: 'MARSH USA IS BROKER OF RECORD P. O. Box 2177 INSURER D: Little Rock AR 72203-2177 INSURER E: COVERAGES _. ." ,.... ....., THE POLICIES OF IN~URANCE LISTED BELOW HAVE BEEN ISSUED TO HiE INSURED NAMED ABOVE FOR THE POLICY pERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERMOR 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. ~~~ ~~~ TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITY - X COMMERCIAL GENERAL LIABILITY COP0686800 I CLAIMS MADE ~ OCCUR PD9,,~~rJ~rJg~E PgkJf:(~W,~JlgN A 01/01/05 01/01/06 EACH OCCURRENCE PRE'MiS'Es (Ea occurence) MED EXP (Anyone person) - - GEN'L AGGREGATE LIMIT APPLIES PER: Xl POLICY n ~~8;: n LOC AUTClMOBILELlABILlTY. i. - A ~ ANY AUTO COP0686800 _ ALL OWNED AUTOS INCLUDES GARAGE LIABILITY _ SCHEDULED AUTOS ~ HIRED AUTOS ~ NON-OWNED AUTOS - PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS-COM~OPAGG COMBINED SINGLE LIMIT 01/01/05 01/01/06 (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EACH OCCURRENCE 01/01/05 01/01/06 AGGREGATE ~RAGE LIABILITY I ANY AUTO EXCESS/UMBRELLA LIABILITY A :!J OCCUR D CLAIMS MADE I DEDUCTIBLE ~ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE B OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER CCC4428700 ,_,",..'..,",...",.._,- LIMITS $ 1,000,000 $ 1,000,000 $ 5,000 $ 1,000,000 $2,000,000 $ 2,000,000 $ 1,000,000 $ $ $ $ $ $ $ 10,000,000 $ 10,000,000 $ $ $ WA7-64D-005098-015 WC7-641-005098-025 01/01/05 01/01/05 X I TORY LIMITS i i oJ~- 01/01/06 E.L. EACH ACCIDENT $ 500,000 01/01/06 EL DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 - DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ....... e.@ RE: Oshkosh 26. Certificate Holder is included as Additional In r- ~~-Ie n W ~ ~l -, V n JAN 0 4 ?OWj .'l CITY 1"'1 -- A Prop-Direct Risk CP00686800 01/01/05 01/01/06 Limit: CERTIFICATE HOLDER CANCELLATION $5,000,000 - City of Oshkosh Attn: Stephan Brand, utilities Superintendent P.O. Box 1130 Oshkosh, WI 54903-1130 CIOFOS2 SHOULD ANY OF THE ABOvl IES O~BH EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~."...S 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. A~IZ'-;:~R~ENTATIVE ACORD 25 (2001/08) @ ACORD CORPORATION 198: ACORDw CERTIFICATE OF LIABILITY INSURANCE OP 10 A~ DATE (MM/DDNYYY) ALLTE-8 12/28/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA TIE Rebsamen Insurance Inc(LR) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1500 Riverfront Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Little Rock AR 72202 Phone:501-661-4800 Fax:501-666-9592 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Cincinnati Ins CO INSURER B: Liberty Insurance Corp* Appleton-Oshkosh-Neenah MSA INSURER C: 'MARSH USA IS BROKER OF RECORD P.O.. Box 2177 INSURER D: Little Rock AR 72203-2177 !, 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. . . .. .. ... L TR NSR[ TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITY I-- A X COMMERCIAL GENERAL LIABILITY COP0686800 I CLAIMS MADE ~ OCCUR PD9,,~ffJ~rJ.f~E PgkJf:(~rJ;b~~~N LIMITS ... I-- I-- ~ ~ ALL OWNED AUTOS SCHEDULED AUTOS HIRED Al.rr6s NON'OWNED AUTOS INCLUDE~GARAGE .LIAB~LITY EACH OCCURRENCE $ 1,000,000 01/01/05 01/01/06 PRE'MiS'Es (Ea occurence) $ 1,000,000 MED EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS-COM~OPAGG $ 2,000,000 COMBINED SINGLE LIMIT $1,000,000 01/01/05 01/01/06 (Ea accident) BODILY INJURY $ (Per person) .. BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EACH OCCURRENCE $10,000,000 01/01/05 01/01/06 AGGREGATE $10,000,000 $ $ $ - - GEN'L AGGREGATE LIMIT APPLIES PER: Xl POLICY n ~~8T n LOC AUTOMOBILE LIABILITY - A ~ ANY AUTO COP0686800 ... I-- GARAGE LIABILITY =1 ANY AUTO EXCESS/UMBRELLA LIABILITY A :!J OCCUR D CLAIMS MADE CCC4428700 I DEDUCTIBLE ~ RETENTION $ WORKERS COMPENSATION AND B EMPkO'yERS'L1ABILlTY ... ... ...... ... ANY PROPRIETOR/PARTNERlEXECUTIVE B OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER WA7-64D~005098-015 WC7-641-005098-025 01/01/05 01/01/05 01/01/06 01/01/06 I v I_~~" '''' u-l IU..!!:'- 0-LJQ.I3Y LIMITS I ER EL EACH ACCIDENT $ 500 , 000 EL DISEASE-EAEMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500 , 000 CERTIFICATE HOLDER CANCELLATION 01/01/06 ...~ r= ~ _.. ~ ~a~ ~ U \:' ~]; !~ JAN 0 4 100~ g -.-. -. --- -.. . VL.a;;.;ru,,~ vr-r'Il,,1:: Limit: $5,000,000 A Prop-Direct Risk CP00686800 01/01/05 - DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Oshkosh 26, City of Oshkosh, Attn: Stephan Brand, Utilities Superintendent, Po Box 1130, Oshkosh, WI 54903-1130 is named as , Insured ATIMA. City of Oshkosh Attn: City Attorney 215 Church Ave. P.O. Box 1130 Oshkosh, WI 54903-1130 CIOFOS2 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. A~11~EPRE~ENTATIVE -1 ACORD 25 (2001108) @ACORD CORPORATION 1988 ACORDw CERTIFICATE OF LIABILITY INSURANCE OP ID A~ DATE (MM/DDNYYYI ALLTE-8 12/28/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Rebsamen Insurance Inc(LR) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1500 Riverfront Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Little Rock AR 72202 Phone:501-661-4800 Fax:501-666-9592 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Cincinnati Ins CO INSURER B: Liberty Insurance Corp* Appleton-Oshkosh-Neenah MSA INSURER C: 'MARSH USA IS BROKER OF RECORD P. O. Box 2177 INSURER 0: Little Rock AR 72203-2177 INSURER E: ... . THE POUCIES OF INSURANCE t:lSTED BELOW HAVE eEEN ISSUED TdTHEINSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED: NOTWITHSTANDING .ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE. MAYBE 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 REDUCEDBY PAID CLAIMS. . I~~~ ~~~[ POUCY NUMBER P_Cl.L1CY EJ'F!=2~E POLICY EXPIRAT~N LIMITS TYPE OF INSURANCE DATE {MMJDDNY DATE (MM/DDNY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 I--- A X COMMERCIAL GENERAL LIABILITY COP0686800 01/01/05 01/01/06 UAMAlj~ I U K~N I ~u $ 1,000,000 PREMISES (Ea occurence) I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) ~_J~.~-_ - PERSONAL & ADV INJURY $ 1,000,000 - GENERAL AGGREGATE $ 2 ,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 XlnPRO- un X POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $1,000,000 A ~ ANY AUTO COP0686800 .01/01/05 01/01/06 (Ea accident) .. I--- A~L OWNED.AUTOs... INCLUJ;lE;S qARAGEI;IAllILITY BODILY INJURY .. $ SCHEDULED AUTOS. . (Per person) I-- ~ HIRED AUTOS BODILY INJURY $ ~ NON-OWNED AUTOS (Per accident) I--- PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $ R ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10,000,000 A ~ OCCUR D CLAIMS MADE CCC4428700 01/01/05 01/01/06 AGGREGATE $ 10,000,000 $ ~ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND --. X IT,(;,,~~~C;~lWS I _..IU~~- B EMPLOYERS' LIABILITY w.A7-64D-005098-015 01/01/05 01/01/06 $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT B OFFICER/MEMBER EXCLUDED? WC7-641-005098-025 01/01/05 01/01/06 E.L. DISEASE - EA EMPLOYEE $500,000 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000 SPECIAL PROVISIONS below OTHER A Prop-Direct Risk CP00686800 01/01/05 01/01/06 Limit: $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Oshkosh 26. City of Oshkosh, Attn: Stephan Brand, Superintendent, PO Box 1130, Oshkosh, WI 54903-1130 is L1 1i"h W 1F1 ~ Insured ATIMA. ,. .111M fl A,.,,,,,," CERTIFICATE HOLDER . CANCEL I LUUJ I i CIOFOS2 SHOULD J 'Gll'Y:J:"L~SCRI I .' __ E LED BEFORE THE EXPIRATION City of Oshkosh DATETHrI~~~ -;'....ISS . ~$ik@lalFye~1V IL ~_ DAYS WRITTEN Attn: City Manager NOTICE TO THE CERTIFICATE HOLD E ,I UT FAILURE TO DO SO SHALL 215 Church Ave. - P.O. Box 1130 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Oshkosh, WI 54903-1130 REPRESENTATIVES. A~lr-;:PRE;>ENTATIVE ACORD 25 (2001/08) @ ACORD CORPORATION 1988 COVERAGES ACORDw CERTIFICATE OF LIABILITY INSURANCE OP 10 1 DATE (MM/DDNYYY) ALLTE 8 01/04/06 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER Rebsamen Insurance Inc(LR) 1500 Riverfront Drive Little Rock .AR 72202 Phone,:.501-661-4800 Fax: 501-666-9592 INSURED Appleton-Oshkosh~Neehah MSA P. O. Box 2177 'Little Rock AR 72203-2177 COVERAGES INSURERS AFFORDING COVE;JPi.i:;~: INSURER A: INSURER B: NAIC# 22667 INSURER c: INSURER D: INSURER E: ~) ',j Lexington Insurance 'C,ornpa;ny *Marsh USA Broker of Record 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. IN:::iK ~~[ POLICY NUMBER PD9,,~~iJ~rD'WtW;E Pgk!fl(~~b~~~N LI MITS LTR TYPE OF INSURANCE GENERAL LIABILITY EACH OCCURRENCE $1,8.50,000 I--- A X COMMERCIAL GENERAL LIABILITY XSLG21714355 01/01/06 01/01/07 PRE'MISES (Ea occurence) $ 150,000 ~ CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5,000 - PERSONAL & ADV INJURY $ 1,8.50,000 - GENERAL AGGREGATE $ 9,8.50,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,8.50,000 Xl n PRO- nLOC X POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $2,000,000 '-- A ~ ANY AUTO ISSH08219035 01/01/06 01/01/07 (Ea accident) ALL OWNED AUTOS BODILY INJURY - $ SCHEDULED AUTOS (Per person) - 'HIRED AUTOS BODILY INJURY - $ NON-OWNED AUTOS (Per accident) f-- ., .. "" .,~;-- ~.:: -.' I--- ',':;:.-' PROPERTY DAMAGE $ . (Per accident) .... , .- GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ =1 ANY AUTO , OTHER THAN EA ACC $ ,"' AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10,000,000 A ~ OCCUR D CLAIMS MADE XOOG23571036 01/01/06 01/01/07 AGGREGATE $ 10,000,000 $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X I TORY LIMITS I IUEft B EMPLOYERS' LIABILITY 64D-005098-016* 01/01/06 01/01/07 $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT OFFICER/MEMBER EXCLUDED? 641-005098-026* 01/01/06 01/01/07 EL. DiSEASE - EA EMPLOYEE $1,000,000 If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000 SPECIAL PROVISIONS below . OTHER C Prop-Direct Risk 7086600 01/01/06 01/01/07 Limit 5,000,000 --=:::;;:\ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS . n 'Vi ~ \ l"'\~ I RE: Oshkosh 26, City of Oshkosh, Attn: Stephan Brand, ~.TS-~~ r Superintendent, Po Box 1130, Oshkosh, WI 54903-1130 ~\ . _ ,~..l_nnaIl\\ \, Insured ATIMA. I' \\ )l "'" 10Gb '! I -'li fi,N 1 \) ','" j j J ,.". \. -~~...- ~,~,~. ~ CERTIFICATE HOLDER CANCELL 0 - _~V'\c:. Of';' ;'...... \ CIOFOS2 SHOULD AN OC~~O I ED~ I.IGJeS"Sf"CANCELLED BEFORE THE EXPIRATION City of Oshkosh DATE THERE~ G INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Attn: City Attorney NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 215 Church Ave. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. Box 1130 Oshkosh, WI 54903-1130 REPRESENTATIVES, A~11~PRE~ENTATIVE -;J ACORD 25 (2001/08) @ACORD CORPORATION 1988 ~et ACORDw CERTIFICATE OF LIABILITY INSURANCE OP ID 1 DATE (MM/DDNYYY) ALLTE-8 01/04/06 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER Rebsamen Insurance Inc(LR) 1500 Riverfront Drive Little RockAR 72202 Phone:501-661-4800 Fax: 501-666-9592 INSURED Appleton-Oshkosh-Neehah MSA P. O. Box 2177 Little Rock AR 72203-2177 iNSURER A: INSURER B: INSURER C: INSURER D: INSURER E: Ace American Insurance., Company Liberty Insurance Corp*' NAIC# 22667 INSURERS AFFORDING COVERAGE [:1 Lexington Insurance 'Company *Marsh USA Broker of Record 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. A TYPE OF INSURANCE GENERAL LIABILITY - X COMMERCIAL GENERAL LIABILITY I CLAIMS MADE ~ OCCUR POLICY NUMBER PD9,,~~rJ~rJ6~E PgkJfEYI~W,b~~~N LIMITS EACH OCCURRENCE $1,850,000 01/01/06 01/01/07 UAMA<.;t: $ 150,000 PREMISES (Ea occurence) MED EXP (Anyone person) $ 5.,000 PERSONAL & ADV INJURY $ 1,850,000 GENERAL AGGREGATE $ 9, 8!50, 000 PRODUCTS - COMP/OP AGG $ 1, 8!50 , 000 COMBINED SINGLE LIMIT $2,000,000 01/01/06 01/01/07 (Ea accident) BODILY INJURY $ (Per person) L TR NSR[ XSLG21714355 A - GEN'L AGGREGATE LIMIT APPLIES PER: Xl POLICY n ~~8;: n LOC AUTOMOBILE LIABILITY - ~ ANY AUTO ALL OWNED AUTOS - _ SCHEDULED AUTOS HIRED AUTOS ISSH08219035 - _ NON-p~;/NE.D tU.:rOS ,',,,;:., I," BODILY INJURY (Per accidenl) $ lI/';-' . B GARAGE LIABILITY ==1 ANYAUTO EXCESS/UMBRELLA LIABILITY ~ OCCUR D CLAIMS MADE R DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERlEXECUTIVE OFFICER/ME'MBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER - .. '. .-C- PROPERTY DAMAGE (Per accident) . - $ ..... AUTO ONLY - EA ACCIDENT . OTHER THAN AUTO ONLY: EA ACe AGG $ $ :..:" .. .... $ $10,000,000 $10,000,000 $ $ $ A XOOG23571036 01/01/06 01/01/07 EACH OCCURRENCE AGGREGATE 64D-005098-016* 641-005098-026* 01/01/06 01/01/06 01/01/07 01/01/07 X I TORY LIMITS I IV~~- E.L. EACH ACCIDENT $ 1 , 000 , 000 EL. DISEASE - EA EMPLOYEE $ 1 , 000 , 000 EL DISEASE - POLICY LIMIT $ 1 , 000 , 000 . C Prop-Direct Risk 7086600 01/01/06 -~'~'Tn\Qr2 ~, 00,000 ~ o~ - DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISION I : RE: Oshkosh 26. City of Oshkosh, Attn: Stephan Brand, Utilit'~ Superintendent, PO Box 1130, Oshkosh, WI 54903-1130 is name Insured ATIMA. i I ddJ.af.fl~ 2006. ~ ~ CITY CLERK'S OFFICE ~ CERTIFICATE HOLDER CANCELLATION . CIOFOS2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Oshkosh DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN Attn: City Manager NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 215 Church Ave. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. Box 1130 Oshkosh, WI 54903-1130 REPRESENTATIVES. A~11-;-EPRE~ENTATIVE ACORD 25 (2001/08) @ ACORD CORPORATION 1988 OlM ACORDw CERTIFICATE OF LIABILITY INSURANCE OP 10 1 DATE (MM/DDIYYYY) ALLTE 8 01/04/06 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER Rebsamen Insurance Inc(LR) 1500 Riverfront Drive Little Rock AR 72202 Phone:5pl-661-4800 Fax:501-666-9592 INSURERS AFFORDING COVERAGE Liberty Insurance NAIC# 22667 INSURER A: INSURER B: INSURER C: INSURER D: INSURER E: Ace American Insurance. -.company INSURED '1; Appleton-Oshkosh-Neehah MSA P. O. Box 2177 ~LittleqRock AR 72203-2177 Lexington Insurance ~.Co~p,any *Marsh USA Broker of Record 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 MAYBE 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. NSR[ POLICY NUMBER POLICY EFFECTIVE P!,lpC!(AA~PIRAT~~N LIMITS LTR TYPE OF INSURANCE DATE (MM/DDNY) DATE MM/DDNY GENERAL LIABILITY EACH OCCURRENCE $ 1,850,000 - A X COMMERCIAL GENERAL LIABILITY XSLG21714355 01/01/06 01/01/07 PRE'MiS'Es (Ea occurence) $ 150,000 I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $ 1,850,000 I-- GENERAL AGGREGATE $ 9,850,000 I-- GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,850,000 !Xl . n PRO- nLOC X POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $2,000,000 - A X ANY AUTO ISSH08219035 01/01/06 01/01/07 (Ea accident) I-- ALL OWNED AUTOS BODILY INJURY ~ $ SCHEDULED AUTOS (Per person) I-- HIRED AUTOS BODILY INJURY - $ NON~QWNED AUTOS {Per accident) I-- I' '. .......".'. : .i,;), .. I-- ..".' .. " I- PROPERTY DAMAGE $ . ... .. .~ . ' (Per accident) , GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $' ==1 ANY AUTO ",:,', OTHER THAN ---, EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10,000,000 A !J OCCUR D CLAIMS MADE XOOG23571036 01/01/06 01/01/07 AGGREGATE $10,000,000 $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X I TORY LIMITS I Iv,n- ER B EMPLOYERS' LIABILITY 64D-005098-016* 01/01/06 01/01/07 $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT OFFICER/MEMBER. EXCLUDED? 641-005098-026* 01/01/06 01/01/07 E.L. DISEASE ~ EA EMPLOYEE $1,000,000 If yes, describe under E L. DISEASE - POLICY LIMIT $1,000,000 SPECIAL PROVISIONS below OTHER C Prop-Direct Risk 7086600 01/01/06 01/01/07 T.~mit 5,000,000 ~ Je! ~ na n " 11 ~ f-'il. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ~ ~: ~o U20:6 jD RE: Oshkosh 26. Certificate Holder is included as Additional Insure -- ::.; .-.. ~, LI J Y ;- CERTIFICATE HOLDER CANCELLATION .. < . ....,- 'f>o_-~ CIOFOS2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Oshkosh DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN Attn: Stephan Brand, Utilities NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Superintendent IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. Box 1130 Oshkosh, WI 54903-1130 REPRESENTATIVES. ~lr~EPR~ENTATIVE -r ACORD 25 (2001/08) @ACORD CORPORATION 1988 QJJWL