HomeMy WebLinkAboutLakeshore Golf Course 05/06
DATE (MM/DD/YY)
09/30/05
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTlFICA TE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
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.
INSR
LTR
PRODUCER
Aon Risk services, Inc. of the carolinas
121 west Trade Street
2400 Interstate Tower
charlotte NC 28202 USA
PHONE- 866) 283-7124 FAX-(866) 430-1035
INSURER A:
INSURERB:
INSURED
Compass Group USA, Inc.
Canteen vending, Eurest Dining,
chartwells
2400 yorkmont Road
charlotte NC 28217-4611 USA
INSURER C:
INSURER D:
INSURERE:
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECT
DATE(MM\DDlYY)
A
GL5749897
commercial General Liability
09/30/05
GENERAL LIABILITY
A
5768948
Auto - All other States
5768950
Auto - Texas only
5768949
05-06 Auto - VA only
5768951
05-06 Auto - MA Only
09/30/05
09)30/05
09/30/05
09/30/05
COMMERCIAL GENERAL LL-iliILIW
CLAIMS MADE 0 OCCUR
Contractual
GEN'L AGGREGATE LThill APPLIES PER:
POLICY 0 ~g~ [8] LOC
AUTOMOBILE LIABILITY
. A.NY AQTO
ALL OWl\'ED AvrOS .
SCHEDULED AurOS
HIRED AUTOS
A
NON OWNED AUTOS
Self Ins.phys.Damage
A
A
GARAGE LIABILITY
o
6610568
wc - All other states
6610572
work comp (WI only)
6610569
wc (AZ,ID,MD,OR,VA)
09/30/05 09/30/06 OTH-
ER
09/30/05 09/30/06
E.L. DISEASE-POLICY LIMIT
09/30/05 09/30/06
E.L. DISEASE-EA EMPLOYEE
OCCUR
o CLAIMS MADE
47UKA14 09
Excess Liability (1st Layer)
09/30/05
DEDUCTIBLE
RETENTION
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
E
C
OTHER
DESCRIPTION OF OPERA TIONSILOCA TIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
INSURERS AFFORDING COVERAGE
American Home AssUrance Co.
New Hampshire Ins Co
Insurance company of the State of PA
ACE American Insurance company
Commerce & Industry Ins Co
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POLICY EXPIRATION
DA TE(MM\DDWY)
09/30/06
LIMITS
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VI
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VI
EACH OCCURRENCE
$1.,000,000
$1,000,000
FIRE DAMAGE(Anv one fire~
MED EXP (AnI' one person)
PERSONAL & ADV INlURY
$1,000,000
$10,000,000
$1,000,000
$1,000,000
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GENERAL AGGREGATE
PRODUCTS-COMP/OPAGG
Liquor Liability Lim
09/30/06
09/30/06
09/30/06
09/30/06
COMBIN"ED SINGLE LIMlT
(Ea accident)
$5,000,000
BODILY INlURY
( Per person)
BODILY INlURY
(Per accident)
PROPERTY DAMAGE
(per accident)
AUTO ONLY - EA ACCIDENT
OTHER THAN
AUTO ONLY:
EA ACC
AGG
09 30 06
EACH OCCURRENCE
$10,000,000
$10,000,000
$10.000,000
AGGREGATE
products/Comp 1 eted 0
$2,000,000 =
$2,000,000 !I!
$2,000,000 iiii
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LAKESHORE GOLF COURSE
215 CHURCH AVENUE
OSHKOSH WI 54901- USA
P 'LI~S.flt~~i';h,i:EoilEF~IRATlON
DATE THEREOF, THE ISSUING CO kVGR"ULMAlk....:......__.::::._.i
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT F AlLURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF A.1'\!Y KIND UPON THE COMPA-NY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENT A TIVE
~ ~ SelWiad. 1,g.. ~ 76e ~
Attachment to ACORD Certificate for 6)mpass Group USA, Inc._
The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the
coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the
policy.
ADDITIONAL POLICIES
If a policy below does not include limit information, refer to the corresponding policy on the ACORD
certificate form for policy limits.
INSURER F Illinois National Insurance Co
INSURER
INSURER
INSURER
INSURER
INSURED
Compass Group USA, Inc.
Canteen vending, Eurest Dining,
chartwells
2400 yorkmont Road
Charlotte NC 28217-4611 USA
POLICY POLICY
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS
LTR POLICY DESCRIPTION DATE DATE
GARAGE LIABILITY
5768948 09/30/05 09/30/06 Garage Limit
A ~uto - All Other States $500,000
WORKERS COMPENSATION
6610571 09/30/05 09/30/06
A Workers Comp (CA)
6610570 09/30/05 09/30/06
B Nork Comp (MO,NY)
6610573 09/30/05 09/30/06
F work Comp (FL ONLY)
DESCRIPTION OF OPERA TIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Certificate No :
570015101237