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MECHTEC..01
BRBA
ACOR~M CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY)
09/08/2005
PRODUCER (920) 739-7711 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
122 E College Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO Box 877
Appleton, WI 54912-0877 INSURERS AFFORDING COVERAGE
INSURED Mechanical Technologies Inc INSURER A: Reaent Insurance Co
POBox 12176 INSURER B: General Casualtv Co of WI
Green Bay, WI 54307-2176 INSURER c:
INSURER 0:
I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR tHE POLICY PERIOD INDiCATED. NotWitHsTANOING
ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECT to WHICH THIS CERTIFICATE MAY BE ISSUED (jR
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.
I~M TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION I LIMITS
EACH OCCURRENCE $ 1 000 00(
BFl~I)~MA~~~L onelir~ L_~____"1Q9))Qt
MED EXP (Anyone person) $ 5 001l
PERSONAL & ADV INJURY $ 1,OOO,OOll
GENERAL AGGREGATE $ 2.0000011
PRODUCTS - COMP/OP AGG $ 2,000,OOIl
~NERAL LIABILITY
A X COMMERCIAL GENERAL LIABILITY CCI0281343
I CLAIMS MADE [iJ OCCUR
09/11/2005
09/11/2006
~
~
~N'L AGGRE~E LIMIT AP~S PER:
I POLICY I X I ~fR-;: I I LOC
~TOMOBILE LIABILITY
B X ANY AUTO
--"- ALL OWNED AUTOS
f-- SCHEDULED AUTOS
eX HIRED AUTOS
eX NON-OWNED AUTOS
CBA0281343
COMBINED SINGLE LIMIT $
09/11/2005 09/11/2006 (Ea accident)
BODILY INJURY 1$
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
, (Per accident)
I AUTO ONLY - EA ACCIDENT $
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EACH OCCURRENCE $
09/11/2005 09/11/2006 AGGREGATE $
$
$
$
~1C STATU-, i jOJbI-
DBYLIMJIS
09/11/2005 09/11/2006 E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
I---
nRAGE LIABILITY
11 ANY AUTO
EXCESS LIABILITY
A [Xj OCCUR D CLAIMS MADE
ICCU0281343
n DEDUCTIBLE
iii RETENTION $
10 000
.... WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY .
A
CWC0281343
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
, Commerci~1 Gelleral L.i';bilityC~~er~ge Includes aBI~llket "dc~.i!Ipncill~fgr~CfgH~~t~~T~r:
, . ~~________",_=~,_~"""-",,,,,,.:_..c,,_,,,,_.~,,,__~,,,:'~:-,"':''''''''':~':,:-:'~'~''-^~':':''"''-'''''' :":'-'~_'~:'::-"'<":-~,-~'-,':.::" ~-''':''::-~:''>~'~'':'::,~'~~~~;;(f/''.
. Re: Oshkosh Waste Water Treatme....t Plant, MonorailCraneSystemr7'
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CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER:
CANCELLATION
1,000,001l
5,OOO.OO(
5 OOO,OO(
100,OOll
100,OOll
500.0011
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
City of Oshkosh
POBox 1130
Oshkosh, WI 54902-1130
I
ACORD 25-S (7/97)
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@ACORDCORPORATION1988