HomeMy WebLinkAboutRenovations/Fluor Brothers
PRODUCER
Aon Risk services, Inc. of wisconsin
111 N. washington street, suite 300
P. O. BoX 23004
Green Bay WI 54305-3004
DATE (MM/DD/YV)
10/28/05
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.
COMPANIES AFFORDING COVERAGE
PHONE. (920) 437-7123 FAX. (920) 431-6345
INSURED
Fluor Brothers Construction co., Inc.
203 Otter Avenue
P. O. Box 2326
oshkosh WI 54903 USA
COMPANY
A
Travelers Indemnity Co of America
COMPANY
8
St paul Fire & Marine Insurance Co.
COMPANY
C
THIS IS TO CERTIFY THAT 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 ISSUEDOR MAY PERTAIN,THE II'tSURA-f'iC...E AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS.6F"SUCRpOOClEs.l.1MITS SHOWN MAY HAVE BEEN REDUCEOBVPAlbCLAIMs. ..
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPlRA TlO LIMITS
DATE (MMlDD/YY) DATE: (MMlDD/YY)
10/31/05 10/31/06 GENERAL AGGREGATE $2,000,000
PRODUCTS-COM~OPAGG $2,000,000
PERSONAL & ADV INJURY $1,000,000
EACH OCCURRENCE $1,000,000
FIRE DAMAGEOiny one fire) $100,000
MED EXP (Anyone person) $5,000
10/31/05 10/31/06 COMBINED SINGLE LIMIT $1,000,000
BODILY INJURY
( Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
10/31/05 10/31/06 EACH OCCURRENCE
AGGREGATE
B
KC04800026
CASUALTY PACKAGE
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE. 0 OCCUR
OWNER'S & CONTRACTOR'S PROT
B AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
Kc04800026
CASUALTY PACKAGE
B EXCESS LIABILITY
X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
KC04800026
CASUALTY PACKAGE
A
WORKER'S COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR!
PARTNERS/EXECUTIVE
OFFICERS ARE:
DTH-UB-0052C45-0-05
WORKERS' COMPENSATION
10/31/05
INCL
EXCL
i
II!
ii
..
DESCRIPTION OF OPERATIONSlLOCATIONSlVEHICLESlSPECIAL ITEMS
RE: POLICE DEPT. RENOVATIONS, OSHKOSH, WI. ADDITIONAL INSURED ON THE GEN
A PRIMARY BASIS THE CITY OF OSHKOSH, ITS ELECTED AND APPOINTED OFFICIALS & EMPLOYEES AS RESPECTS THE PROJECT
ABOVE PER BLANKET ADDITIONAL INSURED ENDORSEMENT.
CITY OF OSHKOSH
215 CHURCH AVE.
OSHKOSH WI 54902 USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
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