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Home My WebLink AboutSchmidt, David CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company D American Family Mutual Insurance Company if selection box is not checked. 6000 American Pky Madison, WiscQnsin 53783-0001 Agent's Name, Address and Phone Number (Agt./Dist.) Dennis Cahoon (920) 235-3220 459 N Washburn PO Box 2924 Oshkosh, WI 54903-2924 (056/015) 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 listed below. Insured's Name and Address David Schmidt 850 Portside Ct Oshkosh, WI 54901-1640 This is to certify that policies of insurance listed below have been issued to the insured named above for the poiicy 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. PLY EFFECTIVE Mo Da Yr POLICY NUMBER EXPIRATION Mo Da Yr LIMITS OF LIABILITY TYPE OF INSURANCE Homeowners/ Mobilehomeowners Liability Boatowners Liability Bodiiy Injury and Property Damage Each Occurrence $ ,000 Bodily Injury and Property Damage Each Occurrence $ ,000 00 General Liability Commercil:lI General Liability (occurrenCe) -.....'...:,... PENDING 2/5/2007 Bodiiy Injury and Property Damage Each Occurrence Farm Liability & Personal Liabiiity Each Occurrence Farm Employer's Liability Each Occurrence Statutory Each Accident Disease - Each Employee Disease - Policy Limit General Aggregate Products- Cori1pieieifOpera.tions)(greg~te . $ $ $ ,000 Personal Umbrella Liability Farm/Ranch Liability ,000 000 Workers Compensation and Employers Liability t ************ o o Businessowners Liability Medical Expense (Any One Person) Each Occurrencet t Aggregatett Liquor Liability Automobile Liability D Any Auto D All Owned Autos o Scheduled Autos D Hired Auto D Nonowned Autos D Excess Liability D Commercial Blanket Excess D Other (Miscellaneous Coveraaes) Common Cause Limit Aggregate Limit Bodily Injury - Each Person Bodily fnjury - Each Accident Property Damage ,000 ,000 Bodily Injury and Property Damage Combined $ ,000 Each Occurrence/Aggregate $ ,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS INSPECTOR/APPRAISER - LAND t The individual or partners shown as insured D Have D Have not eiected to be covered as employees under this poiicy. t t Products-Completed Operations aggregate is equal to each o~currenceHrnit~ncl is in.cluded_i~. policy aggregate. . ..~ c;n;v9f<?SHKOSH 215 CHURCH AVE OSHKOSH, WI, 54901 Shouldanyo . tea' ovedescribed poliCies be cancelled before the expiration date thereof, the company will endeavor to mail "( days) written notice to the Certificate Holaer named, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives. "10 days unless different numberof days shown. o This certifies coverage on the date o(issue only. The above described policies are subject to cancellation in conformity with their terms and by the laws of the state of issue, DATE ISSUED 1/16/2007 Stock No. 06668 Rev. 7/02 U-201 Ed. 5/00 Certificate Holder