HomeMy WebLinkAboutDavid Schmidt-850 Portside Ct
CERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company 0
American Family Mutual Insurance Company if selection box is not checked.
6000 American Pky Madison, Wisconsin 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
'COWFi~GE .
This is to certify that 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 poiicies described herein is subject to ail the terms, exclusions, and conditions of such policies.
PlY A
TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS OF LIABILITY
Mo Da Yr Mo Da Yr
Bodily Injury and Property Damage
Each Occurrence $ ,ODD
Bodily Injury and Property Damage
Each Occurrence $ ,000
Bodily Injury and Property Damage
Each Occurrence $ ,000
Farm Liability & Personal Liability
Each Occurrence $ ,000
Farm Employe(s Liability
Each Occurrence $ 000
Statutory ************
Each Accident $ ,ODD
Disease - Each Employee $ ,000
Disease - Policy Limit $ ,ODD
General Aggregate $ 2,000 000
Products - Completed Operations A regate $ 2,000 ,ODD
2/5/2007 2/5/2008 Personal and Advertisin In"u $ 1,000
Each Occurrence $ 1,000,000
Dama e to Premises Rented to You $ 25 000
Medical Expense (Any One Person) $ 5 000
Each Oocurrencet t $ ,ODD
Aggregatett $ ,000
Common Cause Limit $ ,000
Aggregate Limit $ ,ODD
Bodily Injury - Each Person $ ,ODD
Bodily Injury - Each Accident $ ,ODD
Property Damage $ ,000
Bodily Injury and Property Damage Combined $ ,ODD
Each Occurrence/Aggregate $ ,ODD
Homeowners/
Mobilehomeowners Liability
Boatowners Liability
Personal Umbrella Liability
Farm/Ranch Liability
Workers Compensation and
Employers Liability t
General Liability
00 Commercial General
Liability (occurrence)
PENDING
o
o
Businessowners Liability
Liquor Liability
Automobile Liability
o Any Auto
o All Owned Autos
o Scheduled Autos
o Hired Auto
o Nonowned Autos
o
Excess Liability
o Commercial Blanket Excess
o
Other (Miscellaneous Coveraaes\
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS
INSPECTOR/APPRAISER - LAND
t The individual or partners shown as insured 0 Have 0 Have not
elected to be covered as employees under this policy.
t t Products-Completed Operations aggregate is equal to each
occurrence limit and is inctuded in policy. aggregate.
Should any of the a ove escribe p . les e cancelled before the
expiration date thereof, the company will endeavor to mail *( days)
wntten notice to the Certificate HolBer 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
number of days shown.
o This certifies coverage on the date of issue only. The above
described policies are subject to cancellation in conformity with their
termq and by the laws of the state of issue.
. CITY OF OSHKOSH
215 CHURCH AVE
OSHKOSH, WI, 54901
DATE ISSUED
U-201 Ed. 5/00
Certificate Holder
1/16/2007
Stock No. 06668 Rev. 7/02