HomeMy WebLinkAboutOshkosh City Cab/06
ACORlJ,~"- CERTIFICATE OF LIABILITY INSURANCE
DATE, (M~/DIJNYYY)
OSHKO~l 01/19 07
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON TAECERTIFICA TE
HOLDER. THIS CERTIFiCATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCER
Burkart-Heisdorf Insurance
www.burkart-heisdorf.com
1807 Erie Avenue
Sheboygan WI 53081
Phone:920-458-6174 Fax: 920-458-1363
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
'Oshkosh City Cab Co., Inc.
Mr, Don Dav1es"
2723 Harrison Street
Osh,k,9.sh WI 54901
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURER E:
American Country Insurance Co.
AmComp Assurance Corp
Wilson Mutual Insurance,
COVI:RA<3I:S
THE POLICIES OF INSURANCE LISTED BElow HAVE SEEN ISSUED TO THE INSUR.ED NAMEb ABOVE FORTHE POLICY PERIOD INOICATEb, NdT\fVl'rHSTf;NbING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYB'E 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.
L TR NSR TYPE OF INSURANCE POLICY NUMBER
GENERAL LIABILITY
C X COMMERCIAL GENERAL LIABILITY BP182825
CLAIMS MADE ~ OCCUR
LIMITS
EACH OCCURRENCE $ 500000
01/21/06 01/21/07 PREMISES (Ea occurence) $ 250000
MED EXP (Anyone person) $ 5000
PERSONAL & ADV INJURY $ 500000
GENERAL AGGREGATE $ 1000000
PRODUCTS - COMPIOP AGG $ 500000
COMBINED SINGLE LIMIT $ 1000000
12/31/06 12/31/07 (Ea accident)
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROpERTY DAMAGE $
JPer a~dd~nt)
AUTO ONLY - EA ACCIDENT $
OTHERTHAN EAACC $"
AUTQONLY:. "AGG $
EACH OCCURRENCE $
AGGREGATE $
$
$
$
X
03/01/06 03/01/07 $ 100000
E.L DISEASE-EAEMPLOYEE $100000
EL. DISEASE - POLICY LIMiT $ 500000
GEN'L AGGREGATE LIMIT APPLIES PER:
~mT LOC
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
X SCHEDULED AUTOS
HIRED AUTOS
TCAO 0 0 72 3 6
A
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,~({>:-> .
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EXCE;SS/UMBRELLAl.IAall:'hv': '.,
OCCUR D CLAIMS MADE
B
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OTHER
WCV4143949
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER
,,'
OSHK-02 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ElEFORE THE EXPIRATION
City of Oshkosh DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL TEN DAYS WRITTEN
City Clerk NOTICE TO THE CERTIFICATE HOLDER NAMED TO tHE LEFT, BUT FAiLURE TO DO SO SHALL
P.O. Box 1130 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPO/ll THE I/IISURER,rrS P.G'ENTSOR
215 Church Avenue
Oshkosh WI 54903 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
David Burkart, CPCU
CANCELLATION
ACORD 25 (2001/08)
@ACORD CORPORATION 1988