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Home My WebLink AboutSawdust Days/07 ACORD.. CERTIFICATE OF LIABILITY INSURANCE CSR BL I DATE (MM/DDIYYYY) OSHKO-5 06/20/07 PRODUCER V~A'~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION RICHARDS INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA l'E 1010 W 20th Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEN[I OR PO Box 2424 ALTER THE COVERAGE AFFORDED BY THE POLICIES BE:LOW. ~kosh WI 54903-2424 ..bne :920-235-1980 Fax: 920-235-2516 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:. NORTHLAND INSURANCE CO. INSURER B: OSHKOSH SAWDUST DAYS INC INSURER C: ATTN STEVE LENZ PO BOX 436 INSURER 0: OSHKOSH WI 54903-0436 INSURER E: COVERAGES 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 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. NSR[ POLICY NUMBER ~~Id!<'!.!::.~fJIrJ!XE P9~~:YIIEXPI~~N LIMITS LTR TYPE OF INSURANCE DATE (MM/DD DATE MM/DD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 - A X COMMERCIAL GENERAL LIABILITY CP 438453 06/20/07 06/20/08 U!:,~",~,=-. $ 50,000 PREMISES (Ea occurence) I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 1,000 PERSONAL & ADV INJURY $ 1,000,000 - GENERAL AGGREGATE $ 1,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 I ,nPRO- n r=::-'---'~ !--.,..,._------- 1--'----1 POLICY JECT LOC """". ' ......, ',". ,. . , Iii '!I- ,( .... n:.~; \~! 1 !:~11~11 ~TOMOBILE LIABILITY ~~~\' ....? .d COMBINED SINGLE LIMIT $ ANY AUTO ,;Lli 1------- (Ea accident) - I~jl ALL OWNED AUTOS H BODILY INJURY - N 2 9 2007 $ SCHEDULED AUTOS ~- (Per person) - - HIRED AUTOS U ~ -- !--------- _J ! BODILY INJURY 'f.:-:N 1 (Per accident) $ NON-OWNED AUTOS ER;.nSr"l1: - CITY ~_ r--I :'\..; \..;: . ;'1L: - ~-"._"_. -_....,.,.,.;~- PROPERTY DAMAGE $ ...:. (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ R ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE $ o OCCUR o CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND ITS'~/~I~WS I IOlH- ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERlEXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CITY OF OSHKOSH IS NAMED AS ADDITIONAL INSURED . CERTIFICATE HOLDER CITY OF OSHKOSH ATTN DON LAFONTAINE 215 CHURCH AVE OSHKOSH WI 54901 CANCELLATION CITYOSH 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 ENTATIVES. !ZED REPRESENTATIVE l. ) c ACORD CORPORATION 1988 ACORD 25 (2001/08) 06~20/07 WED 15:16 FAX 913 676 9389 HAAs WILKERSON l4I002 .j.!!:..'.........'.'......i'.... . ." .......,.. ii~ ACORD iilit.......~;oj-;-;-m....."'<<.;.:.>>:o>>;.:o...:o:.:>!.. 1M PRODUCER Haas and Wilkerson, Inc. BOO'B21'770~~ JI'J U~ .:J l\ }\ ""oAi ;~MIODNY)""*i 6/20/07 J:i: 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 PO Box 2946 Shawnee Mission, KS 66201-1346 COMI'.o.NY A Tip Top Rides & Attractions LLC Tip Top Shows, Ino p.O. Box 389 Waupaoa WI 54981 COMPANY a Liberty Mutual Ace American Insuranoe Company INSURED COMPANY C "... .... THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A60VE FOR THE POLICY PERIOD INOICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYSE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORClIi!D BY THE POLICI!!S DESCRlaE:D HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEr;;N REDUCED BY PArD CLAIMS. CO LTR POLICY NUMBER POLICY EFF\:iCTIVli PO~ICV EXPIRATION DATE (MMIDDIYVI bAn IMM/DDIYYI TYpe tlF INSURANCE A t;EHERAL LIABILITY X COMMERCIAL GENERAL UAaILITY 'i2~ CLAIMS MAOe [8] OCCUR OWNER'S & CONTRACTOR'S I'I'tOi G20416403 "General Aggregate is per location 12/10/06 12/10/07 AUTOMODILE UA!llUi'V ANY AUTO ALL OWNED AUTOS SCH~PULEO AU'rOS HIRED AUTOS NON.oWNED AUTOS or, , ,,~- " ! ''''''''___,_..~.''',. ~.... ,....'...__k '. GA~GE LIABIUTY ANY AUTO EXCE$$ UABU.rn- UMBRELLA FORM OTHeR THAN UMBRELLA FO.RM B WORKERS COMPENSATION ANO EMPl.OYERS' LIABILITY 345360234047 Coverage applJes to benefits In the state of WI 4/19/07 4/19/08 THE I'AOFRIIITORl '"'CL PARTNS!'lS/llXIlCUTIYE ,. OFFICERS ARE: EXCL OTHER DESCRIPTION OF OPEAATIONSILOCATlONSNEHICLES/SPECIAL fTEM$ Additional Insured: Sawdust Day,.. Inc.; City of Oshkosh . ',C'.('..7 ':~ll \J l~ ,.;".. . C . .~ i\,,\1 C\.... . '..\ /~ \J ,\\.1-,\1 '" ~\\C\\f;;'\\\j,.:i 1\"".:; LIMITS GeN5RALAGGREGATE PFlODUCTS . COMP/OP AGG $ peRSONAL III NJV INJURV EACH OCCUARENce "'RE DAMAGE (Any OM firt;r) MED EXP IAny one perllOnl *2000000 2000000 1000000 1000000 100000 COMBINED SINGLE LIMIT ~ODILY INJURY (Per pereoOl BOOIL Y INJURY (PQr .~cidelltl PAOFERTV DAMAGE AU'rO ONLY. EA ACCIDENT . OTHSR THAN AUTO ONLY; 1~~~;$~;~1~i~1~~i;J;~;Y~i~ni~i~~1i~~~:. EACH ACCIDENT $ AGGFieGAT6 ~eH OCCURRENCE $ AGGREGATE $ OTH. !~~~~;~i~jt~~;~~;~~~~~;~1t~B~~1~~1~1~;H;: 10000l;lO $ 1000000 1000000 .:J~~~~~Jt~~~~~~~~~!$~lli~ili~~~*~~~~i~~~~f;~r:~~f:~~~~~ffii~~I{ill~~~~1~~~i~~lli1ili~m~WJ~!~!~*i~1~~~l11~ Sawdust Days, Inc. Steve Lenz P.O. Box 436 Oshkosh, WI 54903 SHOULD ANY OF THE ABOVE DE$CI'lI41eD POLICII1S BE CANCELLED B~~O~ 'I'HE EXPIRATION DATE TIlEllEO~. TilE ISSUING COMPANY WILL END~AVOFl ,!,J) MAIL ~ DAVS W!llTT~'" NOrlel1 TO THE' CERTIFICATE HOLDER NAM~l) '1'0 THI1 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OIlLIGATlON OR LIABIUTY COMPANY. liS AGENTS OR REPREstNTATIyes.