HomeMy WebLinkAboutUnified Catholic Schools of OShkosh #765
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Certificate of Coverage Date: 5/24/2007
Certificate Holder This Certificate is issued as a matter of information only and
Catholic Diocese of Green Bay confers no rights upon the holder of this certificate. This certificate
1910 S Webster Ave. does not amend, extend or alter the coverage afforded below.
P.O. Box 23825
Green Bay, WI 54305-3825 Company Affording Coverage
THE CATHOLIC MUTUAL RELIEF SOCIETY
10843"0LB MIL1,lill -
Covered Location OM1H}\" l~~~'Slf .',
Unified Catholic Schools of Oshkosh #765 jl~r~" ... '...C """,
110 N. Sawyer Ave. i"
Oshkosh, WI 54901 .. I"l ,
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This is to certify that the coverages listed below have been issued to the C'efHficaTeholder named~boYAX<?il!1,\?jcertificate
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 coverage afforded described heri;:in is subject to all the terms, exclusions and
conditions of such coverage. Limits shown may have been reduced by paid claims.
Type of Coverage Certificate Number Cover age Effective Coverage Expiration Limits
Date Date
Property
Real & Personal Property
General Liability General Aggregate
Products-Comp/OP Agg
0 Occurrence Personal & Adv Injury
0 8878 7/1/2007 7/1/2008 Each Occurrence 500,000
Claims Made
Fire Damage (Anyone fire)
Med Exp (Anyone person)
Excess Liability
8878 7/1/2007 7/1/2008 Each Occurrence 500,000
Other
Each Occurrence
Description of OperationsiLocationsN ehicles/Special Items
Coverage only extends for claims arising out of Neumann Middle Schools Baseball Team's use of South Side Diamond during the School
Year, for the term of the certificate.
Holder of Certificate Cancellation
Additional Protected Person(s) Should any of the above described coverages be cancelled
City of Oshkosh before the expiration date thereof, the issuing company will
Attn: City Clerk endeavor to mail 30 days written notice to the holder of
215 Church A venue certificate named to the left, but failure to mail such notke shall
Oshkosh, WI 54901 impose no obligation or liability of any kind upon the company,
its agents or representatives. /'1
Authorized Representative t1 ....-\iAr( ~
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ENDORSEMENT
(TO BE A TT ACHED TO cliRTIFICA TE)
Effective Date of Endorsement 7/1/2007 Charge I Credit
Cancellation Date of Endorsement 7/112008
Certificate Holder Catholic Diocese of Green Bay
1910 S Webster Ave.
P.O. Box 23825
Green Bay, WI 54305-3825
Certificate No. 8878
of The Catholic Mutual Relief Society is amended as follows:
SECTION II - ADDITIONAL PROTECTED PERSON(S)
It is understood and agreed that Section II - Liability (only with respect to Coverage D - General
Liability, Coverage F - Medical Payments to Others and Coverage H - Counseling Errors and Omissions) is
amended to include as anAdditional Protected Person{s) members of the organizations shown in the
schedule, but only with respect to their liability for the Protected Person{s) activities or activities they
perform on behalf of the Protected Person(s).
It is further understood and agreed that coverage extended under this endorsement is limited to and applies
only with respect to liability assumed by contract or agreement; and this extension of
coverage shall not enlarge the scope of coverage provided under this certificate or increase the limit of
liability thereunder. Unless otherwise agreed by contract or agreement, coverage extended under this
endorsement to the Additional Protected Person(s) will not precede the effective date of this certificate of
coverage endorsement or extend beyond the cancellation date.
Schedule - ADDITIONAL PROTECTED PERSON(S)
City of Oshkosh
Attn: City Clerk
215 Church Avenue
Oshkosh, WI 54901
Remarks: Coverage only extends for claims arising out of Neumann Middle Schools Baseball Team's
use of South Side Diamond during the School Year, for the term of the certificate.
PKS-122 (1-99)