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A CORDm CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY)
04/20/2007
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Monroe Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
15th & Oregon Streets ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
>. Box 2467
ikosh, WI 54903-2467 INSURERS AFFORDING COVERAGE NAtC #.
INSURED INSURER A: Capitol Indemnity
Waterfest, Inc. INSURER B:
120 Jackson Street INSURER C:
Oshkosh, WI 54901 INSURER D:
INSURER E:
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.
INSR ~~~~ POLICY Ef.~ECTIVE P~~!fJ EXPIRATION
LTR POLICY NUMBER LIMITS
~NERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY CP 00203142 05/01/2007 05/01/2008 ~~~~~i~9E~~~~~nce' $
I CLAIMS MADE o OCCUR MED EXP (Anyone person) $
i I PERSONAL & ADV INJURY $ 1,000,000
I GENERAL AGGREGATE $ 2,000,000
-
n'L AGGREFl LIMIT APn PER: I t"'~"'~\ ;:,;.~ PRODUCTS - COMPJOP AGG $ 2,000,000
POLICY ~~R;: LOC '.. ._,.,..~ '.^'. . " ......... -""'" ~
t';:'~'\ ~'h . ..:':~:~:' ----..-.= -'!
-.1 P T l.S; "'c';; T .T" , },
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT
I ! ~c) , ,_." ~-'~"""'" -,....-,..- ,'-," "~".~ ..........-. -'. ,,-~ j (Ea actident) $
- ANY AUTO I; I
- ALL OWNED AUTOS Ii '"'i I t PR 2 5'ZOOI i BODILY INJURY
J (Per person) $
- SCHEDULED AUTOS ni I
- HIRED AUTOS ii..: ,~L_ BODILY INJURY
! :,-0'.'1""" .." ...~~- ~-- - $
NON-OWNED AUTOS \ Vl l ~ ~L.En; .'.....f (Per accident)
- !- ",'
"
-"" " .~. """. .... ,~.... . ~ - . ~ ~ ..~..,~ PROPERTY DAMAGE
) - ,..,,,,,. .1. - .,' $
(Per accident)
I-
RRAGE LIABILITY AUTO ONLY. EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
~ESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000
A X OCCUR 0 CLAIMS MADE CP 00203142 05/01/2007 05/01/2008 AGGREGATE $ 1,000,000
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I T~~-7mJM;, I IOJ~-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $
O~FI,....t::R'~u='J1QC:(,) c::x"'" UDt::,...;..... E.L. DISEASE. EA EMPLOYEE $
I \ .' .__ ...._...__., _, __ _u, \
If .ves. describe under
SPECiAL PROVISIONS below E.L DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
City of Oshkosh, and its officers, council members, agents, employees, and authorized volunteers named as
additional insureds with regards to concerts held at Riverside Park, Oshkosh
CERTIFICATE HOLDER
CANCELLATION
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 OF
COVERAGES
City of Oshkosh
'7 Church Ave
'1kosh, WI 54901
ACORD 25 (2001/08)