HomeMy WebLinkAboutGrand Scoop/07
ACORD. CERTIFICATE OF LIABILITY INSURANCE CSR RG 1 DATE (MM/DDIYYYY)
OSHOP-1 06/14/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
McClone Insurance Group-Osh ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
505 North Westfield street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. BoX 2743 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
Oshkosh ~ 54903
Phone: 920-233-4000 Fax: 920-233-2728 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: General Casualty Company 24414
INSURER B:
Oshkosh o~era House, Inc. INSURER C:
P.O. Box 004 INSURER D:
Oshkosh WI 54902
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED N01WITHSTANDING
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.
L TR NSRC
TYPE OF INSURANCE
POLICY NUMBER
';,%!~IMM;ODNY)O: DATE (MMIDDIYY)
EACH OCCURRENCE
~~~:S~S (Ea occurence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS. COMP/OP AGG
GENERAL LIABILITY
I--
A X X COMMERCIAL GENERAL LIABILITY
~ ~ CLAIMS MADE ~ OCCUR
CCI0154911
05/03/07
05/03/08
A
GEN'L AGGREGATE LIMIT APPLIES PER
il POLICY !Xl j~& n LOC
AUTOMOBILE LIABILITY
I--
X_
-
-
~ HIRED AUTOS
~ NON-OWNED AUTOS
PROPERTY DAMAGE
(per accident)
CCI0154911
05/03/07
05/03/08
COMBINED SINGLE LIMIT
(Ea accident)
ANY AUTO
BODILY INJURY
(Per person)
ALL OWNED AUTOS
,"." ._'.'~__._ ._,. M
.. ~.-- .-.
\-~", ..~. ,M__
I j- ..._.~----_.. .......-. .
l '; ".,o?! ; . 'I'" .. . 'J(' ". "
f ,:. f....-\i~;..;\ ~ I II I rr.. I AI. J .
ii', ii.:: JU 'I ~ '1:''-' v
\ ~. ~ ~ 1
II U t1 ", -.-------- --.--....'
-,'.-\,'\,1 ,,: :,"'.,::J~<i~ (....,1:~:'...-
~ :. ,'iT . S ,
-c::::.:.- ._~-,--"^^' -....... .-' -......-.....
EACH OCCURRENCE
AGGREGATE
SCHEDULED AUTOS
BODILY INJURY
[Per accidenl)
~
AUTO ONLY. EA ACCIDENT
GARAGE LIABILITY
==1 ANY AUTO
EXCESS/UMBRELLA LIABILITY
o OCCUR 0 CLAIMS MADE
RDEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
A ANY PROPRIETOR/PARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OTHER
OTHER THAN
AUTO ONLY:
CWC0154911
05/03/07
05/03/08
X ITORY LIMITS I ~
E.L. EACH ACCIDENT
EL DISEASE - EA EMPLOYEE
EL DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
RE: special Event, "Grand Scoop"; July 1st. 2007. The City of Oshkosh,
ifts officers, council members, agents, employees and authorized volunteers
are Additional Insured with respects to General Liability and Auto
Liability. The General Liability General Aggregate applies seperately to
this event.
LIMITS
$ 1000000
$ 100000
$ 5000
$ 1000000
$ 1000000
$ 1000000
$ 1000000
$
EA ACC $
$
$
$
$
$
$
AGG
$ 100000
$ 100000
$ 500000
OSHKOS1
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
CERTIFICATE HOLDER
CITY OF OSHKOSH
215 CHURCH AVENUE
P.O. BOX 1130
OSHKOSH WI 54902-1130
("~
@ ACORD CORPORATION 1988
ACORD 25 (2001/08)