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ACORDTlf CERTIFICATE OF LIABILITY INSURANCE I DATE (Mr,iIlDDIYYVY)
6/26/.2007
PRODUCER Phone: 440-248-4711 Fax: 440-248-5406 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Britton-Gallagher and Associates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
6240 SOM Center Rd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Cleveland OH 44139 ALTER THE COVERAGE AFFORDED BY THE POLICIES. BELOW.
INSURERS AFFORDING COVERAGE NAIC#
I-
INSURED INSURERA:Lexinrrton Insurance Co
Spectrum pyrotechnics Inc. INSURERB: Illinois National Insurance C ?3817
W9285 Hwy 16 INSURERC:JI..xis Surnlus Ins Comnanv
Reeseville WI 53579
INSURERD:Tris-State Ins Co of MN
INSURER E:
,
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING A~ 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.
lTR= POUCVNUMBER P~H~Y EFFECTIVE POUCY EXPIRATION UMITS
A ~ERALLIABlUTY 6990277 6/24/2007 6/24/2008 EACH OCCURRENCE $1000000
X COMMERCIAL GENERAL UABILITY ~~~~SIEaocx:urence\ $50000
I CLAIMS MADE 0 OCCUR ~._._-' MED EXP (Anyone ...rson)
f!~~\ rc:1 fi~~ E!~ U \!l ";:~ ! $
"""," ~.,., ",;:;, d PERSONAl & ADV INJURY $1000000
- ')! -::. ,'-'
,L J ,:--~- ---11 GENERAL AGGREGATE $2000000
- ! !
n1.AGGRErilE LIMIT APn PER: ~ I ' " PRODUCTS - COMPIOP AGG $2000000
POLICY I X 'i'~ lOC qn ,1111 O. Z007 I ~ " i I
CA626E lJJ:u I 1:.:,-,'-' 6V24/2008
B AUTOMOBILE UABIUTY . 6/24/20jJ(l;':; COMBINED SINGLE UMIT
f-"- $1000000
2L ANY AUlTO CITY CLER~\ 'S ("\r,'" , I (Ea acciderd)
All OWNED AUlTOS '-iTr! c
- ! BODilY INJURY
-'.....-"......-.".-..-'"- --' (per person) $
SCHEDULEDAUlTOS
-
2L HIREDAUlTOS BODilY INJURY
(Per accldel1l) $
2L NON-OWNEDAUTOS
- PROPERTY DAMAGE $
(Per acclderd)
GARAGE UABIUTY AUlTOONl Y - EAACCIDENT $
=1 ANY AUTO OTHER THAN EAACC $
AUlTO ONLY: AGG $
C EXCESSIUMBRELlA UABILlTY EAU726894 6/24/2007 6/24/2008 EACH OCCURRENCE $ 4000000
txJ OCCUR 0 ClAIMS MADE AGGREGATE $ 4000000
$
=1 DEDUCTIBLE $
RETENTION $ $
D WORKERS COMPENSATION AND WC4802006195 6/28/2007 6/28/2008 X I T~~;r{llN~ I 10J~-
EMPLOVERS'lIABllITY EL EACH ACCIDENT $ 500 000
, ANY PROPRIETORIPARTNERlEXECUTlVE
ORRCE~EMBEREXC~UDED? E,L DISEASE - EA EMPLOYEE $ 500 000
~~c~~~S1S~NS beloW EL DISEASE - POLICY LIMIT $ c;nn nnn
OTHER
DESCRIPTION OF OPERATIONS I lOCATIONS I VEHICLES I EXCLUSIONS ADDED BV ENDORSEMENT I SPECIAL PROVISIONS
Ioisplay Date: July 4, 2007 Rain Date: July 5, 2007
~ocation: Oshkosh, WI
~dditional Insured: Festival Foods, Midwest Communications, City of Oshkosh and all their entities.
CERTIFICATE HOLDER
COVERAGES
,
Festival Foods
2276 West Mason street
Green Bay WI 54303
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 IMPOSE NO OBLIGATION OR LIABILITY OF A~~ KIND UPON
THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
dJ! ;;. Ii r'
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@ACORDCORPORATION1988
ACORD 25 (2001/08)