HomeMy WebLinkAboutAlltel 10/1/2007
ACORD,. CERTIFICATE OF LIABILITY INSURANCE OP ID 19 DATE (MM/DDIYYYY)
ALLTE-8 01/10/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MAHER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Rebsamen Insurance Inc(LR) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1500 Riverfront Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Little Rock AR 72202
Phone: 501-661-4800 Fax:501-666-9592 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Ace American Insurance Company 22667
.. Liberty Insurance .. .... -..
INSURER B: Corp*
Appleton-Oshkosh-Neehah MSA INSURER C: Lexington Insurance Company
L1mited Partnership dba ALLTEL
P. O. Box 2177 INSURER 0: *Marsh OSA Broker of Record
Little Rock AR 72203-2177
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.
'LTR 'NSR[ TYPE OF INSURANCE POLICY NUMBER ~9N~Ttl~2W~ P8k~1,v{ij*ltb'}f~N LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,850,000
-
A X COMMERCIAL GENERAL LIABILITY XSLG21714550 10/01/06 10/01/07 PREMISES (Ea occurence) $ 150,000
l CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5,000 I
PERSONAL & ADV INJURY $1,850,000
-
GENERAL AGGREGATE $9,850,000
I---
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1,850,000
!Xl .nPRO- n
X POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $2,000,000
-
A X ANY AUTO ISAH08221297 10/01/06 10/01/07 (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
I--- .
HIRED AUTOS
f-- BODILY INJURY $
NON-OWNED AUTOS (Per accident)
I--- .' ..
- 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 $10,000,000
A ~ OCCUR o CLAIMS MADE XOOG23713652 10/01/06 10/01/07 AGGREGATE $10,000,000
$
~ DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND X I TORY LIMITS I IU~~-
B EMPLOYERS' LIABILITY 64D-005098-066* 10/01/06 10/01/07 $1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.l. EACH ACCIDENT
O~~rCER/MEMaEREXCLUDED? 641-005098":-016*- .. 10/01/06 10/01/07 E.L DISEASE - EA EMPLOYEE $1,000,000
If yes, describe under E.L DISEASE - POLICY LIMIT $1,000,000
SPECIAL PROVISIONS below
OTHER
C Prop-Direct Risk 4555642 12/31/06 03/01/08 Limit 5,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE: Oshkosh 26, City of Oshkosh, Attn: Stephan Brand, Utilities
Superintendent, Po Box 1130, Oshkosh, WI 54903-1130 is named as Additional
Insured ATIMA.
CERTIFICATE HOLDER
CANCELLATION
CIOFOS2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Oshkosh DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
Attn: City Attorney NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
215 Church Ave. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
P.O. Box 1130
Oshkosh, WI 54903-1130 REPRESENIATIVES.
~1~~EPR~ENTATlVE
1
ACORD 25 (2001/08)
@ACORDCORPORATION 1988