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Home My WebLink AboutOSHKOSH AREA HUMANE SOCIETY ACORD... CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDlYYYYl 9/25/2007 PRODUCER (920)235-3450 FAX: (920)232-8731 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FirstChoice Insurance Agency -~1:i~i~,~.' THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ~i .,'.~""'''''''>;'. .~.."~_.~~."""....-.._v "AL ~...T . E COVERAGE AFFORDED BY THE POLICIES BELOW. 338 Pearl Ave \ - ,=." 'c '^!').r.:) P.O. Box 766 .) I'\J_lv .., Oshkosh WI 54 903 -\0 16~ ~'-'-<'_..- ----,-.---. "Nsi]~~R$l FFORDING COVERAGE NAIC# ..... INSURED .' F" 1 At "'H \ LOOl L Z d- ~nCinnati Ins. Co. CL Oshkosh Area Humane Society, I lb. l INSUR ~" ... . 1925 Shelter Ct \ I' P INSUR' I, ..-;~ '; I __~_' '., \. \\ ~ ,--'~-'""""""'- , ;i >- II JI Oshkosh WI ~ I lj I:L . 54901- _.-~"' ,INSLJRERcE";;- r...-..___-----.---.~ ,~" 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 REDlICED BY PAID CLAIMS. I~~: ~o,,~~ TYPE OF INSURANCE POLICY NUMBER Pci>..t+i~~~~g8,w~ P~~fll~~~~N LIMITS ~NERAL LIABILITY EACH ocr~IIRRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY ~~~~~H9E~~~~J>ence\ $ 5'00,000 A l CLAIMS MADE ~ OCCUR CPP3649049 10/1/2007 10/1/2008 MED EXP (Anv one nerson) $ 10,000 I-- PERSONAL & ADV INJURY $ 1,000,000 I-- GENERAL AGGREGATE $ 2,000,000 -il'L AGG~EnE LIMIT AnS PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY ~rP.r LOC ~TOMOalL.E LIABILITY COMBINED SINGLE LIMIT 1,000,000 ~ (Ea accident) $ ANY AUTO A ~ ALL OWNED AUTOS CPA3649049 10/1/2007 10/1/2008 BODILY INJURY (Per person) $ SCHEDULED AUTOS '" - - HIRED AUTOS BODILY INJURY (Per accident) $ - NON-OWNED AUTOS - PROPERTY DAMAGE $ (Per accident) RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY "M"" $ 2,000,000 ~ OCCUR 0 CLAIMS MADE AGGREGATE $ 2,000,000 $ A 8 DEDUCTIBLE CPP3649049 10/1/2007 10/1/2008 $ X RETENTION $ 0 $ WORKERS COMPENSATION AND I YY9, ST ~ m;.. I OJ,tl- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L DISEASE.. EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERA TIONSfLOCA TIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITY OF OSHKOSH ITS ELECTED OR APPOINTED OFFICIALS 215 CHURCH AVE OSHKOSH, WI 54901 ACORD 25 (2001/08) INS025 (0108).08a 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 L.EFT, aUT FAILURE TO DO SO SHAL.L IMPOSE NO OBLIGATION OR LIABIL.ITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Rachel Cleven/RACHEL \..fJ.-~ ~ @ ACORD CORPORATION 198 Page 1 of ADD I TI 0 N A L I N T ERE S T NOT ICE OF COMMERCIAL PACKAGE POLICY POLICY NO cO 0405987 04 .. ISSUED AT GENERAL CASUALTY CO OF WI CANCELLATION TO TAKE EFFECT AT 12:01 AM .11/29/2007. DATE OF NOTICE 11/14/2007 A GENERAL. CA.SUALTY , ." -,-' GENERAL CASUA.I..TYCb. OF~1 ONE GENERAL DRIVE SUN PRAIRIE WI 53596 CITY OF 05Hl{OSH C/O CITY CLERK 215 CHURCH AVE OSHKOSH WI NOTICE TOADPITIONAL INTERESTS: YOU ARE HEREBY NOTIFIED THAT YOUR INTEREST IN THE INSURANCE UNDER THE ABOVE NUMBERED POLICY IS TERMINATED EFFECTIVE ON THE DAY AND TIME AS INDICATED ABOVE . - . .-" . . - ,,- ' --------~-----~~-~~-~~~-~-- AGENT THOMAS INSURANCE PO BOX 3387 OSHKOSH WI AGENT NUMBER- 048-1113 AUTHOR IZEP REPRESENTATIVE - . NOT ICE 0 F CAN C ELL A T ION OF COMMERCIAL PACKAGE POLICY AGENERAL CASUALTY POLICY NUMBER: CANCELLATION EFFECTIVE: DATE OF NOTICE: 6088374440 CCI0405987 04 12:01 AM 11/21/2007 1110612007 ADDITIONAL INTEREST CITY OF OSHKOSH clO CITY CLERK 215 CHURCH AVE OSHKOSH WI ?O~JCY ISSUED TO- OSHKOSH AREA HUMANE SOCIETY 'J INC 1925 SHELTER COURT OSHKOSH WI 54901 CABS ACCOUNT: 9324129108 YOU ARE NOTIFIED THAT THE POLICY DESIGNATED ABOVE WILL CANCEL IN ACCORDANCE WITH THE TERMS AND CONDITIONS OF THE POLICY UNLESS THE "MINIMUM DUE" IS RECEIVED AT THE HOME OFFICE OF THE COMPANY PRIOR TO THE EFFECTIVE DATE OF THE CANCELLATION LISTED ABOVE. UPON RECEIPT OF AN AMOUNT EQUAL TO OR GREATER THAN THE "MINIMUM DUE", THIS NOTICE WILL BE RESCINDED. PAYMENTS WHICH ARE RECEIVED AFTER THE EFFECTIVE DATE OF CANCELLATION APPLIED TO ANY BALANCE OWED FOR COVERAGE WHICH THE COMPANY PROVIDED. REMAINDER WILL BE REFUNDED IN ACCORDANCE WITH THE POLICY TERMS. THE WILL REMAIN CANCELLED. WILL BE ANY POLICY IF YOU WISH TO HAVE YOUR POLICY CANCELLED, PLEASE NOTIFY YOUR AGENT SO THAT YOU ARE NOT BILLED FOR UNNECESSARY COVERAGE. REASON FOR CANCELLATION---NON-PAYMENT OF PREMIUM :------._-~---.--....:..,~- :._-:------:...~-_._. '.-- ADMINISTRATIVE MGR. AGENCY NO. AGENT- 0481113 THOMAS INSURANCE GROUP 303 PEARL AVE POBOX 3387 OSHKOSH WI ---------------------------- AUTHORIZED REPRESENTATIVE 10166 54903 l'<20a001CCI04059870404811134Ql'" CANL TR0707