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Home My WebLink AboutLakeshore Golf Course 2007 DATECMM/DD/YV 09/20/07 PRODUCER Aon Risk services, Inc. of the carolinas 121 West Trade Street 2400 Interstate Tower charlotte NC 28202 USA THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHfS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE PHONE. 866) 283-7122 FAX- 847 953-5390 INSURER A: INSURERB: INSURED compass Group USA, Inc. Canteen vending, chartwells 2400 Yorkmont Road Charlotte NC 28217-4611 USA INSURER C: INSURER D: INSURER E: American Home Assurance Co. New Hampshire Ins Co Illinois National Insurance Co Insurance company of the State of PA ACE American Insurance company lo ., !8 .... = ., "Cl ..... lo ., :5! c == LIMITS 0'\ o 0'\ LI'l .q- 0'\ .q- N o o "- LI'l lHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO lHE INSURED NAMED ABOVE FOR lHE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OlHER DOCUMENT WI1H RESPECT TO WIDCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, lHE INSURANCE AFFORDED BY lHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL lHE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . INSR LTR A 1595536 commercial General Liability 09/30/07 POLICY EFFECTIVE POLICY EXPIRATION DATE(MMIDDlYV) DATE(MMIDDIYY) EACH OCCURRENCE $1,000,000 $1,000,000 TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITY X COMMERCIAL GENERAL UABILITY CLAIMS MADE 0 OCCUR cont ractua 1 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY 0 i:g~ 0 LOC A 5455550 wc - All Other States 5455553 work Camp (WI only) 5455562 wc (MA). ___" __., 09/30/07 09/30/07 A ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS 1607095 Auto - All Other States 1607096 Auto - VA only 1607097 Auto - MA only 09/30/07 09/30/07 09/30/07 A Self Ins.Phys.Damage E 47UKA14309 09/30/07 OCCUR 0 CLAIMS MADE DEDUCTIBLE RETENTION 09/30/07 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY c o OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESlEXq~~IO~ DED BY ENDORSEMENT/SPECIAL PROVISIONS pi il OCT 0 B ZOO! i iJ l-il 1.-.-_.. 09/30/08 09/30/08 09/30/08 09/30/08 09 30 08 09/30/08 09/30/08 09/30/08 ", FIRE DAMAGE(Anv one fue) MED EXP (Aov one person) PERSONAL & ADV INJURY $1,000,000 $10,000,000 $1,000,000 $1,000,000 c Z ~ = .. 10: i ., u GENERAL AGGREGATE PRODUCTS. COMP/OP AGG Liquor Liability Lim COMBINED SINGLELIMIT (Ea accident) $5,000,000 BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY. EA ACCIDENT OTHER THAN AUTO ONLY: EA ACC AGG EACH OCCURRENCE AGGREGATE products/completed 0 $10,000,000 $10,000,000 $10,000,000 OTH. ER $2,000,000 = $2,000,000 : $2,000,000 iii1i ~ E.L DISEASE.POUCYLIMIT EL. DISEASE-EAEMPLOYEE .4M ;aa6 SelWla6, 1J1>:-. ~ 7k e~ -- .~ =--- ~ ::r: ~ ~ r- i;fi ~ ~ ...... ~ - . I - LAKESHORE GOLF COURSE 215 CHURCH AVENUE OSHKOSH WI 54901- USA ~Htuill'ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ~DA.TE.THERE()F. THE. ISSUING COMPANYWlLL ENDEAVOR TO MAIL 30 DAYS WRITTENNdnCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Attachment to ACORD Certificate for compass Group USA, Inc. The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, co~erages or exclusions contained in the policy. iINSURER INSURED compass Group USA, Inc. canteen vending, chartwells 2400 Yorkmont Road charlotte NC 28217-4611 USA INSURER INSURER INSURER ADDITIONAL POLICIES iINSURER If a policy below does not include limit information, refer to the cOITesponding policy on the ACORD certificate form for policy limits. POLICY POLICY INSR TYPE OF INSURANCE POLICY NUMBER EFFECfIVE EXPIRATION LIMITS LTR POLICY DESCRIPTION DATE DATE GARAGE LIABILITY 607095 09/30/07 09/30/08 Garage Limit A $500,000 WORKERS COMPENSATION 5455552 09/30/07 09/30/08 A fiorkers comp (CA) 5455551 09/30/07 09/30/08 B Work comp (MO,NY) 5455554 09/30/07 09/30/08 . c work comp (FL ONLY) 5455561 09/30/07 09/30/08 A f.,Jork Comp (OR only) DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate No : 570024945909