HomeMy WebLinkAboutPW CNT 06-07
DATE (MM/DD/YYYY)
06/29/2007
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ACORCl CERTIFICATE OF LIABILITY INSURANCE
FAX (920)722-9011
INSURERS AFFORDING COVERAGE
INSURER A: West Bend Mutual
INSURERB: Steadfast Insurance
INSURER C:
INSURER D:
INSURER E:
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 QR 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.
INSR ~pD:~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE Pg~!f.Y EXPIRATION LIMITS
GENERAL LIABILITY CPS 0726427 00 01/01/2007 01/01/2008 EACH OCCURRENCE $ 1,000,00(
I-- DAMAGE TO RENTED
X COMMERCIAL GENERAL LIABILITY $ 600,00(
- =:J CLAIMS MADE M OCCUR
MED EXP (Anyone person) $ 5,001
-
A PERSONAL & ADV INJURY $ 1,000,00(
-
GENERAL AGGREGATE S 2,000 , 00(
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2 , 000 , 00(
Xl nPRO n
X POLICY JECT LOC
AUTOMOBILE LIABILITY CPS 0726427 00 01/01/2007 01/01/2008 COMBINED SINGLE LIMIT
- (Ea accident) S
X ANY AUTO 1,000,00(
-
ALL OWNED AUTOS BODILY INJURY
I-- (Per person) $
SCHEDULED AUTOS
A fy ,
HIRED AUTOS BODILY INJURY
I-- (Per accident) $
X NON-OWNED AUTOS
-
I-- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT S
==i ANY AUTO OTHER THAN EA ACC S
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY CUS 0890215 00 01/01/2007 01/01/2008 EACH OCCURRENCE $ 1,000,00(
~ OCCUR 0 CLAIMS MADE AGGREGATE $ 1,000,00(
A $
~ DEDUCTIBLE $
X RETENTION $ (J $
WORKERS COMPENSATION AND VHS 0726428 00 01/01/2007 01/01/2008 X I ~;;JT~~~;, I I OJ;tl-
EIVIPI.OYERS' LI,l\!3IL1TY EL. EACH ACCIDENT $ 100 , 00(
A ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? . E.L. DISEASE - EA EMPLOyE[ $ 100 , 00(
If yes, describe under E L. DISEASE - POLICY LIMIT S 500 , 001
SPECIAL PROVISIONS below
OTH~ . 1. b.l. PEC912967100 07/01/2007 07/01/2008 $1,000,000 each claim
8 Pro eSSlona Lla 1 lty $25,000 deductible
& Contractor's
Pollution Liab
~ISCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
DITIONAL INSURED IN RESPECTS TO GENERAL LIABILITY: THE CITY OF OS
)SHKOSH'S ELECTED OR APPOINTED OFFICIALS AND EMPLOYEES ~
o THE EXTENT REQUIRED BY WRITTEN CONTRACT OR AGREEMENT ~ ~ltL
~i.r
'1
PRODUCER (920)722-7531
Babbitt-Sholund Insurance
1524 South Commercial Street
P. O. Box 745
Neenah, WI 54957-0745
INSURED BADGER LABORATORIES & ENGINEERING CO.,
501 WEST BELL STREET (920)729-4945
NEENAH, WI 54956
INC.
COVERAGES
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE AB
EXPIRATION DATE THER
-1!L.. DAYS WRITTEN
BUT FAILURE TO MAIL SI
OF ANY KIND UPON THE
AUTHORIZED REPRESENTAl
Jan Tho son
OSHKOSH, CITY OF
SUPT OF UTILITY
ATTENTION: STEPHEN BRAND
POBOX 1130
OSHKOSH, WI 54903-1130
ACORD 25 (2001/08)
NAIC#
15350
Co (Zurich)
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