HomeMy WebLinkAbout2011-Building (awning) ('rD CITY OF OSHKOSH No 145976
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 408 N MAIN ST Owner WILLIAM J /LUANN M STREUR REV TRUST Create Date 03/19/2010
Designer Appleton Awning Contractor TENANT
Inspector
Category 250 - Satellite Dish /Antennas Plan
Type 0 Building 0 Sign • Canopy 0 Fence 0 Raze
Zoning C3 DO Class of Const: Size
Unfinished /Basement Sq. Ft. Rooms Height Ft. ❑ Projection
Finished /Living Sq. Ft. Bedrooms Stories Canopies
Garage Sq. Ft. Baths Signs
Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication # Dwelling Units 0 # Structures 1
Use /Nature Install new fixed awning for "Paper Tiger" per submitted plan. * *check #101353
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $5,500.00 Plan Approval $0.00 Permit Fee Paid $60.00 Park Dedication $0.00
Issued By: 2YY _ j— Date 05/19/2011 Final /O.P. 00 /00 /0000
❑ Permit Voided Parcel Id # 0401000000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
I have read and understand the afore mentioned information.
Signature Date
Agent/Owner
Address OSHKOSH WI 54901 - 0000 Telephone Number
To schedule inspections please call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
uec, 2. 2010 1:06PM CITY OF OSHKOSH INSPECTION No,3913 P. 1/1
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050 ��HK��H
Fax: (920) 236 -5084
Building Permit Application ON THE WATER
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account n
JOB ADDRESS H 8 A), i v t j /^
■ D
OWNERtipt -3
CONTRACTOR 6 ( t- 1 L id DEwAi =,1 MEN 1 8
NT 1'( DEVEL
INSPECTION SERVICES DIVISION
I am the: ❑ Owner OR 'Contractor
USE CATEGORY
(Mingle Family ❑Duplex ❑Multi - Family [Mental Ofommercial ❑Industrial
Work being done:
0 Addition 0 Deck/Porch/Patio 0 Driveway/Parking
❑ External Remodeling 0 Fence/Hedge/Kennel 0 Garage/Utility Structure
0 Handicap Ramp 0 Hot Tub /Spa 0 Internal Remodeling
❑ Sign/Canopy /Awning 0 Stair/Handrail 0 Stove/Fireplace
0 Swimming Pool 0 Wrecking Permit
❑ Other 7a1-J1 )
Additional information, such as plan submittal and approval, may be required before issuance. Fliers,
located in the hallway, may be referenced to note if any additional information is necessary.
❖ Full description of work being done:
Wit, tic 4 6 &I,) /1 //i9/9"'' '. /4w a i
Anv work not included in this application is not permitted.
Value of the job $ 3-0 0 (Value for materials and labor is required to ensurc consistency in accessing permit fccs for all
applicants)
PLEA READ SIGN, & DATE:
1 certifi the above information is complete and accurate. Any deviations from the above submitted
information may require additional permits to be obtained. 1 acknowledge and agree to these terms.
Name: itel (`�,� . � 1G tl
Signature: (
Date: I 2 1 Cl
3/02
11 -15 -2010 02:59pm From -BPDI CORP +9208303857 T -905 P.001 F -590
BOOK Book World, Inc.
• • 1000 S. Lynndale Drive
A 4.1 4 r► il Appleton, WI 54914
t '` ip Phone: 920 -830 -7897
Fax: 920 - 830- 3857 —%
Date: i ) 5--I 0
To:
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(Including cover)
Fax: _
From: M2nt
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11 -15 -2010 03:OOpm From-BPDI CORP +9208303857 T -906 P.001 F -591
BOOK Book World, Inc.
i•'- • • 1000 S. Lynndale Drive
A '' r, Appleton, WI 54914
,`' Phone: 920- 830 -7897
Fax: 920- 830 -3857
Date: (--- )5- -1 0
To: VD4IINIJ 0 E n Pages
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Received Time Nov, 15. 2010 2:51PM No.3741
11 -15 -2010 03:OOpm From -BPDI CORP +9208303857 T -906 P.002 F -591
`raper ilydr _
Paper Tiger
408 N. Main St
Oshkosh, WI.
Phone: 851 -1450
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store Front awning
Traditional:
Front: Glen Raven, Sunbrella Solids, Forest Green [4637]
Thursday, November 11, 2010
Appleton Awning
Salesperson: Mike Dorschner
Appleton Awning Shop Inc.
3052 W. Elberg Ave.
Appleton„ Wi. 54914
Phone: 1- 920 - 733 -4701
Fax: 1- 920 - 733 -5688
E -Mail: mike @appletonawning.com
Received Time Nov. 15. 2010 2:51PM No. 3741
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11 -15 -2010 03:OOpm From -BPDI CORP +9208303857 T -906 P.004 F -591
Mike
From: Crystal Malenofski [cmalenofski@larsonengr.com]
Sent: Thursday, November 11. 2010 4:51 PM
To: mike @appletonawning.com
Subject: Wind load on Awning
Mike,
Ken Englebert asked me to find the design wind load for the 4'-6" x 4'-6" x 58' -8" awning on the first floor
of a building in Oshkosh that you called about earlier today. The design wind pressure based on a
building located in a typical area (not a very dense urban area) is 24,5psf. If the building is in a dense
urban area (no open areas - parks, water, etc. within 2600ft) then the pressure goes down to 21,0psf but
this condition is not common in this area because we have so many large parks, parking lots and water.
Please let me know if this answers your question or if you need more information or if something isn't
clear. Thank you
Crystal Malenofski, P.E., S.E.
Structural Engineer
Larson Engineering, Inc.
2801 E. Enterprise Avenue, Suite 200
Appleton, WI 54913 -7889
920.734.9867 Fax: 920,734.9880
cma lenofskiOlarsoneng r. com
5 Larson
www . larsonenar.cons
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•
Received TimeiNov, 15. 2010 2:51PM No. 3141
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GATORSHIELD' vs. ALUMINUM
TUBE Er PIPE
Gatorshield tubing has nearly 30% greater load carrying
capacity, size for size, than aluminum. ging iv it supenor
GATORSHIELD vs. ALUItlINUM resistance to wind, ice, or snow loads, This higher strength
TUBE Er PIPE • permits the use of smaller size and/or lighter gauge tubing
for the same performance levei which results in substantial
Gatorshield tubing has nearly 30% greater load carrying ' savings in material costs.
caPachY. 340 for size, than aluminum, giving it superior
ig
resistance o beds This strength
Because of Gatorshield's higher strength. steel structures
t wind. ice. OT snow . hher
permits require significantly fewer welds than those made from
the use of smaller size and/or lighter gauge tubing
aluminum, in l l.
for the same performance level, which results in substantial resulting ower welding labor costs Welding
savings in material
steel also requires less expensive equipment and materials,
•
costs.
and unlike aluminum it can be easily welded in the fled
> Because of Gatorshields higher strength, steel structures
require significantly
> Aluminum loses approximately 50% of its strength in the
si fewer welds Man those made from
weld area, which could cause post failure if
aluminum, resulting in lower welding labor costs. Welding
welds are not located in low areas of the structure
steel also requires less expensive equipment and materials.
during its design. In addition, welding of aluminum. or using
and unlike aluminum. it can be easily vvelded in the field.
aluminum electrodes Which contain magnesium, can result
•
) - Aluminum loses approximately 50% of ffs strength in the in unsightly black deposits,
weld area, which could cause post-installation failure if
Gatorshield tubing is more ductile and withstands the
welds are not located in low areas of the structure
durin ts bending and forming work required tor custom awning
g i design. In addition. welding of aluminum. or Laing
designs Common tempers ot aluminum, however,
aluminum electrodes which contain magnesium, can result
in unsightly black deposits. continue to age-harden while in storage. and can break
during fabrication,
Gatorshield tubing is more ductile and withstands the
bending and formin work required for custom Gatorshield tubing is easily and less expensively painted
g awning
or powder coated than aluminum. Using Gatorshiekl
designs. Common tempers of aluminum., however,
continue to age-harden while in storage, and can break eliminates the extensive pre-cleaning and costly disposal
during fabrication, of waste products generated when liquid or powder coating
aluminum, Because Allied's third coating has the same
> Gatorshield tubing is easily and less expensively painted paint chemistry and surface consistency of costly primers,
or powder coated than aluminum. Using Gatorshield finish adhesion is excellent. providing a long
eliminates the extensive predeaning and costly disposal attractive appearance.
of waste products generated when liquid or powder coating
Allied offers 20 Gatorshield specifically for
alurninum. Because Allied's third coating has the same
the awning industry. Seemingly at a weight disadvantage
paint chemistry and surface consistency of costfy primers.
finish 'adhesion is excellent providing long-lasting
versus aluminum. Gatorshield superior strength means
a ,
attractive appearance, that any given structure can require fewer linear feet than
a structure made from aluminum - and weigh less than
Allied offers 20 Gatorshield specifically for that aluminum structure, while providing greater structural
the awning industry. Seemingly et a weight disadvantage integrity. In turn. these advantages translate into lower
versus aluminum. Gatorshield-Lite's superior strength means costs, easier installation and longer life for awning
that any given svucture can require fewer linear feet than frame structures.
• Structure made from aluminum - and weigh less than
that aluminum structure, while providing greater structural
—
integrity. In turn. these advantages translate into lower
costs, easier installation and longer life for awning
frame structures.
. . ,
. .
...„
WORK ORDER
APPLETON AWNING SHOP
. Quality Awnings & Service Since 1922
3013 W. Wisconsin Ave., P.O. Box 1212, Appleton. WI 54912421
Name __—....___ ._ -- Dote
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Encroachment Agreement
Document Number
R .cordgArei
Name and Return Address
City Attorney's Office
L Oshkosh, WI 54903-1130
904-0100
Parcel Identification Number
CITY OF OSHKOSH •
AND
PROPERTY OWNER
This document drafted by:
David J. Praska, Assistant City Attorney •
City of Oshkosh, Wisconsin •
1
, . , . •-• -••
ENCROACHMENT AGREEMENT
This agreement is between the City of Oshkosh ( "City') and the William J. Streur
and Luann M. Streur Revocable Trust Dated February 26, 2003 ( "Owner"). The parties
enter Into this agreement for $1.00 and other good and valuable consideration, the receipt
of which is acknowledged,
The Owner is the fee owner of the property commonly known as 408 North Main
Street ( "Property"), and is more particularly described as:
The South Sixty (60) feet of Lot Nineteen (1 9) of Block Forty (40) in the
Fourth Ward, City of Oshkosh, Winnebago County, Wisconsin per
Leach's Map of 1894; and
That part of the North Two (2) feet of Lot Twenty (20) of Block Forty
(40) in the Fourth Ward, City of Oshkosh, Winnebago County,
Wisconsin per Leach's Map of 1894, Tying North of the North Wall of the
former First National Bank in Oshkosh building, now located upon the
balance of saki Lot Twenty (20).
Adjoining the Property along its West boundary is a public right -of -way used for
various public utilities, public sidewalks, and a public vehicular way commonly known as
Main Street. The City currently is responsible for maintenance of the right of way for this
section of Main Street and therefore has the authority to enter into this agreement.
The Owner desires to erect an awning which will beattached to the Owner's building
on the Property and will project overand extend Into the right of way no more than four feet
six inches (4' 6") from the face of the building. NO structure or object, including the
proposed awning, is allowed to project into a right -of -way without the City's permission.
The City of Oshkosh has reviewed the Owner's request and will allow the placement
of the requested Projecting awning subject to the terms and conditions identified in this
agreement. Both parties agree that all of the City's terms and conditions In this document
•'•• ''are • to be considered mate'rial:•• and conditions of this agreement"befweeri
City and Owner follow.
1. The City grants permission to the Owner to attach an awning to the building on
his Property which will project into the right -of -way of Main Street, provided that
the Projecting awning Is materially similar to the awning design and
specifications submitted for the City's approval ( "Projecting Awning "). A drawing
of the allowed Protecting Awning is attached hereto as Exhibit A.
2. The City's permission for this Projecting Awning is contingent upon the initial,
and continuing, compliance with all applicable local, state, and federal codes
and rules. The Protecting Awning shall comply with City Ordinances, Including
but not limited to requirements for permits, structures, signs, projecting signs,
Chapter 30-37 and Chapter 30 -27. .• •
3. The Owner agrees that he Is solely responsible for the installation and
maintenance of the Projecting Awning, and that he is solely responsible for any
and all personal or property damage caused by the Projecting Awning.
2 •
4. The Owner is solely responsible for securing, maintaining, repairing, and
replacing the Projecting Awning. The City's permission and approval of the
• Projecting Awning Is not related to the Owner's responsibility for the short and
long term stability and safety of the Projecting Awning,
5. The Owner acknowledges and agrees that public utilities and facilities, and the
• street and sidewalk, in the right-of-way are subject to maintenance, repair or
replacement. In the event that maintenance, repair, or replacement of public
utilities or facilities in the right -of -way will need to occur, the City agrees to make
reasonable efforts to notify the Owner of these activities so that the Owner may
remove or otherwise protect the Projecting Awning. If the Owner elects to
remove or otherwise protect the Projecting Awning, such actions must be taken
within the timeframe for the City's anticipated work. However, The City shall not
be responsible for any damage to the Projecting Awning, or any structure to
which the Projecting Awning is attached, related to the City's actions In Its right
of way. The City has no obligation, but shall be allowed to remove, at its sole
discretion, the Projecting Awning for the purpose of maintenance, repairs, and
replacement of utilities and facilities within the right of way. The Owner shall be
responsible for reinstalling/reattaching the awning in those circumstances where
the City removes the Projecting Awning. The City shall be reimbursed by the
Owner for all costs and expenses related to removing or protecting the
Projecting Awning. The Owner gives the City permission to enter, access, and •
•
alter his property that is not in the right of way for the sole purpose of removing
•
or protecting the Projecting Awning.
•
8. .The City is allowed to revoke Its permission for the Projecting Awning for any of -
the following reasons:
a. The City's use of the right of way prohibits the continued location of the
Projecting Awning;
b. Local, state, or federal rules, laws, or guidelines relating to public
sidewalk or street clearances or distances prohibit the continued location
•
of the Projecting Awning; ..
c. The Owner fails to property maintain, rep _ air, or replace the Projecting
Awning;
d. The Owner falls to provide the City with annual written proof that the
Protecting Awning is covered by the required insurance.
7. The Owner releases the City of Oshkosh, its employees, agents, elected
officials, and authorized volunteers from all debt, claims, demands, damages,
actions and causes of action whatsoever which may result from the Projecting
Awning. The Owner shall protect and hold the Cltyof Oshkosh harmless against
all actions, claims and demands of any kind or character whatsoever which are
related to the Projecting Awning.
8. Both parties understand and agree that accidents and incidents occurring on
City rights of way may result in lawsuits or threats of lawsuits against the City.
Therefore, the Owner agrees to indemnify and pay to the City all amounts that
the City may be required, obligated, or adjudged as responsible to pay, for any
dispute or action related to the Projecting Awning. This indemnification is broad,
and shall include damages, attorney's fees and costs, and defense costs. The
3
payments required of the Owner by this paragraph are due no later than 30 days
after written request for such Indemnification. The Owner agrees that this
paragraph shall be liberally construed in favor of the City of Oshkosh, in
consideration of the privilege granted by the City under this agreement.
9. At all times that the awning projects Into the right of way, the Owner's property
liability insurance shall cover all potential Liabilities related to the Projecting
Awning. The Owner's insurance shall provide reasonable coverage for potential
damages to persons and property cause wholly, or In part, by the Projecting
Awning. Minimum Insurance coverage related to the Projecting Awning shall be
$500,000 for each occurrence for bodily injury and property damage liability and
$500,000 general aggregate. The Owner shall include the City of Oshkosh as an
additional insured on its policy for claims, liabilities, and damages related to the
Projecting Awning. The Owner shall annually provide the City with proof of
Insurance for the Projecting Awning,
10. The City's permission is personal to the Owner, and cannot be transferred or
assigned to any other person or entity, whether voluntarily or involuntarily. The
Owner's rights contained in this agreement do not attach to property and do not
run with the land. Permission for the Projecting Awning is revoked Immediately
and without notice as of the time that the Owner, in the Trust's singular name, is
no longer the sole fee owner of the property at 408 North Main Street.
Revocation of permission will also occur where the Owner forms an entity of
which he Is the sole or partial owner.
11, The Owner's responsibilities pursuant to this agreement extend to other
persons, contractors, and agents performing work on Owner's behalf and related
to the Projecting Awning.
12. This agreement is solely for the benefit of the two parties to this agreement, and
It Is not intended to benefit any third party.
13. The election to enforce or not enforce, as well as the timing of enforcement,
shall be at the City's sole discretion and shall not act as .a waiver of any rights. to
exercise any right relating to the ProJectingAwning in the future.
14. This agreement shall incorporate all immunities and limitations provided to
municipalities within the Wisconsin Statutes, regardless of whether a claim is
based upon contract, tort, or other theory.
This agreement shall not run with the Land.
SIGNATURE PAGE FOLLOWS
4
................. ............................... .
Dated this 2 day of AA ".. LA , 2011.
OWNER:
William .' Streur d Luann M. Streur Revocabl Trust Dated February 26, 2003
William . Streur, Trustee Luann M. Streur, rustee
STATE OF WISCONSIN )
) SS.
WINNEBAGO COUNTY) t�
Personalty came before me this �• a day of r , 2011, the above -named William J. Streur
and Luann M. Streur to me known to be the person(s) who executed the foregoing document and acknowledged the
same.
i . .,, , .„.
0 2 ; ' Notary Public, Ova te , Wisconsin
tea My Commission: 5 2-9 to t
3 C
OF 4 ; J 15' c '� *'
CITY OF osHKOSIa. N k
1111111 I
By ' .r� � And. _ k 1111
Mar A. Rohloff, City Manager Pamela R. Ubr! City Clerk
9 9. ti+
STATE OF WISCONSIN )
SS.
WINNEBAGO COUNTY ) Q 1� t
Personally came before me this of ' J day � 1 , 2011, the above -named MARK A.
ROHLOFF, CITY MANAGER, AND PAMELA R. UBRIG, CITY CLERK, of the City of Oshkosh, a municipal corporation,
to me known to be the persons who executed the foregoing instrunient. and to me known to be such officers of said -
corporation, and acknowledged that they executed the foregoing instru ent as such offl ers as the deed of said
corporation, by Its authority. _
Notary Public, Winnebago Co., WI � �/ •
—
My Commission expires /is: ,�
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Ri5f CERTIFICATE OF LIABILITY INSURANCE OP ID LJ DATE(MMroD/YYYY)
03/31/11
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATNE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certtf sate holder is an AbDITIONAL INSURED, the policy(lesj must be endorsed. if SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may requlre an endorsement A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER - CUNIA61
McClone Insurance Group PHONE 1 FAX
150 Main Street, Ste 102 A J Ext). I (AIC,No):
P.O. Box 389 A ADDRESS:
Menasha WI 54952 CUSTOMER ID*: BOOKW -1
Phone:920- 725 -3232 Fax:920- 725 -3233 INSURER(S) AFFORDING COVERAGE NAIC/
INSURED
INSURER A: Travelers Indemnity ries 25666
Hookworld , Inc. and INSURER B : Traveler. Prop Cos Co of At
Wm J 6Luann M Streur Revocable
Trust dated 2/26/03 INSURERC: The Travelers Indemnity Co. 25658
1000 S. Lynn54914 a Drive INSURER D : 4
App eton WI
INSURER E :
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
IN T E R TYPE OF INSURANCE smut - POLICY W.f. - POLILTEXP • INSR WVD POLICY NUMBER (MMIDDFYYYY) (MMIDDIYYYY) UNITS
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
A X COMMERCIAL GENERAL LIABILITY 680- 9405M849 10 /01 /10 10 /01/11 PREMISES ES(Ea $ 1000000
CLAIMS -MADE I ° OCCUR MED EXP (Arty one person) $ 5000 _
X PERSONAL & ADV INJURY $ included
GENERAL AGGREGATE $ 2000000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMP/OP AGG $ 1000000
n POLICY n JJ n LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000
B X ANY AUTO (Ea accident)
BA-6390L529-09-SEL 10/01/10 10/01/11
BODILY IN.JURY (Per person) 3
ALL OWNED AUTOS
BODILY INJURY (Per acddent) $
SCHEDULED AUTOS
— HIRED AUTOS PROPERTY DAMAGE $
(Per accident)
NON OWNED AUTOS $
r
C X UMBRELLA LIAB v I OCCUR CUP 7745Y34A 10/01/10 10 /01 /11 EACH OCCURRENCE $6000000
EXCESSUAa CLAIMS -MADE AGGREGATE $ 6000000
_ DEDUCTIBLE $
X RETENTION $ 5000
A WORKERS COMPENSATION IDTCHt13640 - 3L960 10/01/10 10/01/11 X WCSTATU• 0TH -
A AND EMPLOYERS' LIABILITY TORY LIMITS I ER
ANY PROPRIETOR/PARTNERJEXECUTIV YIN IEUB6405L363 10/01/10 10 /01 /11 E.L. EACH ACCIDENT $ 500000
OFFICER/MEMBER EXCLUDED? NIA
(Mandatory In NN) E.L. DISEASE - EA EMPLOYEE $ 500000
If yes, describe under
DESCRIPTION OF OPERATIONS below EL. DISEASE - POLICY LIMIT S 500000
DESCRIPTION OF OPERATIONS/LOCATIONS/ VEHICLES {Attach ACORD 101, Additional Remarks Schedule If more space Is required)
RE: Sign installed at 408 -412 N Main Street, Oshkos WI - City of Oshkosh
is included as an Additional Insured as respects the awning projecting over
the City of Oshkosh sidewalk.
CERTIFICATE HOLDER CANCELLATION
OSHKOS1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
CITY OF OSHKOSH AUTHORIZEDREPRESENTATIVH
215 CHURCH AVENUE
P.O. BOX 1130
(OSHKOSH WI 54902 -1130 r.A
® 19 2009 - * CORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks Of ACORD