2007-00450 Ins 09-09-10 - Laserfiche WebLink

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, acoizv ® CERTIFICATE OF LIABILITY INSURANCE D ATE 9/09 /2010 09 /o9 /zolo 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 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificat holder in lieu of such endorsement(s). PRODUCER 1- 414 -443 -0000 CONTACT NAME. Hays Companies of Wisconsin, Inc. PHONE J FAX -(AIC AIC No 1200 North Mayfair Road, Suite 100 E-MAIL ADDRESS $ 500,000 PRODUCER Milwaukee, WI 53226 CUSIQMER IDp INSURERS AFFORDING COVERAGE NAIC e INSURED INSURER A LEXINGTON INS CO 19437 Pierce Manufacturing Inc. INSURER TRAVELERS PROPERTY CAS CO OF AMER 25674 INSURER TRAVELERS IND CO 25658 P.O. Box 2017 I NSURER D LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Appleton, WI 59912 -2017 INSURER E COMBINED SINGLE LIMIT (Ea acclden0 I NSURER F: BODILY INJURY IPer person) $ COVERAGES - - - - ' — CERTIFICATE NUMBER: 17325947 REVISION NUMBER: THIS IS TO CERTIFY THAT 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSR SUER POLICY NUMBER MMI POLIC rrrEYY)( LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IT] OCCUR X 015438059 04/01/1 04/01/11 EACH OCCURRENCE $ 1,000,000 PREMISES Eaoocurrence $ 500,000 MED EXP (Any one person) $ Excluded PERSONAL B ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 5,000,000 SENT AGGREGATE X POLICY LIMIT APPLIES PER PRO- LOC PRODUCTS - COMPIOP AGG $ 1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea acclden0 $ BODILY INJURY IPer person) $ BODILY INJURY (Per acadenl) $ PROPERTY DAMAGE (PeraccWen) $ $ 3 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIk15 -MADE 015438060 04/01/1 04/01/11 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000,000 DEDUCTIBLE RETENTION $ ` E C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER,EXECUTIVE YIN OFFICERMIEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS beios N IA TRJUB117D757110 10 /O1 /1 10 /01/1 10/01/11 10/01/11 X WCSTATU- OTH- E L. EACH ACCIDENT $ 1,000,000 EL DISEASE - EA EMPLOYEF4 S 1,000,000 E L. DISEASE - POLICY LIMIT $ 1, 0 00 , 000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Amch ACORD 101, Additional Remarks Schedule, It more space is required) Regarding: Contract for Purchase of Fire Apparatus. Additional Insured when required by written contract. City of Eugene 1820 Roosevelt Boulevard Eugene, OR 97402 diannewandel ACORD 25 (2009109) 17325947 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE USA �I �i The ACORD name and logo are registered All rights