HomeMy WebLinkAbout473287 SHORT-ELLIOTT-HENDRICKSON INC - INSURANCE CERTIFICATE (7)ACORD CERTIFICATE OF LIABILITY INSURANCE
O09/25/2013ATS5/2013
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
certificate holder in lieu of such endorsement(s).
PRODUCER
H. Robert Anderson & Assocs., Inc.
8201 Norman Center Drive
Suite 220
Bloomington, MN SS437
CONTACT
NAME:
PHONE , Exit_ 9S2.893.1933 X.Ncy952.893.1919
NC No
at
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAICe
INSURER A: XL Specialty Insurance Co.
INSURED Short -Elliott -Hendrickson, Inc.
�/
SEH, Inc. l 1 32-87
353S Vadnais Center Drive I
St. Paul, MN 55110
INSURERS:
INSURER C:
INSURER O:
INSURER E:
INSURER F :
COVERAGES CERTIFICATE NUMBER: 10/13-14 PL 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.
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
MMIDD
MMID
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
71 CLAIMS -MADE OCCUR
EACH OCCURRENCE
$
RERTED—
PREMISES Es o=s enc9
$
MED EXP IAny are person)
$
PERSONAL B ADV INJURY
$
GENERAL AGGREGATE
$
GENL AGGREGATE LIMIT APPLES PER:
POLICY F7 PROJECT LOC
PRODUCTS-COMP/OP AGG
t
$
AUTOMOBILE LIABWTY
ANY AUTO
ALLOWNED SCHEDULED
AUTOS AUTOS
- NON -OWNED
HIRED AUTOS AUTOS
Ea accident
S
BODILY INJURY (Per Person)
S
BODILY INJURY (Per accident)
$
Per accident
S
S
UMBRELLA LIM
EXCESS UAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
S
DED RETENTION$
WORKERS COMPENSATION
AND EMPLOYERS' LIMUTY YIN
ANY PROPRIETOR/PARTNER/EXECUT
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
0 yyeess des Wine under
DESCRIPTIONOFOPERATIONSIeIaW
NIA
TORY LIMITS ER
E.L. EACH ACCIDENT
_
$
$
EL DISEASE - EA EMPL
E.L. DISEASE-POLICVLIMIT
--
S
A
Professional LTabi Tty
DPR971002210/01/2013
10/01/2014
Each Claim/ $S,000,000
Annual Aggregate $10,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aibch ACORD 101, Additional Remarks Schedule, if more space is required)
This certificate or memorandum of insurance does not affirmatively or negatively amend, extend, or
alter the coverage afforded by the insurance policy.
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
300 LaPorte Ave
Fort Collins, MN 80521
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
'� WbcL JU-- 47/16&.1` .d
[KA:13Q :7e\ I I U7 : �i11 � 7 f A S i;173 T.R:T.1
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD