HomeMy WebLinkAbout473287 SHORT-ELLIOTT-HENDRICKSON INC - INSURANCE CERTIFICATE (8)ACORD. CERTIFICATE OF LIABILITY INSURANCE
16/2014
(MMMDfYYY
DATE
09/26/2014
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
NAME:
Est PHONEo 952.893.1933 A/C,Np:952.893.1819
Min,
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAICU
INSURER A: XL Specialty Insurance Co.
INSURED Short -Elliott -Hendrickson, Incorporated
3535 Vadnais Center Drive
St. Paul, MN 55110
INSURER B:
INSURER C:
INSURERD:
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 10/14-15 PL 1 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.
LTN
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
MMMDNYYY
MMIDD
Umn's
GENERAL LIABIUTY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 171 OCCUR
EACH OCCURRENCE
$
PREMISES Ea occurrence
$
MED EXP(Any one person)
$
PERSONAL& ADV INJURY
$
GENERAL AGGREGATE
$
GENL AGGREGATE LIMIT APPLIES PER:
POLICY PROJECT LOC
PRODUCTS-COMP/OP AGG
$
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIREDAUTOS AUTOS
Ea accident
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
Per accident
$
UMBRELLA LIM
EXCESS LIMB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DIED RETENTION$
$
WORKERS COMPENSATION
AND EMPLOYERS' UABIUTY YIN
ANY PROPRIETOWPARTNEWEXECUTIV(T—I
OFFICEWMEMBER EXCLUDED? U
(Mandatory In NH)
If yea, describe under
DESCRIPTION OF OPERATIONS beloo
NIA
_
WC STAT- -
TORY LIMITS ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE -POLICY LIMIT
$
A
Professional Liability
DPR971839
10/0112014
10/01/2015
Each Claim/ $5,000,000
Annual Aggregate $10,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AddlUonal Roma" Schedule, If mom space Is nculred)
This certificate or memorandum of insurance does not affirmatively or negatively amend, extend, or
alter the coverage afforded by the insurance policy.
Lp_121a ga1w.T1IAJ .
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 Fort Collins
300 LaPorte Ave
Fort Collins, MN 80S21
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD