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HomeMy WebLinkAbout473287 SHORT-ELLIOTT-HENDRICKSON INC - INSURANCE CERTIFICATE (13)73905 Ago CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 9/30/2015 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(les) 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 CONTNAME: Tony Blaisdell Commercial Lines - 952-242-3100 PHONE FAX (A/C, No. Exec: (AM, WC, Not: Wells Fargo Insurance Services USA, Inc. E-MAIL on asewesa _ ADDRESS: tyBlidll llf @ �•com 400 Highway 169 South INSURER(S) AFFORDING COVERAGE NAIL / St. Louis Park, MN 55426 INSURERA: Hartford Casualty Insurance Company 29424 INSURED INSURERB: Depositors Insurance Company 42587 Short -Elliott -Hendrickson, Inc. NSURERC: Continental Casualty Company 20443 3535 Vadnais Center Drive INSURERD: Twin City Fire Insurance Company 29459 St. Paul, MN 55110 NSUREIR CAVERAPFS CERTIFICATE NUMBER: 9616336 REVISION NUMBER: See below 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSO VIIFVD POLICY NUMBER MWDD/1'YYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE '�, X OCCUR — 41UENQT9743 10/01/15 10l01/16 EACH OCCURRENCE DAMAGE TO RENTED PREMISES E.00currence), $ 1,000,000 $ 300000 MED EXP (Any one person) $ 10,000 PERSONAL 6 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 1K JEC D LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Combined Total Aggregate _ $ 10,000,000 OTHER: B AUTOMOBILE LIABILITY BAPD 7101965099 10/01/15 10/01/16 COMBINED SINGLE LIMIT Ea accklent) $ 1,000.000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per woldent) ALL OWNED SCHEDULED AUTOS AUTOS rX $ PROPERTY DAMAGE Per accident$ X NON -OWNED HIRED AUTOS AUTOS $ C X UMBRELLA LIAB X OCCUR L6011730036 10/01/15 10/01/16 EACH OCCURRENCE $ 7.000,000 AGGREGATE $ 7,000,000 EXCESS LUAB CLAIMS -MADE DED I X , RETENTION $ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) NIA 41 WEQT9807 10/01/15 10/01/16 X STATUTE ER 1 000,000 f E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE --- $ 1,000,000 It yes, describe under DESCRIPTION OF OPERATIONS below $ 1,000,000 E.L. DISEASE - POLICY LIMIT I I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) Certificate Holder is Additional Insured with regards to General Liability when required by written contract. CERTIFICATE HOLDER CANCELLATION City of Fort Collins 300 La Porte Avenue 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 REPRESENTATIVE The ACORD name and logo are registered marks of ACORD © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 111111111111111111 IN IIIIIIIIIII IIII IIIIIIIIIIIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII CVB01 A30/002727JU202 O/0/o/0'