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HomeMy WebLinkAbout473287 SHORT-ELLIOTT-HENDRICKSON INC - INSURANCE CERTIFICATE (14)73905 p® DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/2112017 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 have ADDITIONAL INSURED provisions or 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 CONTACT NAME: Amy Bond Commercial Lines - 952-242-3100 P tCNNo, Exp: 952-242-3141 IC No Wells Fargo Insurance Services USA, Inc. E-MAIL y• Bond2@welisfargo.com Am wellstar o.com @ 9 400 Highway 169 South INSURER(S) AFFORDING COVERAGE NAICII St. Louis Park, MN 55426 INSURERA: Continental Insurance Company 35289 INSURED INSURER B: National Fire Insurance Company Of Hartford 20478 Short -Elliott -Hendrickson, Inc. INSURERC: 3535 Vadnais Center Drive INSURER D St. Paul. MN 55110 COVERAGES CERTIFICATE NUMBER- 12256164 REVISION NIIMRFR• 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 LTR TYPE OF INSURANCE AD L BR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY I_ CLAIMS -MADE 1xi OCCUR 6043204066 10/1/2017 10/1/2018 OCCURRENCE $ 1,000,000 _PRREMIEMISESEaEACH _ 1 ISETOIiENTE�occurrence $ 500,000 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY � PECT FILOC PRODUCTS - COMPIOP AGG S 2,000,000 S OTHER: A AUTOMOBILE LIABILITY 6043204083 10/01l17 10/01 /18 COMBINE SINGLE LIMIT Ea accident $ 1,000,000 X _ BODILY INJURY (Per person) _ $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) W $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per cidenl $ A X UMBRELLA LIAB X OCCUR 6011730036 10/01/17 10/01/18 EACH OCCURRENCE $ 8,000,000 AGGREGATE $ 8,000,000 EXCESS LIAR CLAIMS -MADE DED X RETENTION$ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNERJEXECUTIVE OFFICER/MEMBEREXCLUDED? C (Mandatory in NH) NIA 6043204116 10/01/17 10/01/18 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000.000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,OOD.000 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 Lj(N" 41, ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD © 1988-2015 ACORD CORPORATION, All rights reserved. 111111111111111111 IN 11111111111111111111111111111111111111111111111111111 IN 11111111 vao,Az„000azeroz,ozro,o,o,o ACC> 0® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 9/20/2017 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 CONTACT Jeanne Danmeier NAME: q/CONNo E:: (952) 893-1933 AX No: (952)893-1819 H. Robert Anderson and Associates, Inc. E-MAIL ADDRESS: 8201 Norman Center Drive INSURERS AFFORDING COVERAGE NAIC# Suite 220 INSURERA:XL Specialty Insurance Co. 37885 Bloomington MN 55437 INSURED INSURER B : INSURER C : INSURERD: Short -Elliott -Hendrickson, Incorporated INSURERE: 3535 Vadnais Center Drive INSURER F : St. Paul MN 55110 COVERAGES CERTIFICATE NUMBER:2017 - 2018 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. INSR I iADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD,"(YYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $DAMAGE CLAIMS -MADE OCCUR TO FIR SES Ea oTED ocurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- JECT ❑ LOC $ PRODUCTS - COMP/OP AGG OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ AGGREGATE EXCESS LIAB CLAIMS -MADE $ DIED RETENTION $ $ WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OTH- STATUTE ER E.L. EACH ACCIDENT _ $ OFFICER/MEMBEREXCLUDED? ❑ NIA -_---_ (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liability DPR9918063 10/1/2017 10/1/2018 Each Claim/ $5, 000, 000 Each Policy Year Aggregate $10, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 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 GANGtLLA11VN 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 REPRESENTATIVE ACORD 25 (2014/01) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD