06-24-2019 Council Packet - Laserfiche WebLink

Home Browse Search

COVERAGE PROVIDED Operations of Contractor: Yes Operations of Sub -Contractor (Contingent): Yes Does Personal Injury Include Property Damage Liability Includes Claims Related to Employment: Yes Completed Operations/Products: Yes Contractual Liability (Broad Form): Yes EXCEPTIONS: Damage Due to Collapse AUTOMOBILE LIABILITY POLICY # No Government Immunity is Waived Yes No No Property Damage Liability Includes Damage Due to Blasting Yes No No Damage Due to Collapse Yes No No Damage To Underground Facilities Yes No No Broad Form Property Damage Yes No. EFFECTIVE DATE: / / EXPIRATION DATE: INSURANCE COMPANY: ( )Any Auto ( )All Owned Autos ( )Scheduled Autos ( )Hired Autos ( )Non -Owned Autos LIMITS: Bodily Injury $ Each Person / $ Each Occurrence OR Combined Single Limit Property Damage $ Each Occurrence UMBRELLA EXCESS LIABILITY POLICY # EFFECTIVE DATE:—/—/ EXPIRATION DATE: INSURANCE COMPANY LIMITS: Single Limit Bodily Injury and Property Damage $ Each Occurrence $ Aggregate COVERAGE PROVIDED: Applies in excess of the coverages listed above for Employers' Liability, General Liability, and Automobile Liability: Yes No Are any deductibles applicable to bodily injury or property damage on any of the above coverages? Yes No If So, List Amount $ AGENT CARRIES ERRORS AND OMISSIONS INSURANCE: Yes No Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will mail 30 days notice to the parties to whom this certificate is issued. Dated at: MN License # Authorized Insurance Representative On: 23 an