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2016.09.19 CC Packet
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2016.09.19 CC Packet
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1/14/2019 11:59:17 AM
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9/16/2016 10:16:17 AM
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City Council
Document Type
Agenda/Packets
Meeting Date
9/19/2016
Meeting Type
Regular
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A� CERTIFICATE OF LIABILITY INSURANCE <br />DATE30/2 16 Y) <br />8!30/2016 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER AND THECER71FICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poiicy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject <br />to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights <br />to the certificate holder in lieu of such endomement(s). <br />PRODUCER <br />USG INSURANCE SERVICES, INC. <br />CONTACT <br />NAME: <br />PHONE <br />ONo E><t: (877) 546-9800 FAX rvat <br />550 MAIN ST STE 270 <br />NEW BRIGHTON, MN 551123273 <br />(877) 5463800 <br />E -MAI <br />ADDRES_S:_ <br />X <br />INSURER(S) AFFORDING COVERAGE NAICR <br />12:01 016 <br />12:01 AM <br />INSURERA: United States Fire Insurance 21.113 <br />INSURED SPORTS AND RECREATION PROVIDERS ASSOCIATION(PURCHASING GROUP) AND <br />ITS PPRTICIPATING MEMBERS'. <br />INSURERS: <br />INSURERC: <br />OCCURRENCE $1,000,000.00 <br />Tribute to the Troops of MN <br />P.O. BOX 272 <br />NsuRERO: <br />INSURERE: <br />Circle Pines, MN 55014 <br />INSURERF: <br />COVERAGES CERTIFICATE NUMBER: USS307403 RKVISInN NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH <br />THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. <br />INSF <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSR <br />SUBR <br />WYD <br />POLICYNUMSER <br />POUCYEFF <br />MMMDIYYYY <br />POLICYEXP <br />MMIDDNYYY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL UABILITI <br />CLAIMS -MADE �occuR <br />X <br />SRPG-101-0715 <br />12:01 016 <br />12:01 AM <br />04/03/2017 <br />2:01AMEACH <br />12:01 AM <br />GENERAL AGGREGATE $2,000,000.00 <br />FRODUCTS-COMP/OPAGG $2,000,000.00 <br />PERSONAL&ADVINJURY $1,000,000.00 <br />OCCURRENCE $1,000,000.00 <br />FIRE DAMAGE (Anyone fire) $300,000.00 <br />GENL AGGREGATE LIMIT APPLIES PER'. <br />X POIJCi JECTPRLL LLC <br />MED E, P (Any one person) $0.00 <br />AUTOMOBILE <br />LIABILITY <br />ANYAUTO <br />ALL OWNED SCHEDULED <br />AUTOS MITTS <br />HIRED AUTO NON -OWNED <br />AUTOS <br />COMBINED SINGLE UNIT $ <br />Ea aDou.n <br />BODILY INJURY(Perperson) $ <br />BODILY INJUPY(Peraccident) $ <br />PROPERTY pAMAGE <br />POS MerR $ <br />UMBRELLA LIAR <br />EXCESS LIAR <br />06CUE <br />CLAIMS -MADE <br />I <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />DED RETENTION $ <br />EACH OCCURRENCE $ <br />GENER AL AGr.REPATE $ <br />EACH OCCURRENCE $ <br />GENERAL AGGREGATE $ <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) <br />The Certificate holder is added as an additional insured but only with respect to liability arising out of operations of the named insured during the policy <br />period. <br />Covered Activity: Fundraisers <br />City of Hugo <br />14669 Fitzgerald Avenue N <br />Hugo, MN 55038 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE VHLL BE DELIVERED IN <br />ACCORDANCE VATH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />vSG Insurance Services, Inc. <br />ACORD 25 (2010/05) v141120.001 © 1988-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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