1994-05-24 Cert of Insurance
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............................................................................. 05 24 94
THIS CERTIRCATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERnRCATE HOLDER. THIS CERnRCATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
PRODUCER
APOLLO INSURANCE
28 S 11TH AV
P 0 BpX 1206
ST CLOUD
AGENCY
MN 56302-1206. ~NN A
TRANSCONTINENTAL INSURANCE CO
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INSURED
ANNANDALE CONTRACTING INC
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TRANSPORTATION INSURANCE CO
............. .................. ............................._.....-....................
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TRANSPORTATION INSURANCE CO
...........-.-.............. ........-.... ....-...............--....--.. .-..................
6646 CTY RD 5 NW
ANNANDALE
MN 55302
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THIS IS TO CERTIFY THAT THE POUCIES INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDmONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co
LTR
TYPE OF INSURANCE
POUCY NUMBER
. POLICY EFFEC11VE POUCY EXPlRAnON.
DATE (MM4lOIYV) . DATE (MMIDDIYV)
Uln'S
GENERAL UAIllLJ1'Y Al12 0 6 6 0 1 0
X COMMERCIAL GENERAL UABIUTY
ClAIMS MADE X . OCCUR.
OWNER'S & CONTRACTOR'S PROTo
OS/23/94 OS/23/95
.GENE~~~~':l~~~~............$.~ .f..9.9..<:l.f..9.<:lq..
..PRoo~~p.f()....~~~:.......$.~.,.9.<:l.<:l.,..9<:l<:l...
PERS()NAI.:.~. ~v.: .~~~~... ....~1...,.<:l q .9.(.. <:l q 9....
EACH ~.U.':l~~~. ............~.1...t..<:lq9..t.q.99....
FIRE D:,!,,~~~ (~.CltMt..~)......$.. ......?.<:l.,9.<:lq...
MED. EXPENSE (Ant one P8'*l'II . $ 5 0 0 0
COMBINED SINGLE $1,000,000
UMIT
AUTOMOBH.E UABIUTY Al12 0 6 6041
X ANY AUTO
AU. OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS
GARAGE UABIUTY
OS/23/94 OS/23/95
BODILY INJURY
(Per pe<son)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
$
EXCESS UAIllLJ1'Y
X UMBRELLA FORM
OTHER "THAN UMBRE!.!.A FORM
Al12066024
OS/23 / 9405/2 3 /95 EACH OCCURRENCE
WORKER'S COMPENSAnoN
AND
EMPLOYERS' UAIllLJ1'Y
EACH ACCIDENT $
DISEASE-POUCY UMIT $
DISEASE-EACH EMPLOYEE $
01lIER
DESCRI'T1ON OF OPERA11ONSILOCA11ONSIVEHICLESlSPECIAL ITEMS
PROJECT: HARDWOOD POND, 2ND ADDITION, UTILITIES & STREET, ALBERTVILLE MN
CERTIFICATE HOLDER & MEYER-ROHLIN, INC., ENGINEERS ARE ADDITIONAL INSUREDS
FOR THIS PROJECT
CITY OF ALBERTVILLE
CITY HALL
ALBERTVILLE MN 55301
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR
UABIUTY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTA11VE