1997-11-21 Cert of Insurance
Stein Insurance Agency
12800 Lake Blvd.
P.O. Box 603
Lindstrom, MN 55045
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
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PRODUCER
COMPANY
A AMERICAN STATES INS
INSURED
C & N Sewer & Water Contracting Inc
19880 Quinnell Avenue North
COMPANY
B AMERICAN STATES INS
COMPANY
C AMERICAN STATES INS
Scandia, MN 55073
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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM/DD/VV) DATE (MM/DD/VV)
A GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000
COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ 2,000,000
CLAIMS MADE [IJ OCCUR 01-CC-503198.9 11/09/97 11/09/98 PERSONAL & ADV INJURY $ 1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1. 000,000
FIRE DAMAGE (Anyone fire) $ 100,000
MED EXP (Anyone person) $ 10,000
B AUTOMOBILE LIABILITY
X COMBINED SINGLE LIMIT $ 300,000
ANY AUTO
ALL OWNED AUTOS 01-CC-503198-9 11/09/97 11/09/98 BODILY INJURY
(Per person) $
SCHEDULED AUTOS
HIRED AUTOS BODILY INJURY
$
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCiDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
--{ . . WORKERS COMf>I!:r:sATION AND .sTATUTOJ:l'f.l~
EMPLOYERS' LIABILITY 01.WC-675805.80 11/26/97 11/26/98 100,000
EACH ACCIDENT $
THE PROPRIETOR/ INCL DISEASE - POLICY LIMIT $ 500,000
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL DISEASE. EACH EMPLOYEE $ 100,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
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City of Albertville
5975 Main Street North
Albertville, MN 55301
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 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 FAILUR 0 MAIL SUCH NOTICE SHALL IMPOSE OBLIGATION OR LIABILITY
TS OR REPRESENTATIVES.
OF ANY
AUTHORIZED
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