1997-10-14 Cert of Insurance
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..Qi71INStJa.ANC.ES.....
DATE (MMIDD/YY)
10/14/97
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
PRODUCER
J. A. PRICE AGENCY, INC.
7100 Shady Oak Road
Eden Prairie, MN 55344
COMPANY
ATravelers Grou
INSURED
Kuechle Underground, Inc.
20 Main Street
P. O. Box 509
Kimball, MN 55353
COMPANY
B
COMPANY
C
COMPANY
o
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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 CONDlTIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE rOLlCY EXPIRATIONI'
DATE (MM/DD/YY) I DATE (MM/DDIYY)
03/24/97 03/24/98
LIMITS
A GENERAL LIABILITY
OMMERCIAl GENERAL lIABllIT
CLAIMS MADE [XJ OCCUR
WNER'S & CONTRACTOR'S PRO
DTC0327N8644IND
GENERAL AGGREGATE $2
PRODUCTS.COMP/OP AGG $2
PERSONAL & ADV INJURY $1
EACH OCCURRENCE $1
FIRE DAMAGE (Anyone fire) $
MED EXP (Anyone person) $
o 0 0 ,JL91L-
000 000
000 000
000 " 0 0 0
100 000
5 000
A AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS
DT810327N8644TIL
03/24/97 03/24/98
I~~~;~~~~:~f '~_~~~:o 0
l (Per accident) 1$
I PROPERTY D~-MAGE -r
tl\'='!9_()~.L Y.EA A~~.P._~.!.j$
1.0TJ::i,ER T':!.~ AUTO ONL Y: ,... ... .'. . ...d<.. ..'
~... ... _"c;~;;:;;.~_!;__ ___~
!EACHOCCURRENCE $4 ~ 000
AGGREGATE $4 000 000
$
03/24/97 03/24/981 X I STATUTORY LIMITS I
EACH ACCIDENT $100 , 000
I DJ.SEi\!;E:PO!-ICY lIM.!.T_~? 0 0_1.0 _Q.Q._
DISEASE -EACH EMPLOYEE $10 0 0 0 0
03/24/97 03/24/98 $867 1270
$500 Deductible
GARAGE LIABILITY
ANY AUTO
A EXCESS LIABILITY
X UMBRELLA FORM
DT810327N8644TIL
03/24/97 03/24/98
OTHER THAN UMBRELLA FORM
A I WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
I THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFACERSAR~ EXCL
A OTHER Contractors
quipment Floater
DTKUB327N8644
INCL
036IZ25887413FCA
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAl ITEMS
RE: Center Oaksl 2nd Addition,
(See Attached Schedule.)
Street and utility improvements,
amended cancellation clause
6HOIcILB MJ'f grTIIC ^B9VE DCC8RIBEB P9Ll9IE& BC OM/GCllCD BCnlnC TIIC
E:XPIRM'ION 9.-TIi TI~IiRIiOr, TH61CCI.IIPJ8 SGMPAI/Y WilL CIIDCN/OR TO MAil
~ nAV"" WD'TTEN NOTICE TO THE CERTIF'IC^TIi HQl9liR IIMl1i9 TQ TilE LEfT,
Center Oaks Partnership
13736 NE Johnson Street
Ham Lake, MN 55304
.bertville, MN.
~ertificate Holder, Meyer Rohlein, Inc., 1111 Highway 25 North,
Buffalo, MN 55313, The City of Albertville, 5975 Main Ave NE,
Albertville, MN and SEH, 113 S Fifth Avenue, P.O. Box 1717, St. Cloud, MN
56302-1717 are all named as Additional Insureds on the General Liability
as respects the above mentioned project.
* Should any of the above described policies be materially changed,
suspended, or cancelled before the expiration date thereof, or fail to be
renewed upon their expiration, the issuing company will mail 30 days
written notice to the named certificate holder.
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