2019-123-E Human Resources - Springsted Waters executive search

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DocuSign Envelope ID: EB5D5FB9-1F00-4836-9CE0-355AF8D06137 DATE IMMIDDIYYYY] MACC>REY CERTIFICATE OF LIABILITY INSURANCE 12/7/201 g — 11`.� r THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such andorsement(s). PRODUCER 1'11o11e: (952)944-2929 CONTACT Chelsey Van Eyll Fax: f952W44-3091 NAME: Horizon Agency,Inc. PHA&LONE [952)914-7135 FA C No 500 City West Pkwy#l00 noaEss: chelsey®harixonagency.cam Eden Prairie,Minnesota 55344 _ INSURERS AFFORDING COVERAGE NAM# INSURER A: Federal Insurance Company 20281 INSURED INSURER a: Executive Risk Indemnity Inc, 35181 Springsted I Waters INSURERC: 380 Jackson Street 9300 INSURER D: St.Paul,MN 55101 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:10006 REVISION NUMBER: 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, JA TYPE INSURANCE DD S SR POLICY EFF POLICY ExP LIMrCB POLICY NUMBER MM1I1DIYYYY MMIDDIYYYY ERCIAL GENERAL LIABILITY 35342568 8/11/2018 8/11/2019 EACH OCCURRENCE $ 1,000,000 LAIMS-MADE OCCUR 1,000,000 $0 Deductible PREMISES Ea occurrence $ME➢ExP An one erson $PERSONAL&ADVINJURY $ 1,000,000 REGATE LEMI7APPLIES PER: GENERALAGGREGATE $ 2,000,000 Y PRO LOC PRODUCTS-COMPIOPAGG g2,0D0,000 JECTR: $ JA LELIABN.ITY 73234006 8/11/201 S 8/11/2019 C0MBINED s[NGLE LIMIT $ 1,000,000 EaaccidentUTO BODILY INJURY[Per person] $ DSCHEDULEDBODILY INJURY(Per aoc[dent] $ S ONLY AUTOS NON-OWNED PROPERTY DAMAGES ONLY AUTOS ONLY Per accidentELLALIAB OCCUR 79764838 8/11/2018 8/11/2019 EACH OCCURRENCE $ 4,000,000 SS LIAB CLAIMS-MADE AGGREGATE $ 4,000,000 I ►/ I RETENTION$ 0 $ WORKERS COMPENSATION 7t646620 8/11/2018 8f11/2019 J PER OTH- A AND EMPLOYERS'LIABILITY STATUTE ER 500,000 ANYPROPRIETORIPARTNERIEXECUTiVE YIN E.L.EACH ACCIDENT $ OFFICE OFFICEAMEn NH1 MBER EXCLUDED? F NIA .L 500,000 E .0ISEASE-EA EMPLOYEE $ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMrf $ 13 LErrorsOmissions 92079210 1/14/2018 1/14/2019 EachClaim 2,000,000 Deductible ARpreFale 2,000,000 DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES [ACORD 101,AddillanaI Remarks Schedule,may he attached If more space is raqul red I CERTIFICATE HOLDER CANCELLATION Holder's Nature of interest:CerliFicate Holder SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Informational Purposes Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. �I 00000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD