2021-195-E-Human Rights Relations-Houck Transit Advertising

Browse Search

DocuSign Envelope ID:5D04E744-49DD-4FEE-ACA8-703D1BBDA528 CERTIFICATE OF LIABILITY INSURANCE P ATE(MMIDD/YYYY) 10/15/2020 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 INSURER(S), 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 endorsement($). PRODUCER CONTACT Sandi Wong David Schiminsky,Agent PHONE 651-774-8671 1 FAX 651 415-1284 AIC No Ext: A/C No 2097 County Road D Suite B E-MAIL sandi.won e94h statefarm.com ADDRESS: g' Maplewood, MN 55109 INSURERS AFFORDING COVERAGE NAIC# INSURER A: State Farm Fire and Casualty Company 25143 INSURED INSURER B: State Farm Mutual Automobile Insurance Company 25178 Houck Motorcoach ADV INC. INSURER C: 1025 Tomlyn Ave Suite 100 INSURER D: Shoreview, MN 55128 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE ®OCCUR DAMAGE TO RENTED 300,000 PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 A N N 93-EE-K459-0 03/01/2020 03/01/2021 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY❑ERCO 0 LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: line 2 Includes fire llab $ AUTOMOBILE LIABILITY N N 163-8623-F22-23G 06/22/2020 12/22/2020 oa MI1INFD a cider SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ 1,000,000 B OWNED SCHEDULED BODILY $ 1,000,000 AUTOS ONLY AUTOS ) HIRED NON-OWNED PROPERTY DAMAGE $ 1,000,000 AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIABixi OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE 93-BG-C698-9 07/29/2020 07/29/2021 AGGREGATE $ 5,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE I ER A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? � NIA Y 93-MD-EO39-9 02/09/2020 02/09/2021 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REP75iNTATIVE ©1988-2015 ACORD CORPORATION. II rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 01486 132849.12 03-16-2016