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CERTIFICATE OF LIABILITY INSURANCE5/28/2014Y) 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 ':PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. .APORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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(s). PRODUCER• CONTACT Michele Miller CISR NAME: Bearence Management Groin PHONE N .Extl: (651) 379^7800 �P^ q/C.No): (651)379-7801 2010 Centre Pointe Blvd E-MAILnnnRF�e• mmiller@bearence.com Mendota Heights MN 55120 INSURERS AFFORDING COVERAGE NAIC # INSURERA:Continental Casualty Company 20443 INSURED Peterson Companies, 8326 Wyoming Trail Chisago City Inc. MN 55013-9382 INSURERB:Continental Insurance Company 42625 INSURERC:SFM Mutual Insurance Company 11347 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:CL13123025153 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. INSR LTR — TYPE OF INSURANCE ADDL SUBR WVD - POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYYj LIMITS_ GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL_ GENERAL LIABILITY CLAIMS -MADE Fx I OCCUR 5090748190 1/1/2014 1/1/2015 DAMAGE ( RENTED PREMISESS Ea occurrence) $ 300,000 MED EXP (Anyone person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 X Contractual X X,C,U GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY PRL LOC X AUTOMOBILE _ LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1 , 000,000 BODILY INJURY (Per person) $ B X ANY AUTO SCHEDULED AUTOS AUTOS ALL OWNEDrxx 5090748206 1/1/2014 1/1/2015 BODILY INJURY (Per accident) $ r�fxc__ NON -OWNED HIRED AUTOSAUTOS PROPERTY DAMAGE$ Per accident Hired Physical Damage $ 75,000 Comp Ded $500 Coll Ded $500 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DED X Rf_TENTION$ 10,000 $ 5090748223 1/1/2019 1/1/2015 C WORKERS COMPENSATIONX AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? I (Mandatory in NH) N/A 84839.204 1/1/2019 1/1/2015 WC STATU- 0TH - EACH ACCIDENT $ 1 000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Installation Floater 5090748190 1/1/2014 1/1/2015 Limit $75,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Project No.: 003-2014 City of Roseville shall be named as an additional insured in regard to the general liability Form G140331D where required by written contract on a primary and non contributory basis including completed operations. CERTIFICATE HOLDER CANCELLATION City of Roseville 2660 Civic Center Drive Roseville, MN 55113 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 REPRESENTATIVE Miller, CISR/MILLER ACORD 25 (2010105) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD