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072318 Insurance Cert AE2S dba EIMA` Q® CC)R v CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 7/31/2018 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(s). PRODUCER Cobb Strecker Dunphy & Zimmermann 225 South Sixth Street Suite 1900 CONTACT NAME: Clinton LaGrander PHONE FAx N E : 612- 349 -2400 AD No): A DRIESS: clagrander@csdz.com INSURERS AFFORDING COVERAGE NAIC# Minneapolis MN 55402 INSURER A: Zurich American Insurance Company 16535 1014/2017 INSURED ADVAELEI INSURER B: American Guarantee & Liab Ins Co 26247 AE2S Construction, LLC DBA: EIM 4050 Garden View Dr Suite #200 INSURER C Grand Forks, ND 58201 INSURER D: INSURER E: $ 300,000 X INSURER F: $10,000 Cr%VPRAn=Q f'- FRTIFIr'ATF NIIMRFR, 13RR317RRn 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 POLICY NUMBER MM DDI EFF IPM /DICD LIMITS A X COMMERCIAL GENERAL LIABILITY GLOO13708603 1014/2017 10/4/2018 EACH OCCURRENCE $1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 X MED EXP (Any one person) $10,000 Contractual Llab X XCU /Policy Form PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 HPOLICY � JERCOT rx] LOC $ OTHER: A AUTOMOBILE LIABILITY BAP013708503 1014/2017 101412018 =SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ X Comp: $500 X Coll: $1,000 B X UMBRELLA LIAB X OCCUR AUC013710203 1014/2017 10/412018 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $, $ • WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YN WC013708803 10/4/2017 10/4/2018 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,OOD,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N/A E.L. DISEASE - POLICY LIMIT $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below • Stop Gap Liability WC013708803 1014/2017 10/4/2018 Applies to: ND, OH, WA, WY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Shorewood Boulder Bridge MCC Replacement Additional Insured only if required by written contract with respect to General Liability, Automobile Liability and Umbrella /Excess Liability applies on a primary basis and the Insurance of the Additional Insured shall be Non - Contributory: City of Shorewood, WSB & Associates, Inc. and others required by written contract. Waiver of Subrogation only if required by written contract with respect to General Liability, Automobile Liability, Workers Compensation and Umbrella /Excess Liability applies in favor of: City of Shorewood, WSB & Associates, Inc. and others required by written contract. The following supersedes the cancellation wording: Should any of the above described policies be cancelled before the expiration date, 30 Days written notice (10 Days for Non - Payment) will be delivered to the certificate holder. City of Shorewood Attn: Larry Brown, Public Works Director 5755 Country Club Road Shorewood MN 55331 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE ,%.► WP ©1988 -2015 ACORD CORPORATION. All rights reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ENDORSEMENT ADDITIONAL INSURED — AUTOMATIC- OWNERS, LESSES OR CONTRACTORRS This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement only with respect to liability for "bodily injury ", "property damage" or "personal and advertising injury" that occurs subsequent to the execution of such written contract or written agreement and if 1. The written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under the Insurance Services Office (ISO) ISO CG20 10 10/01 edition or the ISO CG20 37 10/01 edition, then such party is an additional insured only to the extent that "bodily injury" "property damage" or "personal and advertising injury" arises out of "your work ", which is the subject of the written contract or written agreement; or 2. The written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under the Insurance Services Office (ISO) CG20 10 07/04 edition, the ISO CG20 10 04/13 edition, the ISO CG20 37 07/04 edition, the ISO CG20 37 04/13 edition, an ISO CG20 10 with no specification of edition date, an ISO CG20 37 with no specification of edition date, or no specific form is required such party is an additional insured only to the extent that "bodily injury" "property damage" or "personal and advertising injury" is caused, in whole or in part by, a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf, in the performance of "your work" which is the subject of the written contract or written agreement; However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. 3. Does not apply to "bodily injury" or "property damage caused by "your work" and included within the "products- completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage. If the the minimum time period for providing such coverage in the written contract or written agreement ends prior to or during the policy period, such coverage would not be available after that minimum time period. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury ", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. U -GL- 1114 -A CW 10 -02 ENDORSEMENT This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage ", or the offense which caused the "personal and advertising injury ", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV — Commercial General Liability Conditions: The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim; 2. We receive written notice of a claim or "suit" as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non - contributory. D. For the purposes of the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section IV — Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV— Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence ", offense, claim or "suit ". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non - contributory basis. E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the minimum amount of insurance: 1. Required by the written contract or written agreement referenced in Paragraph A. of this endorsement; or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. U -GL- 1114 -A CW 10 -02 ENDORSEMENT If the minimum amount of insurance required by the written contract or written agreement for General Liability coverage is less than the Limits of Insurance shown in the Declarations but the written contract or written agreement requires umbrella or excess coverage, we will include that requirement in our assessment of the minimum amount of insurance. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. U -GL- 1114 -A CW 10 -02