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Client#: 118291 HAKAAND DATE(MM/DD/YYYY) ACORD.,,, CERTIFICATE OF LIABILITY INSURANCE 11/03/2015 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 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 Michelle Balck NAME: CBIZ Insurance Services, Inc. :PHONE 763 549-2200 FAX 763-549-2299 A/C,No,Ext (A/C,No): 2800 Freeway Blvd. E-MAIL ADDRESS: mbalck@cbiz.com Minneapolis, MN 55430 INSURER(S)AFFORDING COVERAGE NAIC# 763 549-2200 INSURER A:Depositors Insurance Co. 42587 INSURED INSURER B:SFM Mutual Insurance Co. 11347 Hakanson Anderson Assoc Inc INSURER C:Continental Casualty Company 20443 3601 Thurston Avenue#101 Anoka, MN 55303 INSURER D: INSURER E: 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 CONTRACTOR 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. ADDLSUBR IN TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXPM) LIMITS (MM/DD/YYYY) (MM/DD/Y ) A GENERAL LIABILITY ACP7144733339 11/01/2015 11/01/2016 EACHOCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISESOEa occurs nce $300,000 CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $11,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY M PRO LOC $ JECT A AUTOMOBILE LIABILITY ACP7144733339 11/01/2015 11/01/2016EaacccideDSINGLELIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident A X UMBRELLA LIAB X OCCUR ACP7144733339 11/01/2015 11/01/2016 EACH OCCURRENCE s2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s2,000,000 DED I X RETENTION$2000000 $ B WORKERS COMPENSATION 043702206 11/01/2015 11/01/201 X TyORYLTU- MITS EORH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N] N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$500,000 C E&O AEH004312681 6/20/2015 06/20/201 $250005000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION City of Elk River SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 13065 Orono Parkway ACCORDANCE WITH THE POLICY PROVISIONS. Elk River, MN 55330 AUTHORIZED REPRESENTATIVE CBIZ Insurance Services, Inc. ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1213070/M1212551 OPRS