Loading...
HomeMy WebLinkAboutKnife River Certificate of Liability Insurance with Hoiness LaBar Insurance Client#:4861 MTCONTRA ACORD,r., CERTIFICATE OF LIABILITY INSURANCE F DATE IMMIDDIYYYY) fi/2812012 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 Hoiness LaBar Insurance -NAME,PHONE FAx — (Me,No,EXQ'-406-238-1900 wc,No A Member of Payne Financial Group EMAIL -- ADDRESS: P.O. Box 30638 Billings,MT 559107-0638 ._ INSURER(S)AFFORDING COVERAGE _ NAIC# INSURER A:Safety National Cas.Corp. INSURED INSURER B Knife River-Belgrade A Member of the MCCF INSURER C: PO Box 9 INSURER D Belgrade, MT 59714 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 INSR TYPE OF INSURANCE ADD L SUBR POLICY EFF POLICY EXP LTR _ _ fNSR W_ VID POUCYNUMBER (MMIDDIYYYY MMIDWYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ PREM PREMISES LE occu rrence} $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR ME D EXP(Ary one persoi) S PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENTL AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOP AGG $ POLICY( CCT TILOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _ {Ea accident} $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULE❑ BODILY INJURY Per accident $ AUTOS AUTOS C ) NON-OWNED PROPERTY DAMAGE S HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEO RETENTION S $ WORKERS COMPENSATION WC STATU- CTH- AND EMPLOYERS'LIABILITY YIN T Y FR ANY PROPRI ETC RIPARTNERIEXEC UTIVE 5 OFFICERIMEMBER EXCLUDED? ❑ NIA E.L EACH ACCIDENT (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes,descrihe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I S A Workers Comp 5P4045598 1/01/2012 0110112013 Coverage A—Statutory Employers Liab Excluded DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD f Ol,Additional Remarks Schedule,if more Space is required) Subject to the terms and conditions of the policy as issued by the Insurance Company. SIR for Work Comp$1,000,000 per occurrence. Covers Montana State Resident Employees. All claims are administered by the Montana Contractor Compensation Fund(MCCF). Job: 2012 Street Improvements-City of Bozeman CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Bozeman THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Engineering Department ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1230 Bozeman,MT 59771-1230 AUTHORIZED REPRESENTATIVE 1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD ##S7945241M749348 SCM1 CERTIFICATE OF LIABILITY INSURANCE D06ATE 0120ID1 z DIYYYyi osr2912o 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 poticy(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 Marsh USA Inc. NAME' 333 South 7th Street,Suite 1600 lAfCPHON,Na,Exl): itc,Nol: Minneapolis,MN 55402.24DO E-MAIL, ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# J43750-JTLBE-GAX°12-13 10137 2048 2001 AIP N INSURER A:Liberty Mutual Fire Ins Co 23035 INSURED INSURERS:NfA NIA Knife River-Belgrade,MT PG Box 9 INSURER C; Belgrade,MT 59714 INSURER 0: INSURER E- INSURER F COVERAGES CERTIFICATE NUMBER: CHI-004448756-03 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 CONDIT}ON 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. TN—S TYPE OF INSURANCE ANDL SUB R POLICY NUMBER MMIDWYYYY MM1DDIYYYY LIMITS A GENERAL LIABILITY 182641005097-D42 01/01/2012 81/01/2013 FACHOCCURRENCE S 2,000,00U DAMAGETO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence S 500,880 CLAIMS-MADE M OCCUR MED EXP(Arty one parson) $ ANO X PER PROJECT AGGREGATE PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GENT.AGGREGATE LIMIT APPLIES PER PROOUCTS-COMPX)P AGG $ 4,080,000 POLICY PEC LOC S A AUTOMOBILE LIABILITY AS2 641005097.052 01/01/2012 0110112013 COMBINED SINGLE LIMIT 2,008,800 Ea accident 5 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident} $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident) $ 5 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ RED RETENTION$ g WORKERS COMPENSATION JOTH. AND EMPLOYERS'LIABILITY T RY ihnl'LS 1 IER A ANY PROPRIETORIPARTNERrEXECUT)VE YIN N1A7-540-Bl}5097°812(AQ$) 0110112012 01(8112013 E.L.EACH ACCIDENT $ 1,OOB.t?00 OFFICERIMEMBER EXCLUDED? N f p` "MT Employers y y" (Mandatory in NH) Uabilil Only- E.L.DISEASE-EA EMPLOYE $ 1,000,1}00 If yes,describe under 1 DESCRIPTION OF OPERATIONS below E-L.DISEASE-POLICY LIMIT $_Fl I L DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACOR.D 101,Additional Remarks Schedule,if more spate is required) Re 2012 Street Improvements–City of Bozeman Owner,Engineer,and Engineers CUnsultants islare included as additional insured per the attached CG 2010 and CG 2037 endorsements and does not include professional liabilily coverage, Blanket Additional Insured for Automobile Liability is included per allached designated Insured Endorsement CA 20 48. Primary and Non-Contributory applies rer General Liability per LN 20 01 attached- Genarat liability policy includes contractual habitity but only to the extent provided in the policy. No explosion,collapse or underground damage exclusion is included on the general liability policy. CERTIFICATE HOLDER CANCELLATION City of Bozeman SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Engineering Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 1230 ACCORDANCE WITH THE POLICY PROVISIONS. Bozeman,MT 59771-1230 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. ManashlMukherjeeC�„uc,� .S✓��,_ec_,,. r.� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Policy Number AS2-641-005097-052 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CAN CELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY— UMBRELLA COVERAGE FORM Schedule Name of Other Person(s)I Email Address or mailing address: Number Days Notice: Organization(s): Per Schedule on file with the 90 company A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. Wewill send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 01 05 11 G 2011 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Policy Number TB2-641-005097-042 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCE=SS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE: PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PROD UCTSICOMPLETE❑ OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY-- UMBRELLA COVERAGE FORM Schedule Name of Other Person(s)I Email Address or mailing address: Number Days Notice: Organization(s): Per Schedule on file with the 00 company A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM gS 01 05 11 C 2011 Liberty Mutual Group of Companies.All rights reserved, Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. THIS ENDORSEMENT CHANGESTHE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below.We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancella€ion becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the Policy. SCHEDULE Name of Other Person(s)I Email Address or mailing address: Number Days Notice: Organization(s): Per Schedule on file with the 90 company All other terms and conditions of this policy remain unchanged. Issued by LIBERTY INSURANCE CORPORATION For attachment to Policy No. WA7-B41D-005097-012 Effective Date 01/0112012 Premium$ Issued to WM 90 18 06 11 Q 2011 Liberty Mutual Group of Companies Page 1 of 1 Ed. 0610112011 All Rights Reserved THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modified insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE= FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s)or organization(s)who are"insureds"under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name of Person(s) or Any person or organization whom you have.agreed in writing to add as an additional Organization(s): Insured,but only to coverage and minimum limits of insurance required by the written agreement and in no event to Exceed either the scope of coverage or the limits of insurance provided in this policy. Each person or organization shown in the Schedule is an"insured"for Liability Coverage,but only to the extent that person or organization qualifies as an "insured"under the Who is An Insured Provision contained in Section II of the Coverage Form. Policy No: AS2-6,11-005097-052 Isgwt d By: Lberty Mutual Fire Insurance Company Effective Date: 1/1/2012 Expiration Date: 1!1!2013 CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 TMS 'NDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL IONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS -, SCHEDULED PERSON OR ORGANIZATION This rnodi€ies insurance providcd under the foi'ovving: GO 01.,!IERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE `Name Of Additional insured Persor(s) Location(s) Of Covered Operations Or Or aWzatiT s); i Any owner, lessee or contractor for w1iom you have agreed in v.Ti ting prior to a loss to provide liability insurance � f I 1nforn3atiori recruired to complete this Schedule,if not shown above,will be shoven in the Declarations. A. Section it -- Who Is An insured is amended to B. With respect to the insurance afforded to tti)ese include as an additional insured the persons) or additional insureds, the following addiitionat exclu- organization(s) shown in the Schedule, but only sions apply Mth respect o liability for "bodify injury" "property This insurance does lot apply to "boall y injury" or damage" or "personal and advertising fri u,-y" property darnago"occurring after: caused,in whole or ip par;, by: 1 All v.:ork. including mater n(s, p,ar s 0r eq,,`>Z) 1. Your acts or orissions or . merit furnished In connection vt th such work. 2. The acts or omissions of those a'.".ti g an your on he;project (other than service, niainten nce beha;t; or repairs) (o ue performed by or 3n behalf of m the performance ref vu-,;r ongoing operabcns for the a[diti[}rtal insured(s) a? the =ovation of tine .Y CG 20 10 07 04 !C-0 Proper ties. Inc_ 20;i44 Page t of 2 2. Tnai portion of "your .•.tork" out or which the i.-..j ury+ or damage prises has been put to is in- tended use by any persorl or oiner ttt2n another contractor or subcontractor en- gaged in parso-rrlin- operd«ons for a prinoipa as a par,or the same prcjoct. This endorsemer t is exact Leo by the LIBERTY f-OU FUAL FIRE INSURA,=4CE OW,4PO4Y r'rurm�um $ Eft`rtive DE:te rxmratlon Date Fcr attachment to Policy No. ie2-641-005097-n42 AL'IcIIt Q2S;S I.ut,stl Ta Couilltrsigred"y ssr.re.' Ssl s Wine and!•1a. Ft;'-S� Igo. Page 2 of 2 'r ISO Proper`ues, Inc.,2004 CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL.LIASiLITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Operations Or Organization(s): Any person or organization for whom you have agreed in writing prior to a loss to provide liability insurance lnformaiion re wired to complete this Schedule, if not shown above,will be shown in the Declarations. Section 11 — Who is An insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for"bodily injury" or"property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". This endorsemenl is executed by the LIBERTY/MUTUAL FIRE INSURANCE COMPANY Premium $ Effective Data 1/1/2012 Expirelion Dale 111/2013 For atlachnient to Policy No, T132-641-0050 97-042 Audit Basis Issued To CG 20 37 07 04 ©ISO Properties, Inc.,2004 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILTT`Y COVERAGE FORM SECTION E-WHO IS AN INSURED is amended to include as an insured any person of organization for whom you have agreed in writing to provide liability insurance. But The insurance provided by this amendment: 1. Applies only to"bodily injury"or"property damage"arising out of(a) "your work"or(b)premises or other property owned by or tented to you; 2. Applies only to coverage and minimum limits of insurance required by the written agreement,but in no event exceeds either the scope of coverage or the limits of insurance provided by this policy,and 3. Does not apply to any person or organization for whom you have procured separate liability insurance while such insurance is in effect,regardless of whether the scope of coverage or limits of insurance of this policy exceed those of such other insurance or whether such other insurance is valid and collectible. The following provisions also apply: 1. Where the applicable written agreement requires the insured to provide liability insurance on a primary,excess,contingent,or any other basis,this policy will apply solely on the basis required by such written agreement and Item 4. Other Insurance of SECTION IV of this policy will not apply. 2. Where the applicable written agreement does not specify on what basis the liability insurance wilt apply,the provisions of Item 4, Other Insurance of SECTION TV of this policy will govern- 3 This endorsement shall not apply to any person of organization for any"bodily injury"or"property damage"if any other additional insured endorsement on this policy applies to that person of organization with tegatd to the"bodily injury" or "propetty damage" 4. I£any other additional insured endorsement applies to any person or organization and you are obligated under a written agreement to provide liability insurance on a primary,excess,contingent,or any other basis for that additional insured,this policy will apply solely on the basis required by such written agreement and Item 4.Other Insurance of SECTION IV of this policy will not apply,regardless of whether fne person or organization has available other valid and collectible insurance. If the applicable written agreement does not specify on what basis the liability insurance will apply,the provisions of Item 4. Other Insurance of SECTION IV of this policy will govern. This endorsement is exerated by the LIBERTY MUTUAL FIRE INSURANCE COMPANY Prcrniom $ EffectivslJate T/1J2012 Expira6oaDase 1/1/2013 For attachment to Policy No. TB2-641-0050 97-04 2 A edit Easit ]ssutd To LN 20 0106 05 f �c EVIDENCE OF PROPERTY INSURANCE F DATE 0512912012rDD1YYYY) THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW, THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST. AGENCY PRONE COMPANY ILAJC,No-EMI, Marsh USA Inc. Zurich American Insurance CD 333 South 7th Street.Suite 1600 Minneapolis,MN 55402-2400 J43750--Prol4-12-13 AI N FAX EMAIL A1C Nol: ADDRESS: CODE: SUB LODE; AGENCY T MER Ig INSURED LOAN NUMBER POLICY NUMBER Knife River-Belgrade,MT CPP3704500-10 PO Box 9 Belgrade,MT 59714 EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 01101/2012 01/0112013 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION L OCA TION rD E S CR I P TI ON Re 2012 Street lmprovemenls-City of Bozeman 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 WfTH RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE INFORMATION COVERAGE I PERILS I FORMS AMOUNT OF INSURANCE DEDUCTIBLE "Ail Risk"Blanket Real and Personal Property including Earthquake,Flood,and Boiler and Machinery 25,000,000 '25,000 Contractors Equipment Blankel Policy Limit(Any occurrence,all coverages combined) 25,000,000 '25,0W LeasedlRenled Contractor's Equipment Urait($1,000,000 per item,$2,500,000 per occurrence) 1,000,000 '25,000 Crane and Waterborne deducible 10%11V Min $25.000 'Deductibles apply to all coverages. Business Income,Rental Reimbursement,Service-Inlerruplion and Extra Expense are subject ID a 72 hour deductible any one Occurrence. REMARKS(including Special Conditions Owner,Contractor,Subcontractors,Sub-Subcontractors,Engineer,Engineers Consultants,and any other persons or entities identified in the Supplementary Conditions,each of whom is deemed to have an insurable interest,are included as additional insured where required by written contract. 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. ADDITIONAL INTEREST CHI-004448761-01 NAME AND ADDRESS MORTGAGEE X ADDITIONAL INSURED LOSS PAYEE City Of Bozeman LOAN# Engineering Department PO Box 1230 Bozeman,MT 597711230 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee ACORD 27(2009112) ©1993-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD