7A, Cruisin' for St. Jude Fundraising Event

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.4co °0 CERT1F1ChE OF LIABILITY 1NSURAFSE OP 1D JS DATE (MM /OD/YYYY) 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 Maguire Agency 1935 West County Road B-2,#241 Roseville MN 55113 Phone :651 -638 -9100 Fax:651 -638 -9762 UON I A( 1 NAME: Erik D. Thompson PHONE N No, 651- 635 -2756 FAX AI, No): 651- 638 -9762 -MAIL echo ADDRESS: meson @maguireagency. com PRODUCER CUSTOMER ID It FLAHE - 2 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Flahertys Arden Bowl, Inc. 1273 West County Road E Arden Hills, MN 55112 INSURER A : SECURA Insurance A Mutual Co INSURER B : Accident Fund InsuranceCompany 10166 INSURER C : 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 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 AUUL INSR SUI3ti WVD POLICY NUMBER POLICY EFF (MIDDfYYYY) POLICY EXP (MMJDOIYYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X OCCUR CPO 0 314 6 3 0 6 - 9 01/01/11 01/01/1z EACH OCCURRENCE $ 1, 0 0 0, 0 0 0 DAMAGE TO REN I ED PREMISES (Ea occurrence) $ 100 , 000 CLAIMS -MADE MED EXP (Any one person) $ Excluded GEN'L PERSONAL & ADV INJURY $ 1, 000 , 0 0 0 GENERAL AGGREGATE $ 2,000,000 AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ I BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIV OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y 1 N 1A WCV 6 0 517 5 6 01/01/11 01/01/12 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1, 0 0 0, 0 0 0 below E.L_ DISEASE - EA EMPLOYEE $ 1 , 0 0 0 , 0 0 0 E.L. DISEASE - POLICY LIMIT $ 1 , 000 , 000 A Liquor Liability CP003146306 -9 01/01/1101/01/12 1,000,000 *See Below 2,000,000 Aggregate DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) *Each Common Cause CERTIFICATE HOLDER CANCELLATION XARDEN2 City of Arden Hills 1245 West Highway 96 Arden Hills, MN 55112 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 ACORD 25 (2009/09) 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD