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<br /> <br /> <br /> <br /> <br /> <br /> <br /> Th~ itertifi~~te her~inbefor~ ~eferred t€~ ~'hall be 3.n <br /> appr~~imately the fs>llowin~ forms t$-Witi <br /> <br /> «+rt s s. s w • r~nsuran$e C ,pat7y ~ereby coPtif lea tYIat i~`i has <br /> ia'4isued to • • • *sa liability Insu1"`ance poliCy des'ak?C1ats& 6!S <br /> . 0000!4i! ll.0: M4i!?I8Js6rA+4 ing the l.i4.a9w~,+6a4it.y o.b, • 4 t d1 i i! ~ ,4~c~ 4! 210`a,~ci# <br /> . . . thO." #+?i1~iYld~ty tii/~+?~M#lMpt #MR Rf R~ tv 4~E.ke I~M*? '~•~i <br /> •w!*~~ <br /> with bodi17 in~ury l.lzit~~ Of twer~~~~-fiva thousand dal:Lars <br /> ~~,~~~+~.~3~~ ~~d t~.o~e~tand do1]ar~r (tb~3,00~}.t~0), ar~d <br /> ,~~opez~~~ ~~~ge ~~~~an~~ ~otznC of twenty-five thoasarrd <br /> ~~ll~~~ (~2,50000000),, whi~~ ~aid instx~~~~~ ~ ~n f~ll fo,~~~ <br /> offecG. ~t I~ fu~~~~~ ~~~tifioc~ t.-At ~ » Insu:~~~~~ <br /> ~~~any hereb~ ~epresents anc~ t'A,,,At the inata~~~~e provided <br /> ~~~d Poli~y ftaber * . * o * ~ ll anuro tc~ the ber~atii~ of the <br /> V1L1^gs o,~ ~~~~n 111.ills and 3:~~ ~~f ice,~~ In t3~ ~~e a~&tansr and <br /> to the *"e ex'~~~t a~ ~ha~~ ~si~ Vi4llago its s~ff~~~~~ were nas~~~ <br /> ~s ln~~~~~~ ~~~ein in respect tc~ claim or su~t made agai~~~ <br /> ~illage, or '~ts of~."icors ezRnAtin~ from (nazo of 11- <br /> coraa~~ or c~tractor), negl~~~~~ ~ ~~nduct* Qr alleged <br /> ~~gligen'~ *eta oc oonduct, In t:~~ ~~~~rmanc~ of that cextaln <br /> cozatract entered into betweera the Yillage of A.rden a;iills and <br /> . . f# *4 OM • i ? *dat*d. t~he o*y • *i# day of A M • 4 4 6 R f t ! ~ • » ! M ? M , or <br /> th~t oertAit~ li~ense grantea~ by the Vil1age aaf Arden Hills on <br /> ;e s • a rt ~ s a rr ~ ~ ? ~ s s s r ~ ~ ~r a~ ¦ + ~ whioh cC:1n'~'i$"ac~'i C)r w.4iC' h liC; eYl, se Is S3 n <br /> t i ].e in t ho c]t`f ies of 'G 1~ Clerk 4f ~ Vil1aglk ea f Arden Aills • <br /> ~s furtbor e~~tified that n+~ ~~ncell~tion, or pretended c,an-» <br /> ~el,~tion o2" said tnsurance, os~ ~~~~e in the irravisSo~~ thereof, <br /> sbalI be ef4factiqe as tc~ Vil1age un3.es;~ ~ri~ten not~~~ <br /> ~~~~~~of ~~ll ~~llage at 1~~~~~ ~~~~ty ~~ys <br /> ~ofere said; ooncel1.at1on oz~ chang+a in to ~)e e.ffective, <br />