|
.......................... .................................
<br /> A CCM, Ill F:Zt�1 11 DAM IM111i
<br /> 111lC`,,,AI E I1011F 1L. II I Y 2/27/2019
<br /> T I .:
<br /> THIIIIS i F11111CUI 113 1ISSU1II:::1II)JkS A I1WKIlT1II:..:,1IIR III 11111IVI"1111M DIML."ir M4111) 111910 111013HTS UPON TIll Ill-11M DIIEIII
<br /> CERT1F11ICAr1II:::�IMES IN IDIIR 14IEGKMn:..1Y AMIll.;LIM11%EXTEND DRAILIll"ER T11HE COVEIII AFFORDED III THIII:.. IPOLIIIIC13111:..�S
<br /> BELOW, rilus III 1111INSLIJIll III III Ir.01Il1II:..:A C',C)NT111I 131FTVWE1II:..:JIM T'llillE 111ISMIU11INCIP 1111IMS111.11REFRIll AIUTkPD1Ii?3Z1II:..D
<br /> 110111t 1:1011RODUCER,AN III: IME D115111IL
<br /> ill W'P01III 1111111he ceii Ilkoldeir Is Namm AIDIII)PRISMAIll INSUIll thilio pollicl
<br /> V(Ws.)ii be an'11:111i lif ISUIII:ROGAFION fi 'VIRNfU ,irru,ulol U"mle,u
<br /> the terms;iliiiindl Irmmui 0 the III ,c all III III requirealin SwilidamerinetTL A cWtommint ii:i n ffids wrUtIcaft does iimat.confair iiiLghts li Ift
<br /> ly
<br /> irwril 11110deir 111in 11159im of suall.cpineiii
<br /> ..111,
<br /> ................................"I............................................................................................................................................. Fu ................�.T,................................................................................
<br /> pau"11a,t/S.'Later PHONC� 6,44-0311.
<br /> IM ............................................................................
<br /> 711 HaI A."ve Nortl% E4ANL
<br /> ADDR0,M,
<br /> ...........................•...........................
<br /> 9111.11U.-il 101 MKI,I
<br /> .................................................................................................................
<br /> St. Palal MN Sh128 C3
<br /> ;�il� 5'.., 1.11.................................
<br /> ..... .......... .......i ................................................................... ......
<br /> IIIIMNMrAINWRER,B.-,SOCIUM............... .......... ................................ ................................................................................ ...................
<br /> iCh,ef 'Eria Erwimrpri�mi -TXC ripiRM.C.".
<br /> il!........................................................ .......................................................................
<br /> INSURER.0�
<br /> ............................................................................................. .................................................................................................................................. ......................................................................................
<br /> 2400 Univerii Amn NL E.
<br /> ..........................................................I........................................................................................
<br /> hWiTM1I:Mp01:1;q 11M 55,11,18 3467
<br /> MMAJR F.
<br /> Z
<br /> T
<br /> C01VERAGES C1ll:..:,1lI(TI1F1CAX1II:..:. All.1 31.'dnea REMSIll
<br /> rc)C.,EFtni::�Y rmr nnl�F'011]CIES C)IF WSUIRANGE I STED BELMHOWE BEI:IN INSURED INAMED ABOVE ll:::OR'rHE�:101..ICYPE,�:�,,[O�')
<br /> INMUXIED NO IIIAM DIST41N,DING ANY RIl:iQUl11REMII:::'NT,TEIRIM C)IR CONDI"TON IDIF ANY CON'rRAC"r CYR 011--iEIR 4..)0CUMIl:.W'r WIFIH IR11:�.SFU,3T ID WHIICH rHIS
<br /> MAY IM MUM)OR IWAY IPPER DUN, i ii-I E MSII l:::,AFFORCIED BYTHE POLUES I)ESC RIBED HEREIIN JS SLPBJEG'T'R)ALL rIl R E ITIRMS,
<br /> EXCA USIONS AND cam wmks I011::''sli.,Cl I M 11CIIIES,1 41011 M Sli.-M, MAY N IAWE BEEN Rll::.::DUCED BY JDAIII.)C1 AIIIIAS.
<br /> ............... ...................I...........................................................................ii: i W.0 ...............................................................................................................................
<br /> AKXM M—BR r—
<br /> Pffl-EOF INSURAIN CE POUCYINUMMR, MM#DKNYV'r A INY, IIIM
<br /> ................
<br /> PIERW)MAL A,jIM INJILSKIr
<br /> 0(,X,'UIi1TREhICE 11 1,1 D00
<br /> LM
<br /> x COMMOR1.13M i U&STY
<br /> 1w,001D
<br /> M,CiJR ................................................................................................
<br /> ..........!�
<br /> :11.0,000
<br /> 1=3238802 5/23P2020 IMED E-.XP ploy iDne pwwn) is
<br /> ................ .............................................................................................................. .......................................................................................
<br /> ............... .....................•11............. ............................................................................................ .........................-.-..............
<br /> GEN'i1..JIWGGW'KwftJ'E 1JMI'Tfi4:1P1iJ1I:SPEIR.� C-111EN H'PAIL ACIG 1 2,11
<br /> 0 Pf.ko.. 11................. ......... .....—
<br /> POLICY JECT PRODUCV 4XJMR0PMR:.; $ 2,000,000
<br /> .................. DTHEIR� C ERIMED-11i
<br /> NJ M(MOX Mil Mr :3 1,000,1DOn
<br /> _IA-Mrallm—--
<br /> E-K-1DU )KRURY(Parpklxwnb Na
<br /> x Adlily AIU RD
<br /> A ................. ............. -- —---------
<br /> ,ALI[.. WM1I:ED !.,�CHIEDULIHD M RY F"r $YAM INJU anderVj
<br /> AUTOS AUT10,15i A32388M.3 s/1.3/2020 ..................................................... ....
<br /> NON4.�MNI:;:D PRX)PERTYll 977ff--
<br /> AUTC61 I ...............................................................
<br /> ................. ................ $
<br /> ........................ ---------
<br /> U`M'M`M.11—AUAH DCCUR EACH WXUIRRENCE S 11 000 220
<br /> .............................................................................................. ...........................................
<br /> ................. ..................
<br /> CXCESS IJAB Mii REWE .1,000
<br /> -.1-.11111,........................ —1 1
<br /> .............................................. ......
<br /> is
<br /> .12.21201.9 3/h.3/2020
<br /> 32,,
<br /> ....................................... ....................................................................................................... ...............................................................................................
<br /> r—. ...........
<br /> WMPA(MMS UMPENSA"110hil c) X
<br /> ANDTEMPLCIR RS4 IIARR IITY ............ ..... .....................E! �..................................................................................
<br /> WrA 11 d!Irl::'IDENII 6 500,000
<br /> DIFFIC'MEMEMBER BrCLUDED? ..........
<br /> qmandataq in MH) SWIC12312,17 311412.029 Wh.9121020
<br /> . 11ASEASE E i�EIMPL.j,'.)YEE 9
<br /> ................................................................!...........— �500 0410
<br /> DE �1: LIMI
<br /> UMON CW CX:'ERAINCY6 bWuw .................................................. 1110Y
<br /> ............................................ .......................
<br /> ............................................................................................................... ..............................................................................11 11
<br /> DESCR. IPMON OF CII'MERAMMIS R 1.01IMTKI)IMS I VERK,Lr-S(AC ORD101,AddAHq.wkW RomadinEwhMbiffe,uny ba affachad IN mom spum is Mguii",vQ
<br /> Phril:Int Date: nMla 2, 2019
<br /> CoNmragp Z,�tbends to Off Pni-mmise D� rll:I
<br /> ............................................................................................................................................................ .......................................................................................................................... ...............................................................................................
<br /> HFICAT E,114,0111 11IM1114 C IVu III'rmlll,,.'I
<br /> SHOUl OF-MIE A111KNE IMBSCRIBEIII)111:101 Ill BE CAIII F-"D 111ii
<br /> JaInXII PUII"M:r "MIE EXPIRAIII11110 "IIIIII:.!"W 11HIII!::NR.EOF,INCYTICIII Ill BE DM
<br /> AIIIICE M1134'JII'Hjll;i!M..rjCy N:qjojflgR:)N&
<br /> 076 ldal1arri Way
<br /> M550313 .......................................................................................................
<br /> AUMORGIMID RUIRESEARAME
<br /> 41
<br /> 0 tlmr ,IC" 1nm RCIl illllift'110N. AH irliightsu ni!.ii
<br /> ACORD 25(2014101) 1"he A11C.:,01111,1D ii-,.iiiind Illogo avii imiglilstaiii ii oill'Ali
<br /> INS025 M01401) 113
<br />
|