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® DATE fMMfaVAff '1� <br />ACORN CERTIFICATE OF LIABILITY INSURANCEI 21312023 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or he endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rl uhts to the certificate holder in lieu of such endorsements). <br />PRODUCER <br />Preferred Insurance Services, Inc. <br />1306 West County Rd F <br />Arden Hills MN 55112 <br />INSURED <br />Midwest Multisport Races LLC <br />2370 County Rd J <br />White Bear Lake MN 55110 <br />Kaiti n Gombold <br />L n. 6512877409 <br />kaitl n referredmn.com <br />INSURER -Si AFFORDING COVERAGE <br />A: West Bend Mutual <br />MIDVOAUL-01 INSURER 8 <br />INSURE:R C <br />INSURER a. <br />IN, <br />URER E <br />;H 651-255-3502 <br />NAME <br />COVERAGES CERTIFICATE NUMBER:322408330 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ` <br />INSft AGDL�SU6FC POLICYEFF { POLfCYEXP UMiTS <br />Lip TYPE OF INSURANCE �!;�'+'.-, � POLICY NUMBER 1 ttt6•-DD'] 1.k h+�'UD: ,"1"'1 � ._ <br />A I X I COMMERCIALGENER AL LIABILITY Y I I A559999 1129M23 1129/2024 EACH OCCURRENCE $1 000 000 <br />"DAk iA:-.l- TO RENTrD <br />I 1 CLAIMS -MADE I OCCUR i pq_. ]SES=aoccu[rgtl�l $300,DU0 <br />1 f ! MED EXP (Any one person' 5 EXCLUDED <br />PERSONAL&ADV INJURY 51,000,000 <br />GEN'L AGGREGATE LIMTr APPLIES PER: GENERAL AGGREGATE $ 2 000,000 <br />POLICY PRO- LOG I PRODUCTS-COMPIOP AGG $ 2,000,000 <br />PRO-JECT — <br />i f OTHER, + 5 <br />A k AUTOMOBILE LIABILITY i A559999 1/2M023 ' 1/2912024 i i5aacci ant) <br />51NGLELIM g1000,040 <br />ANY AUTO <br />OWNED <br />AUTOS ONLY <br />HIRED <br />AUTOS ONLY <br />X ! UMBRELLALIAB <br />' fSCHEDULED <br />AUTOS <br />I NON -OWNED <br />F� AUTOS ONLY <br />! X I OCCUR <br />EXCESS IJAB I CLAIMS -MADE <br />DED I X RETENTiON$,,-,',,, <br />i WORKERS COMPENSATION I <br />IANDEMPLOYERS'LIABIUY YIN <br />ANYPROPRIETORIPARTNERIEXECUTiVE ❑ NIA <br />OFFICERIMEMBEREXCLUDED7 <br />(Mandatory in NH) <br />If ves. describe under <br />BODILY INJURY (Per person) 5 <br />BOOLLY INJURY (Per accident) $ <br />pROPERTYDAMAGE S <br />..LPeraccident: — — <br />A559999 1129/2023 1/29/2024 EACH OCCURRENCE _$1.000,000 <br />AGGREGATE S 1,D00,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES IACORO 101, Additional Romarks Schedule, maybe altaehed ti more space is [erlulreA) <br />County of Anoka, and their agents, officers, directors, and employees are listed as additional insured on the General Liability coverage where required by <br />written contract. <br />Anoka County <br />2100 ,3rd Ave <br />Anoka MN 55303 <br />USA <br />ACORD 25 (2016103) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />O 1988 2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />