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A� �® CERTIFICATE OF LIABILITY INSURANCE DATE (MM1DDfYYYY) 0312912023 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 have ADDITIONAL INSURED provisions or 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 N Association Member Benefits Advisors, LLC. PHONE 1-800-503-9227 FAX 4ti81Lie[It In CA dha Assn. Member Benefits & Insurance Agency I.,, Iru a PO Box 14575 EMAIL ADDRESS: ptsdsteam.service@mercer.com Des Moines, IA 50306-4575 INSURED Anoka Co RadiolEmergency Service CIO Robert W. Cardell CEO PO Box 982 Anoka, MN 55303 INSURER A: New Hampshire Insurance Cc. INSURER B : IwS~ C ; ASL AAA CI JHIWA_F4t_ r ; 23841 GOVER;ACPES UI=Kl 11-IGA I t NUMt3tK: KtVIaIUN NurnII 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 ADDL 3UBR POLICYEFF POLICYEXP i LIMITS LTR TYPE OFINSURANCE ,«., POLICY NUMBER :MMIDD,'rp'P I i'MMIDDy'YlVI A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F X] OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ PRO-❑ LOG OTHER: JECT AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED x HINEDAUTOS X. AUTOS ONLY NON -OWNED AUTOS ONLY I UMBRELLA LAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETORI?ARTNERIEXECUTI VE OFFICERNEMBER EXCLUDED? ❑ NIA (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below OTHER EACH OCCURRENCE $1,000,000 RGL-724982404 02/01/2023 02/01/2024 DAMAGE To RENTED PREMISES Xa OGGLnence $100 DOD MEDEXP•An.oneierson, $10,000 PERSONAL & ADV INJURY - $1 000 000 GENERAL AGGREGATE $2000000 PRODUCTS - COMP/OP AGG $1.000000 - COMBINED SINGLE LIMIT $1,000,000 RGL-724982404 02/01/2023 02/01/2024 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE $ $ EACH OCCURRENCE $ E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) Effective 0612312023 include City of Centerville as additional insured: Certificate Holder (CG2011) but only with respects to the named insured's negligence with regards to the ARRL 2023 Field Day event to be held at Laurie Lamotte Park, 6970 Lamotte Dr, Centerville, MN 55038 on 06/2312023 through 0612512023. CERTIFICATE HOLDER CANCELLATION City of Centerville 1880 Main St ,entervilie, MN 55038 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 / ` % 1-21- ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD @ 1988-2015 ACORD CORPORATION. All rights reserved.