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<br />::= 10/05/2006 THU 16:30 <br />:::1 Certificate of Insurance <br /> <br />FAX 763 694 9955 THE INTERAGENCY <br /> <br />~001/001 <br /> <br />~ <br /> <br />10/4/2006 <br /> <br />PRODUCERS' Beulke Agency, Inc 902240 <br />4782 Washington Avo <br />White Bear Lake, MN 55110 <br /> <br />The InterAgency/Blackburn, Nickels & Smith, Inc. <br />Box 47248 <br />Plymouth, MN 55447 <br /> <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF <br />INFORMATION ONLY AND CONFERS NO RIGHTS UPON <br />THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES <br />NOT AMEND, EXTEND OR ALTER THE COVERAGE <br />AFFORDED BY THE POLICIES BELOW. <br /> <br />INeVRED: <br /> <br />Company Providing Coverage: <br /> <br />Trio Inn, Mountain Enterprises, Inc. DBA: <br />6510 Centerville Road <br />Lino Lakes. MN 55038 <br /> <br />:::.::B9Y~[~~S!:'!:i.:::~: <br /> <br />Capitol Specialty Ins Co. <br /> <br />This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy <br />period indicated, not withstanding any requirement, term or condition of any contract or other document with respect to <br />which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all <br />the terms, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. <br /> <br />Type of Insurance Policy Number Policy Effective Policy Expiration Limits <br /> Dale Date <br />General Liability General Aggregate <br /> Products - CompOp Agg <br />Comm'l Gen. Liab. Personal 8. Adv Injury <br /> Each Occurrence <br /> Fire Damage (Any One Fire) <br /> Med Exp (Any One Person) <br />Liquor Liability CS00330517 1 0/5/2006 10/5/2007 Aggregate Limit $500,000 <br /> Ea. Common Cause Limit $500,000 <br />PROPERTY Limils: Coinsurance: Form; Deductible: <br />Building: <br />Business Personal Property <br />Business Income: <br /> <br />LOCATION( OF RISK <br />DESCRIPTION OF RISK <br /> <br />7082 Centerville Road, Centerville, MN 55038 <br /> <br />Tavern. Liquor Liability <br /> <br />I Certificate Holder <br /> <br />Cancellation <br /> <br />: ___I <br /> <br />City of Centerville <br />1880 Main Street <br />CEnterville. MN 55038 <br /> <br />Should any of lhe described policies be cal'1celled before the expiration dale <br />thereof, lho Issuing company will endeavor 10 mail 10 days wrinen nolice of <br />oanoellation to the eer1ifieateholder named to the left. but failure to mail sueh <br />notice lOhall impoee no obligation ility of an'!,Jiri/lJn the company. its <br />agents or representatives. ~ Jf""'"~ <br /> <br />Authorized Representative im Holm bnsmn@aol.eom <br /> <br /> <br />