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<br />. ~te: 11/01/06 Time: 02:12 PM To: 651-429-B629 651-641-8981 Page: 001-001 <br />. . <br />. . <br />. . <br />. . <br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIVVYV) <br /> 10/11/2006 <br /> PRODuceR (651)644-0311 FAX (651) 641-8981 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Paulet/Slater, Ine ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 2610 University Ave. AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> St. Paul MN 55114 INSURERS AFFORDING COVERAGE NAIC# <br /> INSUReD INSURER A SFM <br /> SaHawk of M1nnesota, Inc. INSURER B State National <br /> dba: Sagers Bar and Grill INSURER c- <br /> 7098 Centerville Rd INSURER D <br /> Centerville MN 55038 INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT IMTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR. ADD'L POLICY EFFECTIVE POLICY EXPIRATION <br />LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMIODNY) DATE (MMIDDNYI LIMITS <br /> GENeRAL LIABILITY EACH o CCURREf\CE S <br /> - ~~~~~~J?E~~~~u~?ence) <br /> - 3MERCIAL GENERAL LIABILITY S <br /> - CLAIMS MADE 0 OCCUR MED EXP (Anv one person) S <br /> PERSONAL & ADV INJURY $ <br /> GENERAL AGGREGATE S <br /> GE~'l AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ <br /> I -n PRO- n- <br /> POLICY JECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> - (E. accident) S <br /> ANY AUTO <br /> - <br /> - ALL OWNED AUTOS BODll Y INJURY <br /> (Per person) S <br /> - SCHEDULED AUTOS <br /> - HIRED AUTOS BODilY INJURY <br /> (Per accident) $ <br /> - NON-OWNED AUTOS <br /> PRO PERTY DAMAG E S <br /> (Per accident) <br /> ~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTriER THAN EA ACC S <br /> AUTO ONLY AGG S <br /> eXCeSSIUMBRELLA LIABILITY EACH OCCURRENCE S <br /> :=J OCCUR o CLAIMS MADE AGGREGATE $ <br /> S <br /> ==i DEDUCTIBLE S <br /> RETENTION S S <br />A WORKERS COMPENSATION AND I T'6~,~\t~Ns I IOJ~- <br /> EMPLOyeRS' LIABilITY 100,000 <br /> ANY PROPRIETORIPARTNERIEXECUTIVE E.L EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? 027427201 5/26/2006 5/26/2007 El. DISEASE - EA EMPLOYEE S 100,000 <br /> If yes, describe under 500,000 <br /> SPECIAL PROVISIONS below El DISEASE - POLICY LIMIT S <br />B OTHeR Liquor Liability RCA00312306 01/01/2007 12/31/2007 $2,000,000 Aggregate <br /> $1,000,000 Occurr <br />DESCRIPTION OF opeRATIONS/LOCATlONSNEHICLeSIeXCLUSIONS ADDEO BY ENDORSEMeNTlSPECIAL PROVISIONS <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />(651) 429-8629 SHOULD AIf{ OF THE ABOVe DeSCRIBeD POLICIES Be CANCELLeD BEFORE THE <br />City of Centerville EXPIRATION DATe THEREOF, THe ISSUING INSURER 'hiLL ~ MAL <br />1880 Main Street 30 DAYS WRITTeN NOTICe TO THe ceRTIFICATE HOLDeR NAMED TO THe LEFT, ~ <br />Centerville, MN 55038 <br /> AUTHORIZED REPReSeNTATIVE: ~~ -,;::!. ~ <br /> Jeffrey StanleY/AML <br /> <br />ACORD 25 (2001/08) <br />INS025 (0108)06 AMS <br /> <br />@ACORD CORPORATION 1988 <br /> <br />VMP Mortgage Solu/ions. Inc. (800)327-0545 <br /> <br />Page 1 of 2 <br /> <br />!f <br />