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<br />~t., 'of"fo, <br /> <br />Time: 08:52 AM To: 651-429-8629 <br /> <br />651-641-8981 <br /> <br />Page: 001-001 <br /> <br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY) <br /> 10/11/2006 <br />PRODUCER FAX (651) 641-8981 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Paulet/Slater, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />2610 University Ave., #200 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />St. Paul MN 55114 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A Dakota Truck <br />Wiseguys Pizza Inc INSURER B Safeco Insurance <br />7095 20th Avenue S INSURER C <br /> INSURER D <br />Centerville MN 550380000 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 WITH RESPECT TO IM-UCH 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 (MM/DDIYY) DATE (MMIDDIYY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> I-- ~~~~~~J?E ~E:CJuEr?en ce) <br /> I-- 3MERCIAL GENERAL LIABILITY $ <br /> I-- CLAIMS MADE D OCCUR MED EXP (Anyone person) $ <br /> PERSONAL & ADV INJURY $ <br /> I-- <br /> GENERAL AGGREGATE $ <br /> I-- <br /> GE:-J'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ <br /> n nPRC- n <br /> POLICY JECT LaC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> I-- (Ea accident) $ <br /> ANY AUTO <br /> I-- <br /> ALL OWNED AUlaS BODILY INJURY <br /> I-- (Per person) $ <br /> I-- SCHEDULED AUTOS <br /> I-- HIRED AUTOS BODIL Y I:-JJURY <br /> (Per aCCIdent) $ <br /> I-- NON-OWNED AUTOS <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILllY AUTO ONLY - EA ACCIDENT $ <br /> R ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESSIUMBRELLA LIABILITY EACH OCCURREt\CE $ <br /> tJ OCCUR o CLAIMS MADE AGGREGATE $ <br /> $ <br /> R DEDUCTIBLE $ <br /> RETENTION $ $ <br />A WORKERS COMPENSATION AND WC20000338700 07/09/2006 07/09/2007 I WC STATU- I 10TH <br />TORY LIMITS ER <br /> EM PLOY ERS' L1AB ILlTY 100000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE EL. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 100000 <br /> Ilyes. deScribe under 500000 <br /> SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT $ <br />B OTHER Liquor Liability 02BP240321 01/01/2007 12/31/2007 $1,000,000 Ea Cornman Cause <br /> $2,000,000 Aggregate <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />Provides Evidence of Insurance <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLA TION <br /> <br />(651) 429-8629 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City of Centerville EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ~ MAIL <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 (2001108) <br />INS025 (0108)06 AMS <br /> <br />VMP Mortgage Solutlons.lnc (800)327-0545 <br /> <br />@ACORDCORPORATION 19~~/ <br /> <br />pa~o~ <br />