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<br />11/22/2006 WED 11:51 FAX 763 694 9955 THE INTERAGENCY <br />I Certificate of Insurance <br /> <br />~ 003/004 <br /> <br />11/22/2006 <br /> <br />PRODUCERS: Beulke Age nay, Inc 90.2240 <br />4782 Washington Ave <br />White Bur Lake, MN 55110 <br /> <br />The InterAgency/BI:!lckbum. Nickels & Smith, Ino. <br />Box 47248 <br />Plymouth, MN 55447 <br /> <br />INSURED: Trio Inn. Mountain Enterprises, Inc. DBA: <br /> <br />6510 Centerville Road <br /> <br />Lino Lakes, MN 55038 <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 />Company Providing Coverage: <br />Capitol Specialty Ins Co. <br />AMENDED CERTIFICATE <br /> <br />i~~~~~Q~f:~fg~~i <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 he 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 Expirstion Umits <br /> Date Date <br />General Liability General Aggregate <br /> Products - CompOp Agg <br />Comm'( Gen. Liab. Personal & Adv Injury <br /> Each Occurrence <br /> Fire Damage (Any One Fire) <br /> Med Exp (Any One Person) <br />Liquor Liability CS00330517 12/31/2006 12/31/2007 Aggregate Umit $500,000 <br /> Ea. Common Cause Umil $500,000 <br />PROPERTY Limits: Coinsurance: Form: Deductible: <br />Building; <br />Business Personal Properly: <br />Business Income: <br /> <br />LOCATION( OF RISK <br />DI;SCRIPTION OF RISK <br /> <br />7082 Cenlerville Road, Centerville, MN 55038 <br /> <br />Tavern. liquor Uabilily <br /> <br />NOTE: Form CLQ 001 Is on the policy as attached <br /> <br />t Certificate Holder <br /> <br />Cancellation <br /> <br />City of Centerville <br /> <br />1880 Main Street <br /> <br />Centerville, MN 55038 <br /> <br />Should <T1Y of tho d~cribcd poIlclos bo cill"lecllcd before the elq:IlratJol'I dale <br />thereof. the issuing compCll'lY will ende~.", temail '30 days written notice of <br />cancellation to the certifica\eholder named \0 the left, bul f:.illolre tB "'!likl~ <br /> <br /> <br /> <br />aBBR. er feJtfeSenfelti.es. <br /> <br />31 <br />