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<br />9 Minnesota Workers' Compensation Assigned Risk Plan <br />. ~a C Standard Workers' Compensation and Employers' Liability Policy <br />I I Contract Administrator <br />lloIIIoyRiIIk__OJmilonyLLC Berkley Risk Administrators Company, LLC <br />P.O. Box 59143 Minneapolis, Minnesota 55459-0143 <br />Phone (612) 766-3000 NCCI Carrier Code 21466 <br /> <br />MINNESOTA COMPLIANCE WITH APPLICABLE TRADE SANCTIONS LAWS <br /> <br />1. The Insured: <br /> <br />WCIP <br /> <br />Policy Number: WC-22-04-159728-03 <br />Association File Number: 3201395 <br /> <br />GNAW INC <br />dba: Centervllle liquor Barrel <br />7093 20th Ave <br />Centervi/le, MN 55038 <br /> <br />Tax 10#: F 830385468 <br />UIC #: 068707550000 <br />Policy Period: From: 11612008 <br />To: 1'612009 <br />Endorsement Eff. Date: 11612008 <br />Date of Mailing: 1112/2007 <br /> <br />Under Part Six - Conditions, the following condition is added: <br /> <br />This insurance does not apply to the extent that trade or economic sanctions or other laws or regulations prolubit us from providing <br />insurance. <br /> <br />All other terms and conditions remain unchanged. <br /> <br />Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations <br />of the above mentioned policy, other than as stated above. <br /> <br />Aaencv Name and Address <br />Ross Nesbit Agencies Inc <br />Paulet Slater Agency <br />2610 University Ave W <br />St Paul, MN 55114 <br /> <br />WC 220301 <br />3836 639064 <br />