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<br />NDV-03-2005 11:39 From: <br /> <br />To:6514298629 <br /> <br />P.2/2 <br /> <br />Ak08JJIM CERTIFICATE OF LIABILITY INSURANCE 1 l)^ I E(MMIOOI\'YYY) <br /> 11/3/2005 <br />F'RODLJCe~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Paul H Steffel Ins Agency, lnc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOlOE;R. THIS CERTIFICATE OOE;S NOT AMEND, eXTEND OR <br />1709 Main Street AL TER TIiE COVERAGE AFFORDEOD 8Y TH~ POLICIES BELOW. <br />Centerville, MN 55038 <br />651-762-7801 INSURERS AFFORDING COVERAGE NAIC# <br />INSUkt:U Kelly'S Korner, $~ce Fut.tI Mutual Insur..nce CUlUpany - <br />Inc. ..!.NSI IREI'( A <br /> IN~URER R <br /> - <br /> 7098 Ce~terville Road - ~SURIOf{ (;. - - - - <br /> - - <br /> Centerville, MN 55038 IN5LJnm n. <br /> -'---'- <br /> 1651-653-7791 INSURER E <br /> <br />COVERAGES <br /> <br />nlE POLICIES 010 INSURANCE LISTED OELOW HAVE 8EEN ISSUED TO THI: INSURED NAMED ABOVE FOR THE POLICY PERIOO INDICATED. NOTWITHSTANDING <br />ANY REQIJIREME:NT. TERM OR CONDmON OF ANY GONTRACT OR OTHER DOCLJMI-'NT WITH RESP~CT TO WHICH THIS CERTlnCATE MAY BE ISSUEO OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SlIBJeCT TO ALL THE TERMS, FX(:LUSIONS AND CONDITIONS OF SUC~I <br />PO\,.ICII:S. ^GGREGA TE LIMITS SI-IOWN MAY HAVI: ~EEN REDUCIOj') ~v PAID CLAIMS <br />IN~I( ""D'L NC:F POLICY NUt,1I:lt:fot ~~If~~ mEr.T~YF P8,H~1~6'i{'~?N LIMiTS <br />LTR NaRD nA E MMlDDIVY <br /> ~N"'RI\l IIAl:1ILITY eACH OCCIJRRFNCi: $ - <br /> ~!\MA~.l; 10 RENTEu <br /> COMMt.HCIAL GENERAl LIABILITY PRFMISeS fEa OCcurence) $ <br /> D CLAIMf:MADF D'O(;CUR Mt:D EXP (Jlny nne person) Ii <br /> f--- - <br /> PCf<SONAL & ^DI/ INJURY $ <br /> - <br /> GENERAl ACCIIEGATI; S <br /> - -. <br /> ~/,L AGGRECAie LIMIT AF'~IIES 1"t:1<. t'HODUCTf: . COMP/OF' AGG $ <br /> POLICY n rfi?i /'"~ LOC <br /> AllT(lMO€lILE LIABILITY COMBINEO !\INCLE LIMIT <br /> - (t:a&~"[;i<.llll't) i <br /> ANY AUTO <br /> n_ <br /> - ALL OWNm ALil 0$ BClOII '(INJURY <br /> [f'er pe,'$~I\) $ <br /> - SCHEDULED AUTOS <br /> - HIRED AUTOS ROnl! Y INJURY <br /> (PcraCCld&nl) $ <br /> - NON.OWNEDAUTOS - <br /> PROPER I Y DA~GE S <br /> (Peraceidenl) <br /> R~~~~J'TY - AUT0-0NL Y- EAACeILlt:NT-- -$" _..~ <br /> -- --- - - ~- - --- - <br />-- - -- <br /> OTHEK I HAN F.AACC $ <br /> AlITOONLY: AGe; $ <br /> ~t:~llIlJMBRFII A liABILITY ~C~f OCCURRENCr $ <br /> .... OCCUK LI CLAIMI';MAAf.: - <br /> ACCI~GATC $ <br /> S <br /> - - <br /> ==i DEDUCTIBLE i <br /> RETENTION $ S <br /> WOI<Kt:KllCOMPENSA TIOI" ANO 11'7,~~L~JI~~ I IOJ~ <br /> EMPI elYFA$" LIABILITY 022916 201 05/09/05 05/09/06 E I. FAOiACCIDCNl $ 100,~ <br /> '\NV PROPRETORll>AATNfRlEXECUTIVE <br />A OrrICER/MFMRFA exr.:LUOC07 t:,L. UIi:i:EA!'\F.. Ell EMPLOYE $ 500,000 <br /> lIyc~, dc:;cnDounClar C L nl(it:A:::it:.. POLICY LIMIT $ 100,000 <br /> St't:CIAL PROVISIONS llnlnw <br /> OTHER <br />DESCRIPTION OF OPERATIONS ILOCATION:>iVI:HI(;LESI EXr.1.I I;\I{)N$ ADDCD [lYCNOOI-{~t:MENT I SPFr.IAI. PROVISIONS <br /> <br />CERTIFICATE HOLDER <br /> <br />City of Canterville <br />1880 Main Street <br />Centerville, MN 55038 <br /> <br />CANCELLATION <br />$HOULU ANY OF THF AF.lOVE DCSCRleEO t'ULICIES BE CANCELI.rn ElEfOHt: THE EXPIRATIO <br />DATE TllmHII", IHE ISSUING INSURER WILL FNJ'l~AVOR TO MA1LdL DAYS WRITTCN <br />NO liCE TO TlI~ CER'J'iFICATE Hell Of'R NAMCD TO "Ht: LEFT. BIIT FAILUAE TO 00::;0 SHALL <br />IMPOSE Nfl OIiUCATION OR 1.IAIl <br />...--- <br />nCPRCSENIAIIVEi:i:, ,- <br />AUTlloril:':li:u I-lt:PRE NTATI <br /> <br /> <br />----:;? <br /> <br />I <br />ACORD 25 (2001/08) <br /> <br />OM-cf)RPOFlATIO"'} $) <br />