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<br />NOV-21-2005 15:24 <br /> <br />UMPM I f\C. <br /> <br />952 947 0163 P.03/03 <br /> <br /> CERTIFICATE OF LIABILITY INSURANCE " I DA'Jt (lAWP/YY) <br />ACORDm 11.21-05 <br />moaucER l1IIS CER'DFICATE IS ISSUED AS A MATTER OF INFORMAnoN <br />UMPM, Inc. ONLY AND CONFERS NO IUQHTSUPON THE CERllFICAlE <br /> HOlDER. 1ltIS CERllFlCATE DOES NOT AMEND, EXtEND OR <br />9175 Vllley VIew Rd. ALTER lHE COVERAGE AFFORDED !:IV THE POUClES BELOW. <br />SUitt D <br />Eden Prairie, MN 55943 INSURERS AFFORDINQ COVERAGE <br />952-147.0161, <br />MUIlID INSUIIeR ",STATE NAllONAL INSURANCE COMPANY <br />IW.L Y'S KORNER,INC. DBAt KELLY'S KORNER ,'-- <br />7OD8 CENTERVILLE RD. ~II: - <br />CENTERVlLLE. MN 55038 INSUIEFI C; <br />- - INSURER D: - - <br />I ~E; <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE USTED eaow HAV! BEEN ISSUED TO THE INSURED NAMED ABOVE FoR THE POIJCY peuoo INDICATED. NOlWmlSTANDING <br />>><< REQUFlEMENT. TERM OR CO~m1l1ON OF Nf( cotm1ACT OR OlHEA OOCU~ WfOi RESPECT TO WHICH TtlIS CERllRCATE MAY BE ISSUED OR <br />MAY PERTAIN. THE INSURANCE AFFORDED BY lH! POLICies DESCRIED HEAEJN IS SU8JECT 10 All THE TERMS, EXCLUSIONS AND CONomONS Of' suet-! <br />PCXJCIES. AGGREOATI; UMITS SHOWN MAY HAVE BEEN FIEIX.lCS'J BY PAll) CLAIMS. <br />'f.I IlPE 01' ~ PCUCT .... EFFECTIVE POUC:Y Dl'litA1lOM lJIII'B <br /> ~ LIAUJ1T EAaf OCCURRENCE I <br /> - CCMotlR;W. OENEIW. LIAIIlUTY FFE DAMAGE (Jnr ll<ltI 1iJe) I <br /> - DCLAMSMADED(UuR I.fOD EXP (Any _ plrmn) S <br /> I-- PEiL'SONAL & ADV IN.AJIlY S <br /> '. <br /> I-- . BENEM. AQG/EiAli $ <br /> : <br /> nlnLNfTnl ,. I'AODUClS - COM>/OP NJ(J $ <br /> POUCV ~ Lor.: <br /> ~ILI LWWrY CQM8INED $INCII..E LNIT . <br /> Alff AUTO ti.~ <br /> i--- <br /> - ALL OWNED Al./TOS BClO/L Y INJURY <br /> ';. $ <br /> - SCHEDULED AUTOS (Poll pllfll)ll) <br /> - HIlS) AUTOS BOOILY INoMIV <br /> H()N.()'NNED AUTOS (Per ec:dde11ll S <br /> .- <br /> PROPEHJY DAMAOE $ <br /> IPw IICddenO <br /> =TGE ~ AlITO OM.Y - EA ACCIDEtfT S <br /> Nf'( i'UtO OllER 11W4 ~ACC S <br /> AUrOONLYl "00 S <br /> DC!lIi$ IJIUll'Y I'ACIt OOCI.n'ilfNCf $ <br /> 5 OCQJA 0 ClANS t.tADE - <br /> AGGlEGAlE ,I <br /> =1= .' ;$ <br /> s <br /> I S <br /> WOIUlIRS ~1lOfiI ItlD I we STAlU- I I~ <br /> EII'l.DYERll' UABIm <br /> u.. EAai ACCIDeNT I <br /> E.L ~ . EA EMPlOYeE $ <br /> EL DISEASE - I'OUCY Lt.\1T $ <br />A 011iER UQI,lOA UABIUTY UII GOO4054 tM1-os t2-S1.06 $1,DrlO,IXlII/2,oao,DOO . <br />DESCRIt'TION Of' OPERA11ON8ILOCA'TfOfIitlvBtlCl.B.UcWlIIONS ADIIED BY ~ PROVIlIIClN. <br />RESTAURANTnAVERN <br />CER11FICATE HOLDER I I AUIllI1ClMI. Il8IIIIEDi; ICIIIIlEIl LEnIR: CANCELLAlION <br />CITY OF CENTiRVlLLE IHCIUtO Atrt OF 1ItI MOYl ~ .POuc;E$ BE CANCELLm BEFORE nm !llJIlIIAOOM <br />1880 MAIN STREET Dl"IE ntEl'lEOF. 1lfE I8lIlIINQ I!flIURER WU D1DEAVOR TO MAL 30 I)A~ WIlITml <br /> ..rl - <br />CENTERVLU!, MN 55113I-9714 -... - ~Ii. T ~ ....,. 1M fMJllE .. DO .. IIWJ. <br />AnN: UQUOR UCENSE DEPT. II'08E NO 08IJQl1lOll T OJ: tHY UfOIiI 1'HE ..SIIr m AGEHrS OR <br /> ~1MlL. /)1' <br /> J ,. AUIHCIIlIII!D ~A\ ~~.L,{ -71./1.) <br /> <br />ACORD 25-S (7m) <br /> <br />..... <br /> <br />eACORD CORPORAlIOIf 1888 <br />TOTRL P.0~~ <br />