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<br /> <br />e: 11/29/05 Time: 03:09 PM To: City Centervi11e 8 429-8629 <br /> <br />Page: 001-002 <br /> <br />CERTIFICATE OF LIABILITY INSURANCE <br /> <br />DATE CMMlDD/VVVV) <br />11/29/2005 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO. RIGHTS UPON THE CERTIRCATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. <br /> <br />)RODUCER (6~1)429-3383 FAX (651)429-08'3 <br />3eulke Insurance Agency, Ine. <br />1782 Washington Avenue <br /> <br />ifhite Bear Lake MN 55110 <br />NSURED <br />frio.Inn And Mountain Enterprises <br />5510 Cente~ville Road <br /> <br />r.ino Lakes <br />::OVERAGES <br /> <br />MN 55038 <br /> <br />INSURERS AFFORDING COVERAGE <br />NSURERk owners Ins-urance Com <br />NSURER B: Auto owners Ins. Co. <br />NSlAER C <br />NSURER D: <br />NSURER E: <br /> <br />HAle , <br />n - 32700- <br />18988 <br /> <br />THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO 11iE INSURED NAMED ABOVE FOR THE POUCY PERIOD NDICATED. NOlWlTHSTANDING ~Y <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER .DOCUMENT WITH RESPECT TO WHICH THIS CERTlRCATE MAY BE ISSUED OR MAY PERTAIN, <br />11iE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POUCIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS. <br />-tSR ADD.... PaJCY EFFECTIVE PaJCY EXPIRAllON <br />.TA NSRD TYPE OF INSURANCE P<1ICY NUMB~ DATE (MMJDDJYV) DATe \,....,.,.", J UII.ITS <br /> GENERAL LJABlUlY EAa-i OCCURRENCE $ 500,000 <br /> - <br /> X COMMERCIAL GENERAL LIABIUTY ~=~J~~ai~eratl $ 50,0C;>>0 <br /> ~ o a.AIMS MADE [!] OcaJR <br />A 864606-08521783-05 1/1/2005 1/1/2006 MED EXP fArrJ one person) $ 5,000 <br /> --- <br /> PERSONAL & AnV NJLfty $ 500,000 <br /> - <br /> GENERAL AGGREGATE $ 500,000 <br /> - <br /> GEN\.. AGGREGATE LIMIT APPLES PER: PRODUCTS - COMP/OP AGG $ 500,000 <br /> Xl POLICY Ll ~&= n LOC <br /> AUTOMOBILE UABlLITY COMBINED SNGLE LIMIT <br /> - tEa acddent) $ <br /> - ANY AUTO <br /> All. O\\NED AUTOS BODILY IN.J.JRY <br /> r-- f>er person) $ <br /> I-- Sa-tEDULED AUTOS' <br /> ~ HIRED AUTOS BODL Y INJJRY <br /> per accident) $ <br /> r-- NON-oMED AUTOS <br /> PROPERTY DAMAGE $ <br /> per accident) <br /> GARAGE UABIUTY AUTO ONLY - EA ACCIDENT $ <br /> q ANYAUTO OTHER THAN EA AOC $ <br /> AUTO ONLY: AGG $ <br /> EXCES8,1JMBRELLA UABILITY EAa-i OcaJARENCE $ <br /> o OCOJR D a..AIMS MADE AGGREGATE $ <br /> $ <br /> . =i DEDUCTIlLE $ <br /> RETENTION S $ <br />B WORKERS COMPENSATION AND I T~~~BU~s I I Oi~- <br /> EIFLOVERse UABILITY 100,000 <br /> ANY PROPRIETORIPARTN~CUTIVE EL EAa-i AOCIDENT $ <br /> OFFICER,MEMBER EXQ..lDED? 08211038 2/i/2005 2/1/2006 E.L DISEASE - EA EMPLOYEE $ 100,<<;)00 <br /> If yes, describe under 500,000 <br /> SPECIAL PROVISIONS below EL DISEASE - POUCV LIMIT $ <br /> OlHER <br /> ,- r <br />)ESCRIPTlON CF CPERATIONS/LOCATlONS/VEHIa.ES/EXCLUSlONS ADDED BY ENDORSEMENT/SPEClAL PROVISIONS <br /> <br />::ERTIFICATE HOLDER <br /> <br />City of Centerville <br />1880 Ma~n street <br />centerville, MN 55038 <br /> <br />CANCELLAnON <br />SHOULD ANY OF THE ABOVE DESCRIBED POUClES BE CANCELLED BEFORE lHE <br />EXPIRATION DATE THERECF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />10 DAYS WRITrEN NOTICE TO THE CERTIRCATE HOLDER NAMED TO THE LEFT, BUT <br />FALURE TO DO SO SHALL IMPOSE NO OBUGATlON OR UABIUTY OF ANY KIND UPON THE <br />INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AU11-IORIZED REPRESENTATIVE , / <br />Barbara Schumacher/C01 .~d--4iJL#44~~~~~-, 13 <br />C ACORD CORPORATION 1988 <br />\IMP Mortgage SoIution~ Inc. (800)327-0545 Page 1 of 2 <br /> <br />.CORD 25 (2001/08) <br />IS02S (01 08).06 - AMS <br />