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<br />~ <br /> <br /> <br />Certificate of Coverage <br /> <br /> <br />Certificate Holder <br />Archdiocese of St. Paul-Minneapolis <br />Chancery Office <br />226 Summit Avenue <br />S1. Paul, MN 55102 <br /> <br />This Certificate is issued as a matter of information only and <br />confers no rights upon the holder of this certificate. This certificate <br />does not amend, extend or alter the oovefage afforded below. <br /> <br />Covered lM=atiOD <br />St Genevieve Church ,a J <br />7087 Goiffon~ N'dd- <br />Centerville, MN 55038-9719 <br /> <br />Company Affording Coverage <br />THE CAlliOLIC MUTUAL RELIEF SOCIETY <br />10843 OLD MILL RD 8m 300 <br />OMAHA, NE 68154 <br /> <br />COpy <br /> <br /> <br />This is to certifY that the coverages listed below have been issued to the certificate holder named above for the certificate <br />indicated, notwithstanding any requirement, term or condition of any contract or other document with respeet to which this <br />certificate may be issued or may pertain, the coverage afforded described herein is subject to all tbe terms, exclusions and <br />conditions of such coverage. Limits shown may have been reduced by paid claims. <br /> <br />Type of Coventge <br /> <br />Certificate Number <br /> <br />Coverage Effective <br />DB" <br /> <br />Coverage Expiration <br />Date <br /> <br />Limits <br /> <br />Property <br /> <br />Real & Personal Property <br /> <br />_ 0, ~c~~,!~n~ _. <br />D.: .~~msMad! , <br /> <br />,.; ,. <br /> <br />Ge"uetal '~ggregate <br />1;rodQct-s.compJO.~ An it-' ".'" ~ <br />". Personal &'Adv'lnjury f' :,~< '-- <br />Each qeclirrence 500,000 <br />Fire Damage (AJiy one Cae) <br />Med EJ:p (Anyone person) <br /> <br />~~~~al ,Uability <br />J... '.,.' <br /> <br />8589 <br /> <br />.711/2004 <br /> <br />71l!1065 <br /> <br />','i, <br /> <br />Excess LiabUity <br /> <br />Each OeClln-ence <br /> <br />Other <br /> <br />Each Otturreoce <br /> <br />Description of Operations/l..{)catlonsIVebicleslSpedal Items <br />Coverage verified for S1 Genevieve Parish's Festival held on Church grounds on August 15,2004. <br />Includes Liquor Liability and Fidelity for Charitable Gambling. <br /> <br />:,"". ,- <br /> <br />-= ~--- ----"'7'- ~--~- ~---~~- - ~----~--~---- ~-~ - ----....,..~ ---~~ ~ -~-- -~-----~n <br />.... . -. " <br />=~ "->> '2""," _~_=--~__~~::..~~~""-,~.2,,,,--"'-"'-_~__'____~_ _~_~___"-'__ ~__ _~~ ___ __~ __~__A <br /> <br />Should any of the above described coverages be cancelled <br />before the expiration date ~ej-e.;f, theissDlng companyWlIl .. <br />endeavor to mail 30 .. days Written notice to the holder of <br />certificate named to the left:, but failure to mail such notice shall <br />impose no obligation or liability of any kind upon the company, <br />its agents or representatives. <br /> <br />Authorized Representative <br /> <br /> <br />HoJder of Cert:lflCate <br /> <br />City of Centerville <br />.."..... . ". <br /> <br />01llOO0133 <br /> <br />~ <br />