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<br /> -C. Certificate of Insurance <br /> ... 303617 Issue Date: 0610712005 <br />PRODUCER nus CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND <br />Combined Speclanies International, Inc. CONFERS NO RIGHTS UPON THE CERTIFICATE HOlDER, THIS CERTIFICATE <br />8362 Tamarack Village DOES NOT AMEND, EXTEND OR LATER THE COVERAGE AFFORDED BY THE <br />SJJjJe 119 POLICIES BELOW. <br />Woodbury Mimesota 55125 INSURERS AFFORDING COVERAGE <br /> INSURER A: Underwriters. Uoyds of London <br />INSURED INSURER B: <br />Hollywood Pyrotechnics, lnc. INSURER C: <br />1567 Antler Point <br />Eagan Minnesota 55122 <br />COVERAGES <br />THIS IS TO CERTIFY THAT THE POliCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NAMED INSURED ABOVE FOR THE PERIOD <br />INDICATED. NOTWlTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SU8,JECTTO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POlICIES INCLUDING, BUT NOT LIMITED TO THOSE FOLLOWING: LIMITS SHOWN MAY HAVE BEEN REDUCED BY <br />PAID CLAIM$. ADDITIONAl CONDITIONS AND EXCLUSIONS: 1) THE INSURANCE EVIDENCED BY THIS CERTIACA TE IS lIABIUTY INSURANCE ONl V, IT IS <br />NOT A BOND OR ANY FORM OF SURETY AGAINST WHICH SOMEONE OTHER AN -INSURED- MAY ASSERT A CLAIM OR BRING ANY ACTION. SUBJECT TO <br />POLICY TERMS, CONDITIONS, DEFINITIONS AND EXCLUSIONS THE INSURANCE ONLY INDEMNIFIES AN INSURED AGAINST CERTAIN LEGAl LIABILITY. 2) <br />THE INSURANCE DOES NOT COVER ClAIMS FOR 800ll Y INJURY OR PROPERTY DAMAGE Or: THE NAMED INSURED'S SHOOTER{S) ASS1STANT{S) OR <br />ANY OTHER PERSON(S) INCLUDING ANY VOlUTEER(S) PARTICIPATING IN ANY WAY IN ANY DISPlAY OR SPECIAL EFFECT PERFORMED OR EXECUiED <br />BY THE NAMED INSURED. 3)COVERAQE DOES NOT APPLY TO ClAIMS FOR BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF THE INSURED'S <br />FAILURE TO FOllOW NFPA OR OTHER APPlICABLE REQUIREMENTS, LAWS OR RECOMMENDATIONS. INCWDING THOSE RELATING TO POOT DISPlAY <br />OR SPECIAL EFFECT SEARCHES OR CLEAN UP. <br />CO TYPE OF INSURANCE POlICY NUMBER POlICY EFFECTIVE POlICY EXPIRATION UMITS <br />LTR DATE (MMIllDNY) DATE (MMIllDNY) <br />A GENERAL UABIUTV 11162809831005 June 01, 2005 une 01, 2006 EACH ACCIDENT $1,000,000 <br /> CLAIMS MADE MEDICAl EX? I$s,ooo <br /> (any one person) <br /> FIRE LEGAl UABILlTY $50,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> PRODUCTS-CQMPIOPS AGG $1,000,000 <br /> AUTOMOBilE lIABILITY COMalNED SINGLE liMIT $ <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY $ <br /> ANY OWNED AlJTO (Per person' <br /> SCHEDULED AUTOS ODll Y INJURY $ <br /> HIRED AUTOS <br /> NCI\I-OWNED AUTOS (Per acddenl) <br /> PROPERTY DAMAGE $ <br /> (Per person) <br /> EXCESS lIABIUTY EACH ACCIDENT $ <br /> FOLLOWING FORM AGGREGATE $ <br /> WORKERS COMPENSATION we STATU- OTHER <br /> AND TORY liMITS $ <br /> EMPlOYER$' liABIliTY <br /> E.L EACH ACCIDENT $ <br /> EL DISEASE-EA EMPLOYER $ <br /> E.L DISEASE-POliCY LIMIT $ <br /> OTHER <br />OESCRIPTION OFOPERATIONSJlOCATlONSIVEHICLES/EXClUSIONS ADDED BY ENOORSEMENTfSPECIAL PROVISIONS <br />Fete des Lacs, Centerville Festival Committee and City of CentefVille are AcJditlonallnsured as respedS the August 5, 2005 (RO: August 6, 2005) Fireworks Display at <br />Laurie Lamotte Park. Centerville, MN <br />CERTIFICATE HOLDER CANCELLATlON <br />Fete des Lacs ~HOUlO ANY OF THE ABOVE DESCRIBED POliCIES BE CANCELLED BEFORE THE EXPIRATION DATE <br />Centerville Festival Committee !THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE <br />~;S Brian Drive ~TIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHAll IMPOSE NO <br />nterviUe, MN 55038 lGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, Irs AGENTS OR REPRESENTATIVES <br /> 1^"n<N>IZEDREPRESENTATIVEQ ~ _ <br /> <br />53 <br />