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-----------------------------------------------.---------------------------------------------------.-------------------------------------- :ACORD CERTIFICATE OF : :______________________{__~__~__V__fi__~__~___Q__~___________________________________________I_~~V_~__P_~_T~___J2~~_1~L_9_~___: : PRODUCER : THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS : : RED CARPET INSURANCE : NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, : : 3433 Broadway N.E. #185 :_~~I~~~_Qff_~hI~ff_Itl~_~Q~gff~~g_~EEQff~g~_~Y_Itlg_~Qhl~lg~_~ghQ~~____________: : Mi nneapo lis, MN ; __________~_Q_M_~_LLLI_L__LLLQ_LQ_LL~___LQ_YJ__ff_A_9_L--------: : 55413 : COMPANY : : j,HIfH__J_________jL_E~Ml_~QmQ~rry______________________---------------: : COMPANY :_______________________________________________________:_hEIIER__H_________________________________________---------------------- INSURED : COMPANY ROBERT & SUE HENGELFELT :_1tlltR__~___________________________________________--------------------- 1170 W. COUNTY RD B : COMPANY ROS E V ILL E, M N : _hHIgR__Q_____________________________________________------------------- 55113 : COMPANY :_______________________________________________________:_hgIIgR__f_________________________________________-----------------------: ;::: C 0 V ERA G E S :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD: : INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS : CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ; :_E~~h~~IQ~~_~~~_~Q~~IIIQ~~_QE_~~~tl_~Q11~1~~~_1IMII~_~tlQ~~_M~Y_tl~y~_~~g~_ffg~~~g~_~Y_~~IQ_~h~IM~~____________-----------------------: : CO : :: POLICY EFF. : POLICY EXP.: : :hlff:_____IY~g_QE_l~~~ff~~~g___________:_~Qhl~Y_~~M~gff___:_____~~Ig_____:____Q~If____:____________________hlMII~___________________: : : GENERAL LIABILITY: : :_9~~fRAh_A~yH~gAlf____________:_t_________---: : [ ] Commercial Genera1 Liability: : :_EffQQ~~I~:~QMUQL~~~ffg9AIL__:_L___________: : A [ ] Claims Made [ ] Occur. : PK06349437 12/27/95: 12/27/96 :_Efff~QMLLAQ~~_I~J~ffL______:_L___________: : [ ] Owner's & Contractor's Prot.: : :_gA~LQ~~~Rfft~~L______________:_L___l~~J.qqL: : I [X] Personal : I : :_ElRLQ~MA9LiAnLQnLliHL__:_L___________: : ___: _LLhi!~ilitL____________________ : _________________: ______________: _____________: _Mg~~_B~g~~LLAnLQnLQ~r~Qnl : _L___________: : : AUTOMOBILE LIABILITY : : COMBINED SINGLE : $ : : [ ] Any Aut 0 : _UMIL____________________.___ : -------------- : [ ] A 11 Owned Autos : BODILY INJURY : $ : [ ] Scheduled Autos :_L~~r_Q~r~Qnl_________________:______________: [ ] Hi red Autos : BODILY INJURY : $ : [ ) Non-Owned Autos :_L~~r_!ffiQ~ntl_______________:______________: I I [ ] Garage L iabi 1 ity I I I : PROPERTY DAMAGE : $ : :___:_L_1_____________________________:_______________--:-------.-------:-------.-----:------------------------------:--------------: : : EXCESS UA.BI UTY : : : : __M~!bQ~~R~;~,______________: _l__l-"~QQJ.~~Q_ ~ : A: [X] UMBRELLA FORM : PK06349437 12/27/94: 12/27/95 :_~~~ff~~~I~____________________:_t____________: ; I 11 Other Than Umbrella Form I I I I I I 1___1__ _ ____________________________1_________________1_______________1____________1______________________________1_-------------1 : : :: _LLHAI~IQffLUMlIL________: --------------: : WORKER'S COMPENSATION : :_;~~tl_~~~lQ;HI________________:_t____________: : AND: :_QI~g~~g:~Qhl~r_hIMII_________:_t____________: :___:______tM~hQYfR~~_hIAHlhllr_______:______.___________:______________:____________:_QI~f~~f:~~~tl_gM~1QYgt________:_t____________: : : OTHER :: : : j I I I I 1 1 ! I !! I t I I ;'DE;CRipiioi"ofi)PERAiiois/ioCAiioiS7;EHiciESlSPEciil-i;Ews-----------:--------- ~~~.~ :--------------i : YMCA GARAGE SALE SEPTEMBER 13 THRU SEPTEMBER 22ND, 1996 \) ..- \ . : : SEP \3~ Ii, : : ,\ : I ' 1_________________________ _____________1 :::: C E R T I F I CAT E H 0 L D E R ::::::::::::::::::::: CAN C ELL A T I -_:::::::::::::; SHOULD ANY OF THE ABOVE D S BE CANCELLED BEFORE THE : EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO : MAIL _1~___ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE : LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR : ______hlA~lL _QE_A~r_Kl~~_~~Q~_IHf_~QM~A~rJ._II~_A~gHI~_Qff_.Rg~ffg~~~IAIIYf~~__: : : AUTHOR I PRESENTATIVE ~.. : i I J. _e.J2~ I I I I : -ACORO-2K.=s----j--g-O----------------------' ----------------------------------C----ACORO--COFf - ATioN--1-990-: J ____.___.~. _. ._ ....~. u~ '__L_ ___J_..._ ._. ______. . ____u_____.________.__________________________.______l--}--------------------------------------.--.- CITY OF ROSEVILLE 2660 CIVIC CENTER DRIVE ROSEVILLE, MINN.-55113