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<br /> <br />CERTIFICATE OF COVERAGE <br />STATE OF MINNESOTA <br />Risk Management Division <br />309 Administration Building <br />50 Sherburne Avenue <br />St. Paul, MN 55155 <br />(651) 284-3865 <br /> <br />This is to certijjJ that coverage described below is effective per the statutory authority referenced. This certificate is not a policy or a binder <br />of insurance and does not in any way alter, amend or extend the coverage afforded by any reference herein. The coverage is subject to all <br />terms and conditions of the statutory authority. <br /> <br />STATE AGENCY: Location Name (If applicable) <br />Minnesota State Fair Minnesota State Fairgrounds <br />1265 Snelling Avenue North <br />St. Paul, MN 55108 <br /> Date Issued: August 1, 2001 <br /> <br />x,"{ TYPE OF COVERAGE LIMITS <br /> Automobile Liability $300,000 Bodily Injury & Property Damage - per Person! <br /> ~Owned, Hired & Non-Owned $1,000,000 Bodily Injury & Property Damage - per Occurrence <br />XX ~Automobile Physical Damage <br />(Comp & Collision) $500 Deductible <br /> $300,000 Bodily Injury & Property Damage - per Person! <br />XX General Liability $1,000,000 Bodily Injury & Property Damage - per Occurrence <br /> Other <br /> <br />The entry of an XX in this column means that the coverage is afforded per this certificate and the statute(s) referenced below. <br /> <br />STATUTORY REFERENCES <br /> <br />4utomobile Liability - Minnesota Statute 65.B Self-Insurance Number is A-I 046 as assigned by the MN Department of Commerce <br />General Liability - Minnesota Statutes 3.732 and 3.736. <br />Workers' Compensation - Minnesota Statutes Chapter 176 Sections 5401-611 <br /> <br />DATES OF COVERAGE: <br /> <br />July 01, 2001 - July 01, 2002 <br /> <br />DESCRIPTION OF COVERAGE: Evidence of insurance for the Minnesota State Fair <br />Fair dates: August 23, 2001 through September 3, 2001. <br /> <br />ISSUED TO: <br />Roseville Area Schools <br />c/o Khia Bruse, Mgr. (651)604-3760 <br />Fairview Community Center <br />1910 County Road B West <br />Roseville, MN 55113 <br />Certificate Number: 200 1- ~(l <br /> <br />ISSUED BY: RISK MANAGEMENT DIVISION <br /> <br />ti112/7~ Ij~tt~a4YL/' <br />AUTHOIZED s.. GNATURE <br />v <br />