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CERTIFICATE OF INSURANCE 02 - 0 6- 01 <br />This is issued as a matter of information only and confers no rights upon certifkateholder. T is certi icate <br />does not amend, extend or alter the coverages afforded by the policy below. <br />This is to certify that the policy of insurance listed below has been issued to the insured named below for <br />the policy period indicated, notwithstanding any requirement, term or condition of any contract or other <br />document with respect to which this certificate may be issued or may pertain, the insurance afforded by <br />the policy described herein is subj ect to all the terms, exclusions and conditions of such policy. <br />Insured <br />USA WATER SHI <br />LAI� OWASSO SAFE BOATING ASSOC <br />450 HORSESHOE DR1VE <br />SHOREVIEW, MN 55126 <br />Producer: <br />Sullivan & Strauss <br />One Hollow Lane <br />Lake Success, NY <br />Tel: 800-225-6560 <br />Agency,Inc. <br />11042. <br />Fax: 5 16-365-36 15 <br />Policy #: DREA2300090998 Effective Date: January 1,200 1 <br />Ins. Co.: U.S. Fidelity & Guaranty Expiration Date: January l, 2002 <br />TYPE OF INSURANCE <br />Commercial General Liability <br />(Occurrence Form) <br />Products/Completed 0ps <br />Fire Damage Legal Liability <br />Medical Expense <br />Participant Legal Liability <br />LIlVIITS (in thousands) <br />General Aggregate <br />Each Occurrence <br />Aggregate <br />Any one fire <br />Any one person <br />$ NONE <br />$ 1,000 <br />$ 1,000 <br />$ 50 <br />$ 5 <br />Included <br />REMARKS: <br />The Certificateholder(s) shall be an Additional Insured, but only with respect to the <br />operations of the Named Insured and only in accordance with the provisions and limitations <br />of endorsement CG 20 12 11 85 Addtl Insured - State or Political Subdivision - Permits. <br />OWNED WATERCRAFT LIABILITY EXCLUDED <br />Certificate Holder: CANCELLATION <br />Additional Insured 183 -00008 Should the above policy be cancelled before <br />the date of expirat�on, the isswng company will <br />RAMSEY COi1NTY SHERIFF endea�or to mai130 days written notice to the <br />ATTN: WATER PATROL named certificate holder, but failure to mail such <br />655 WEST COUNTY ROAD "E" notice sha11 impose no obligation or liability of any <br />SHOREVIEW, NIN 55126 kind upon the company, its agents or representatives. <br />Authorized Representative: <br />Q���O�i Qi 7���I/u�+0� <br />