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ELSOM-1 OP ID: MM /ILC. /AZ 1/4.--- CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/15/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(tes) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, cortaln policies may require an endorsement. A statement on thls certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Twin City Group 4800 Park Glen Road, Suite 400 Minneapolis, MN 55416 David R Bell CoNTAOT David R Bell PHO((Ale, "N , Ext):952-924.6900 FAX No): 952-925-0631 E-MAIL ADDRESS: Dl3ell@TwinCity©roup.com INSURER(S) AFFORDING COVERAGE NAIL 11 INSURER A ; The Travelers Indemnity Co INSURED El Sombrero Mexican Restaurant LLC 2900 Rice St., #310 Little Canada, MN 55113 -- INSURER B; 11101/2015 INSURER 0 ; EACH OCCURRENCE INSURER 0 : PREMIE S 0 (Ea ccu occurrence) INSURER E ; INSURER F : X TIFICNUMBER: 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSRlT TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF (MM/DDIYYYYI POLICY EXP (MM/OD/YYYY) LIMITS A GENERAL LIAEILITY COMMERCIAL GENERAL LIABILITY 680004G63432A 11101/2015 11101/2016 EACH OCCURRENCE $ 1,000,000 $ PREMIE S 0 (Ea ccu occurrence) CLAIMS -MADE X OCCUR MED EXP (Any one person) $ PERSONAL &ADV INJURY $ X Liquor Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE —TROUT( LIMIT APPLIES PERI PRO- JECT LOC PRODUCTS - COMP/OPAGG $ $ AUTOMOBILE LIABILITY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS OOa aBINI DDtSINGLE LIMIT (EANY BODILY INJURY (Per person) $ BODILY INJURY(Per accident ) $ PROPERTY DAMAGE (PER ACCIDENT) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVEEl, OFFICER/MEMBER EXCLUDED? I J (Mandatory In NH) It Dyes, describRIPTION under OF O DESCRIPTION OF OPERATIONS below N / A WCSTATU- TORY LIMITS OTH- ER EACH ACCIDENT $ E,L, DISEASE - EA EMPLOYEE $ E,L, DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Romarks Schedule, If more space Is required) Cit City of Little Cit LittleLI Canada Canada Rd LittIe Canada, MN 55117-1600 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/06) ©1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD