08-22-2007 Council Agenda - Laserfiche WebLink

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MINNESOTA LIQUOR LIABILITY ASSIGNED RISK PLAN MINNESOTA JOINT UNDERWRITING ASSOCIATION 445 MINNESOTA ST SUITE 514 SAINT PAUL, MN 55101-0760 (651) 222 -0484 OR 1- 800 -552 -0013 CERTIFICATE OF INSURANCE FOR LIQUOR LIABILITY COVERAGE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THE CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE CONTRACT LISTED BELOW. POLICY NUMBER: 07 -0554 CONTRACT PERIOD: 12:01 A.M. 10/27/2007 TO 12:01 A.M. 10/28/2007 CONTRACT HOLDER & ADDRESS LITTLE CANADA RECREATION ASSOCIATION LITTLE CANADA RECREATION ASSOCIATION 515 E. LITTLE CANADA ROAD LITTLE CANADA, MN 55117 SCHEDULED PREMISES: 2621 MCMENEMY , ST JOHNS SCHOOL HALL, LITTLE CANADA, MN 55117 THIS IS TO CERTIFY THAT THE CONTRACT OF COVERAGE DESCRIBED HEREIN HAS BEEN ISSUED TO THE CONTRACT HOLDER NAMED ABOVE AND IS IN FORCE AT THIS TIME. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHIC1-I TI-IIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN TO THE COVERAGE AFFORDED BY THE CONTRACT DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH CONTRACT. TYPE OF COVERAGE LIMITS OF LIABILITY BODILY INJURY PROPERTY DAMAGE LOSS OF MEANS OF SUPPORT ANNUAL AGGREGATE $ 50,000 100,000 $ 10,000 $ 50,000 100,000 $ 300,000 EACH PERSON EACH OCCURRENCE EACH OCCURRENCE EACH PERSON EACH OCCURRENCE ANNUALLY SHOULD THE ABOVE CONTRACT BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE PLAN WILL MAIL 60 DAYS WRITTEN NOTICE TO THE BELOW NAMED CERTIFICATE HOLDER, HOWEVER, IN THE EVENT THE CANCELLATION IS FOR NON PAYMENT OF PREMIUM, THE PLAN WILL MAIL A 10 DAY WRITTEN NOTICE. CERTIFICATE HOLDER NAME & ADDRESS DATE OF ISSUE: 8/13/07 CITY OF LITTLE CANADA 515 LITTLE CANADA ROAD EAST LITTLE CANADA, MN 55113 " C.S.Le-r d .-..,. AGENCY NAME & ADDRESS AUTHORIZED REPRESENTATIVE