08-25-2004 Council Agenda - Laserfiche WebLink

Home Browse Search

MINNESOTA LIQUOR LIABILITY ASSIGNED RISK PLAN MINNESOTA JOINT UNDERWRITING ASSOCIATION PIONEER P.O, 130X 1760 ST. 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: LL04 -0735 CONTRACT PERIOD: 12:01 A.M. 9/25/2004 TO 12:01 A.M. 9/26/2004 CONTRACT HOLDER AND ADDRESS: LITTLE CANADA RECREATION ASSOCIATION 515 E LITTLE CANADA RD LITTLE CANADA, MN 55117 SCHEDULED PREMISES: PIONEER PARK, LITTLE CANADA THIS IS TO CERTIFY THAT THE CONTRACT OF COVERAGE DESCRIBED HEREIN I -IAS 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 WHICH THIS 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 5 50,000 S 100,000 S 10,000 S 50,000 S 100,000 S 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: CITY OF LITTLE CANADA CITY HALL LITTLE CANADA, MN 55117 AGENCY NAME & ADDRESS AUTHORIZED REPRESENTATIVE DATE OF ISSUE: 8/18/04