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Date: 9/8/2014 <br />Certificate of Coverage <br />Certificate Holder <br />Archdiocese of Saint Paul and Minneapolis <br />Chancery Office <br />226 Summit Avenue <br />St. Paul, MN 55102 <br />This Certificate is issued as a matter of information only and <br />confers no rights upon the holder of this certificate. This certificate <br />does not amend, extend or alter the coverage afforded below. <br />Company Affording Coverage <br />THE CATHOLIC MUTUAL RELIEF <br />SOCIETY OF AME121CA <br />10843 OLD MILL RD <br />OMAHA, NE 68154 <br />Covered Location <br />St. John's Church of Little Canada <br />380 East Little Canada Road <br />Little Canada, MN 55117 <br />Coverages <br />This is to certify that the coverages listed below have been issued to the certificate holder named above for the.certificate <br />indicated, notwithstanding any requirement, term or condition of any contract or other document with respect to which this <br />certificate may be issued or may pertain, the coverage afforded described herein is subject to all the terms, exclusions and <br />conditions of such coverage. Limits shown may have been reduced by paid claims. <br />Type of Coverage <br />Certificate Numberpate <br />Coverage Effective <br />Coverage Expiration <br />Dale <br />Limits <br />Property <br />Real & Personal Properly <br />D. General Liability <br />1 Occurrence <br />Claims Made <br />8589 <br />7/1/2014 <br />7/1/2015 <br />Each Occurrence <br />500,000 <br />General Aggregate <br />Products-Conmp/OP Agg <br />Personal & Adv Injury <br />Fire Damage (Any ore fire) <br />Med Exp (Any one person) <br />Excess Liability <br />8589 <br />7/1/2014 <br />7/1/2015 <br />Each Occurrence <br />500,000 <br />Annual Aggregrate <br />Other <br />Each Oe 'titmice <br />Claims Made <br />Annual Aggregrale <br />Limit/Coverage <br />Description of Operations/Location./Vehicles/Special Items (the following language supersedes any other language in this endorsement or the Certificate in <br />conflict with this language) <br />Coverage is verified with regard to Covered Location's Spaghetti Dinner, to be held on parish/school grounds, October 11, 2014. <br />Includes Liquor Liability. <br />Holder of Certificate Cancellation <br />City of Little Canada <br />515 Little Canada Road <br />Little Canada, MN 55117 <br />Should <br />before <br />endeavor <br />certificate <br />impose <br />its agents <br />any of the above described coverages be cancelled <br />the expiration date thereof, the issuing company <br />to mail 30 days written notice to the <br />will <br />holder of <br />notice shall <br />the company, <br />named to the left, but failure to mail such <br />no obligation or liability of any kind upon <br />or representatives. <br />Authorized Representative <br />/r <br />( <br />0111007672 <br />2s"'— <br />