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CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 06/10/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MCGRIFF, SEIBELS & WILLIAMS, INC. P.O. Box 10265 Birmingham, AL 35202 CpNTACT PHON: plc No, Ext); 800.476-2211 we, No): POLICY EFF (MM/DDIYYYY) -MAIL ADDRESS; INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:James River Insurance Company 12203 INSURED RES Specialty Pyrotechnics 21595 206th Street Belle Plaine, MN 56011 INSURER B :National Liability & Fire Insurance Company 20052 INSURER C : 04/01/2016 INSURER D ; $ 1,000,000 INSURER E : INSURER F : DAMAGE TO RENTED PREMISES (Ea occurrence) COVERAGES CERTIFICATE NUMBER:J3DT873Q REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 000376886 04/01/2015 04/01/2016 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ EXCLUDED PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE POLICY X OTHER: LIMIT APPLIES PE Q PER: LOC GENERAL AGGREGATE $ 5,000,000 PRODUCTS - COMP/OP AGG $ 2,000,00r $ B AUTOMOBILE XHIRED LIABILITY ANY AUTO ALTOS OWNED AUTOS X X SOHEDULED NO gWNED UTOS 73APS055761 04/01/2015 04/01/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accldenI $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 000376906 04/01/2015 04/01/2016 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 6,000,000 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? I I (Mandatory In NH) If yea describe under DESCRIPTION OF OPERATIONS below N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E,L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ $ $ $ $ DESORIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, inay be attached it more space Is required) Display Date: August 1, 2016 Location: Spooner Park, Little Canada, MN City of Little Canada, MN; LIttle Canada Canadian Days, Inc.; Independent School District #623 Above listed Is/are included as Additional Insured respects to the General Liability policy as required by written contract. Certificate Holder Is Additional Insured under General Liability as required by written contract, CERTIFICATE HOLDER CANCELLATION City of Little Canada 515 Little Canada Road East Little Canada, MN 55117 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 CA lac - Page 1 of 1 ©1988-2014 ACORD CORPORATION. All rights reserved, ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD