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Commercial Certificate of Insurance <br />FARMERS` <br />Agency , Farmers Insurance Group <br />Name , Frank Andreotti Agency <br />Issue Date (MM/DD/YY) 11/17/2006 <br />& • 1971 Geneva Ave N <br />Address • Oakdale Mn 55128 <br />This certificate is Issued as a matter of information only and confers no rights <br />upon the certificate holder. This certificate does not amend, extend or alter the <br />S[. 13 Dist, 02 Agent 347 <br />coverage afforded by the policies shown below. <br />Companies Providing Coverage: <br />Insured <br />Company A Truck Insurance Exchange <br />. Lake Elmo Inn Inc <br />Letter <br />Name . 3442 Lake Elmo Ave N PO 6,)y,, 1 �2_ <br />company B Farmers Insurance Exchange <br />Letter <br />& Lake Elmo, Mn 55042 <br />Company C Mid -Century Insurance Company <br />Address <br />Letter <br />Company <br />Letter <br />Coverages <br />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 <br />any requirement, term or condition of any contract or other document: <br />with respect to which this certificate may be issued or may pertain, the insurance <br />afforded by the policies described herein is subject to all the terms, <br />exclusions and conditions of such policies. Limits shown may have been reduced by <br />paid claims. <br />Co. <br />Lb. <br />Type of Insurance <br />Policy Number <br />Policy Effective <br />Date (MMmDrrY) <br />Policy Expiration <br />Date (MM/DDNY) <br />Policy Limits <br />c <br />General Liability <br />60122-53-46 <br />01/01/2007 <br />01/01/2008 <br />General Aggregate <br />$ 2,000,000 <br />Commercial General - <br />Products-Comp/OPS <br />re ate <br />Aggregate <br />$ 2,000,000 <br />Liability <br />LiabLiabilityA <br />X <br />- Occurrence Version <br />Personal & <br />Advertising Injury <br />$ 2,000,000 <br />Contractual - Incidental <br />Each Occurrence <br />$ 1,0o0,0o0 <br />Only <br />Fire Damage <br />(Any one fire) <br />$ 75,000 <br />Owners & Contractors Prot. <br />Medical Expense <br />(Any one person) <br />$ 5,000 <br />Automobile Liability <br />Combined Single <br />All Owned Commercial <br />Limit <br />$ <br />Autos <br />Bodily In1'ury <br />(Per person) <br />Scheduled Autos <br />$ <br />Hired Autos <br />Bodily Injury <br />$ <br />Non -Owned Autos <br />(Per accident) <br />Garage Liability <br />I <br />Property Damage <br />$ <br />Garage Aggregate <br />$ <br />Umbrella Liability <br />Limit <br />$ <br />Workers' Compensation <br />Statutory <br />and <br />Each Accident <br />$ <br />Employers' Liability <br />Disease - Each Employee <br />Disease -Policy Limit <br />$ <br />$ <br />Description of Operations/Vehicles/Restrictions/Special items: <br />General Liability policy includes liquor liability coverage of $2,000,000 <br />Certificate Holder <br />Cancellation <br />Should any of the above described policies be cancelled before the expiration date <br />Name City Of Lake Elmo <br />thereof, the issuing company will endeavor to mail 30 days written notice to the <br />- ` &° . ` 38bO L6erde`Ave N` - - - - _- <br />---certiflcaYe'hdider Named ttr-the lefr, alit=fallwe Yo mall-"sud'h ridfiee's1ia71 fmpose'nb- <br />Address Lake Elmo, Mn 55042 <br />obligation or- liability any kind upon company, its agents or representatives. <br />yoof —the <br />Authorized Representative <br />56-2492 4-94 Copy Distribution: Service Center Copy and Agent's Copy H-or <br />