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Date: 11/02/06 Time: 09:36 AM To: 651-777-9615 <br />651-641-8981 page: 001-001 <br />.4CORD. CERTIFICATE OF LIABILITY <br />INSURANCE <br />11/2 20 YYY, <br />11/2/2006 <br />PRODUCER FAX (651) 641-8981 <br />Paulet/Slater, Inc. <br />2610 University Ave., #200 <br />St. Paul MN 55114 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURED <br />Twin Point Tavern <br />D T Lacroix Enterprises Inc Dba - <br />P.O. Box 902 <br />Lake Elmo MN 550429501 1 <br />INSURER A. State National <br />INSURER B: <br />INSURER <br />_ <br />INSURER D. <br />NSURER E <br />rCA/Ps r.FC <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED. TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br />REOUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />ADD'L <br />(NEED <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE �MMND/T1'V) <br />RRppTT''�� <br />PDAITE (MON <br />MIDD/Y) <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />COMMERCIAL GENERAL IABILITY <br />CLAIMSMADE DOCCUR <br />PREMISES Ee ocwrsnce) <br />F <br />MED EXP (Any one person <br />$ <br />PERSONAL&ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS-COMPIOP AGG <br />$ <br />POLICY JECT LOD <br />AUTOMOBILE <br />LIABILITY <br />ANY AUI"0 <br />COMBINED SINGLE LIMIT <br />(En accident) <br />$ <br />BODILY INJURY <br />(Per person) <br />$ <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Par accident) <br />$ <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />(Per .trident) <br />$ <br />GAR.AGELIASIUTY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHERTHAN EA ACC <br />$ <br />ANY AUTO <br />n <br />AUTO ONLY: AGG <br />$ <br />E%CESSAIMBRELLA LIABILITY <br />EACH OCCURRENCE <br />$ <br />OCCUR CLAIMS MADE <br />AGGREGATE <br />$ <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION F <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />WO <br />TOR LMI S E <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETORrPARTNERIEXECUTIVE <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />OFFIOERIMEMBER EXCLUDED? <br />If Yes, describe antler <br />SPECIAL PROVISIONS below <br />EL DISEASE, POLICY LIMIT I <br />$ <br />A <br />OTHER Liquor Liability <br />UM0004444 <br />01/01/2006 <br />01/01/2007 <br />"See Below <br />DESCRIPTION OF OPERATIONS/ OCATIONSNEHICLESIEXCLUSIONS ADDED BY ENOORSEMENT/sPECIAL PROVISIONS <br />$50,000 BI Ea person, $100,000 BI Ea Common Causes, $10,000 PD Ea Common Cause, $50,000 Loss of Means ofsupport Ea <br />Person, $100,000 Loss of Means of Support Ea Cotmnon Carrara, 0300,000 Annual Aggregate <br />(651)777-9615 <br />City of Lake Elmo <br />3880 Laverne Ave N <br />Lake Elmo, MN 55042 <br />ACORD 25 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br />FAILURE TO DO 80 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br />L <br />1988 <br />INS025(0108).08 AMS VMP Mortgage Solutions. Inc.(8G0)S2T-0545 Pogo 1012 <br />