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02-06-90 CCM
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02-06-90 CCM
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2/4/2025 7:00:36 PM
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1ZQVG '-Par'r bey-3 <br />r7;g;oe-c3o i3(=-y-) Inc. <br />=ROM: <br />,fr North Star Risk Services, Inc. <br />1401 West 76th Street, Suite 550 <br />��Minneapolis, Minnesota 55423 <br />(612) 861-8600 FAX (612) 861-8643 <br />SUBJECT �- �C Elm C ! 1 ` o <br />EXCESS LIABILITY QUOTATION FOR THE CITY OF: G ma0 <br />FOLD- a, co©, oao <br />Dear�Gv� �l' °f• <br />Liability Limit: <br />Annual Premium With Wainer of Immnity: <br />Annual Premium Without Waiver of Immunity: .12g29303> <br />�62 <br />Quotation Expires: � �� <br />h <br />Follow Form �al{I <br />Cn <br />00 <br />Special Exclusions: � @� <br />Other Endorsements: <br />119E SLR <br />Remarks: <br />•1, OOGf o� l f 1 Qoa, <br />/ 3, y / 7. /Y, 3 75. <br />ie, yo7- /I.6Q7. <br />$1,000,000 or $5,000,000 <br />i< <br />7, 6! it, 4 <br />3�3a 196 <br />Underlying Coverage as Scheduled <br />Child Molestation <br />An election form must <br />be completed, signed and returned <br />to us before the effective date <br />if coverage is desired. <br />,,a r) K- �/occ, <br />SIGNED �; S <br />DATE ebb e-- <br />
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