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��'-y A R LJ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY) 06/20/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOTAFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT.. If the certificate holder Is an ADDITIONAL INSURED, the poiicy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the po icy, 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 AssuredPartners of Minnesota LLC 2361 Hwy 36 W St. Paul MN 55113 CONTACT Tim Anderson NAME: AICO, NNo, Eat): (651) 644-7200 (AfX, No); (651) 644-9137 E-MAIL ADDRESS: tandorson@apminnesata.com INSURER(S)AFFORDING COVERAGE NAIC # INSURERA : West Bend Mutual 15350 INSURED Big Ten Supper Club, Inc. 4703 North Hwy. 10 Arden Hills MN 55112 INSURERS: Wesco Insurance Company 25011 INSURER : Scottsdale Insurance Company INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 19-20 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 INSURANCEAFFORDED BY THE POLIC ES 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 AD➢L INSD SUBR WVD POLICY NUMBER POLICY EFF (MMID➢IYYYY) POLICY EXP (MM/DDIYWY] LIMITS A X COMMERCIAL GENERAL LIABILITY 165153006 03/27/2019 03/27/2020 EACH OCCURRENCE t: 1 ,000,000 PREMISES JEa occurrence) g 300,000 CLAIMS -MACE n OCCUR MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY ( 1,000,000 GENERAL AGGREGATE i 2,000,ODO GENT. AGGREGATE POLICY OTHER LIMIT APPLIES WR' JECT I 1 LOC PRODUCTS - COMP/OPAGG p 2,OO11,QOO { A AUTOMOBILE X LIABILITY ANY AUTO OWNED X SCHEDULED AUTOS WON-OINIJED AUTOS ONLY 185153006 03/27/2019 03/27/2020 COMBINED SINGLE LIMIT (Ea accident} 1 1,000,000 BONIN INJURY (Per person) 'F BODILY INJURY (Per accldentl PROPERTY DAMAGE /Per accident) UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE 'f AGGREGATE 'D 1' OED I RETENTION S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICERIMEMBER EXCLUDED? ANY PROPRIETORIPARTNER/ED(ECH-RVE (Mandatory In NH) If yes, descnbe under C-SCRIPTiON OF OPERATIONS below YIN N N rA 1MNC335$544 07/0112018 07/01/2019 X SLATUTE I OTTI- FP E L EACH ACCIDENT t. 1 00,000- El. CEASE. EAEMELOYEE t: t00,000 E.L. DISEASE - POLICY UMIT $ 500,000 C Liquor Liability CPS2867791 01/01/2019 01/01/2020 Each Compton Cause Aggregate $1,000,000 $1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS! VEHICLES {ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Coverage included for Catered Events in the State of Minnesota. Certificate Holder is included as General Liability Additional Insured it required by written contract. CERTIFICATE HOLDER CANCELLATION City of Mounds View 2401 Mounds View Boulevard Mounds View MN 55112-1499 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 SF. J,J4 ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. AN rights reserved. The ACORD name and logo are registered marks of ACORD