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LEAGUE OF MINNESOTA CITIES INSURANCE TRUST <br /> c/o North Star Risk Services, Inc. <br /> • 1401 West 76th Street • Suite 550 <br /> Minneapolis, MN 55423 nvoice # 4099 <br /> C;OU'!T NO DATE <br /> bcc L Ujw--e-'P- C C a,.--. 090 6/29/87 <br /> City of St. Anthony �yQ� <br /> 3301 Silver Lake Road <br /> St. Anthony, MN 55418 ur3« ef-r-icil-L-s <br /> INSURED <br /> NAME <br /> PLEASE DETACH AND RETURN THIS PORTION WITH YOl PAYMENT�� C/ -- - <br /> '� --- <br /> ENT ENCLOSED <br /> COMPANY EFFECTIVE POLICY NUMBER DESCRIPTION AMOUNT <br /> DATE <br /> L.M.C. I .T. 5/31/87 MP 822 829R-7 Extended Reporting Period End. # 5 $1,918.00 <br /> TOTAL DUE UPON RECEIPT , $1,918.00 <br /> PLEASE CONTACT YOUR AGENT FOR A FULL EXPLANATION OF THESE CHARGES. <br /> Make checks payable to L.M.C.I.T. and mail to <br /> North Star Risk Services, Inc. at address above. RETAIN BOTTOM HALF FOR YOUR RECORDS <br />