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19 <br /> Page 1 <br /> LIQUOR LIABILITY PROTECTION: <br /> • Provided by: UNITED NATIONAL INSURANCE COMPANY <br /> This policy will provide coverage and pay on behalf of the Insured all sums which <br /> the Insured shall become legally obligated to pay as damages because of liability to <br /> .which this insurance applies, if such liability is imposed under the Minnesota <br /> Statutes of 19852 Section 340A.801 (MN. Liquor Liability Law) and all laws <br /> amendatory thereof, for actions occurring at the insured premises that are not <br /> specifically excluded. <br /> COVERAGE LIMITS: 50 _ Hy,,,��e�+ S <br /> BODILY INJURY-EACH PERSON 1,000,000 <br /> BODILY INJURY-EACH OCCURRENCE 1,0002000 <br /> PROP. DAMAGE-EACH OCCURRENCE 1,000,000 <br /> LOSS OF MEANS OF SUPPORT-EACH ,� o.,��p dE > $0.TT�(� <br /> PERSON Fats �� uca 1,000,000 <br /> LOSS OF MEANS OF SUPPORT-EACH Z�v�«.�t� s0000c <br /> OCCURRENCE � o�►..t 1,000,000 <br /> ANNUAL AGGREGATE 1,000,000 <br /> PREMIUM BASIS: <br /> ON-SALE RATE PER:$100 1.398 <br /> ON-SALE LIQUOR RECEIPTS 7752000 <br /> OFF-SALE RATE PER$100 .253 <br /> OFF-SALE LIQUOR RECEIPTS 1,800,000 <br /> PREMIUM BREAKDOWN: <br /> PREMIUM $ 15,389.00 <br /> SURPLUS LINES TAX 461.67 <br /> INSPECTION FEE 225.00 <br /> AGENCY POLICY FEE N/A <br /> TOTAL ALL PREM UMS $ 16,075.67 <br /> In order to bind coverage and issue a certificate of coverage we would need a <br /> signed application, copies of servers awareness completion certificates and 35% <br /> down payment ($5,626.00). Payment options are available, ask me for details if you <br /> are interested. <br /> Sincerely, <br /> Christopher T. Skelton, CIC <br />