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. • • <br /> NlyME AND ADDRESS Of AGENCY <br /> !,@J 'ANIES AFFORDING COVERAGES INC. COMPANIES <br /> 6009 Penn Ave. So. coMPANY <br /> Mpl s. , MN 55419 LETTER A HOME <br /> COMPANY - <br /> LETTER L.P HARTFORD <br /> NAME AND ADDRESS OF INSURED /� <br /> COMPANY LETTER V <br /> ■ - <br /> DESIGNED AIR CONDITIONING, INC. PINE TOP <br /> 2200 B1 ac.k Oak Drive COMPANY <br /> Minnetonka, MN 55343 LETTER 11.ff EMPLOYERS INSURANCE OF WAUSAU <br /> COMPANY <br /> LETTER <br /> This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. Notwithstanding any requirement,term or condition <br /> of any contract or other document with respect to which this certificate may be issued or may pertain,the insurance afforded by the policies described herein is subject to all the <br /> terms,exclusions and conditions of such policies. <br /> COMPANY TYPE OF INSURANCE POLICY NUMBER <br /> POLICY Limits of Liability in Thousands <br /> LETTER EXPIRATION DATE EACH AGGREGATE <br /> OCCURRENCE <br /> GENERAL LIABILITY <br /> BODILY INJURY f f <br /> A ®COMPREHENSIVE FORM <br /> ® PREMISES—OPERATIONS PROPERTY DAMAGE $ E <br /> ❑ EXPLOSION AND COLLAPSE I DR P 182264 7/12/84 <br /> HAZARD <br /> ❑UNDERGROUND HAZARD <br /> ®PRODUCTS/COMPLETED <br /> OPERATIONS HAZARD BODILY INJURY D <br /> ®CONTRACTUAL INSURANCE PROPERTY DAMAGE $ 500 $ 500 <br /> ® BROAD FORM PROPERTY COMBINED <br /> DAMAGE <br /> ® INDEPENDENT CONTRACTORS - <br /> ® PERSONAL INJURY <br /> PERSONAL INJURY f 500 <br /> AUTOMOBILE LIABILITY BODILY INJURY $ <br /> (EACH PERSON) <br /> B ® COMPREHENSIVE FORM BODILY INJURY $ <br /> OWNED <br /> 41 ABD JE1465 7/12/84 (EACH ACCIDENT) <br /> ❑ HIRED PROPERTY DAMAGE $ - <br /> NON-OWNED BODILY INJURY AND $ 500 <br /> PROPERTY DAMAGE <br /> COMBINED <br /> EXCESS LIABILITY <br /> C UMBRELLA FORM CUM 500 277 7/1 2/84 BODILY INJURY AND $1 ,000 $1 ,000 <br /> PROPERTY DAMAGE <br /> ❑ OTHER THAN UMBRELLA COMBINED <br /> FORM <br /> WORKERS'COMPENSATION STATUTORY <br /> D and Pending 8/1/84 <br /> EMPLOYERS'LIABILITY $ 100,000 <br /> IEACM ACCIDENtI <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES <br /> Cancellation: Should any of the above desciibed policies be cancelled before the expiration date thereof, the issuing com- <br /> pany will endeavor to mail I U days written notice to the below named certificate holder, but failure to <br /> mail such notice shall impose no obligation or liability of any kind upon the company. <br /> NAME AND ADDRESS OF CERTIFICATE HOLDER: - p/2A/O3 <br /> CITY OF ST. ANTHONY DATE ISSUED: <br /> O Y <br /> 3301 Silver Lake Road A St. Anthony, MN 55414 <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(1-79) <br />