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Qxcora <br /> NAME AND ADDRESS OF AGENCY <br /> Preserve Insurance Agency COMPANIES AFFORDING COVERAGES <br /> 14950 Martin Drive • <br /> Eden Prairie, MN 55344 LETTER A Lakeland Fire & Casualty <br /> COMPANY <br /> LETTER <br /> NAME AND ADDRESS OF INSURED COMPAW Thomas G. Shandley LETTER C <br /> TGS Mechanical <br /> P.O. Box 1123 LnERNY D <br /> Minnetonka, MN 55343 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 <br />the <br /> terms,exclusions and conditions of such policies. <br /> COMPANY TYPE OF INSURANCE POLICY NUMBER POLICY <br /> Limits of Liability in Thousands <br /> LETTER EXPIRATION DATE EACH <br /> OCCURRENCE AGGREGATE <br /> GENERAL LIABILITY <br /> BODILY INJURY 8 S <br /> ❑COMPREHENSIVE FORM <br /> ❑PREMISES-OPERATIONS PROPERTY DAMAGE $ 8 <br /> ❑ EXPLOSION AND COLLAPSE <br /> HAZARD <br /> ❑ UNDERGROUND HAZARD p O <br /> ® PRODUCTS/COMPLETED GLA 16 18 70 10-28-83 <br /> OPERATIONS HAZARD <br /> BODILY INJURY AND <br /> ❑CONTRACTUAL INSURANCE PROPERTY DAMAGE 8 $ <br /> ❑ BROAD FORM PROPERTY COMBINED 350, 350, <br /> DAMAGE <br /> ❑ INDEPENDENT CONTRACTORS <br /> ❑ PERSONAL INJURY <br /> PERSONAL INJURY $ <br /> AUTOMOBILE LIABILITY BODILY INJURY $ <br /> (EACH PERSON) <br /> ❑ COMPREHENSIVE FORM BODILY INJURY $ <br /> ❑ OWNED (EACH ACCIDENT) <br /> ❑ HIRED PROPERTY DAMAGE $ <br /> ElBODILY INJURY AND <br /> NON-OWNED BODILY <br /> DAMAGE $ <br /> COMBINED <br /> EXCESS LIABILITY <br /> BODILY INJURY AND <br /> ❑ UMBRELLA FORM <br /> PROPERTY DAMAGE 8 8 <br /> ❑ OTHER THAN UMBRELLA COMBINED <br /> FORM <br /> WORKERS'COMPENSATION STATUTORY <br /> and <br /> EMPLOYERS'LIABILITY $ <br /> (EACH ACCIDENT) <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES <br /> Cancellation: Should any of the above des5ribed policies be cancelled before the expiration date thereof, the issuing com- <br /> pany will endeavor to mail 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: 8-19-83 <br /> City of St. Anthony DATE ISSUED: <br /> 3301 Silver Lake Rd. <br /> St. Anthony, MN �Cm,.Jq ­X,4,dA) <br /> AUTHORI2 REPRESENTATIVE <br />