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CERTIFICATE OF INSURANCE <br /> American Family Mutual Insurance Company . <br /> NAME AND ADDRESS OF AGENCY <br /> PEDERSON AGENCY THIS CERTIFICATE OF INSURANCE IS ISSUED AS A MATTES <br /> 1055 E. WAYZATA BLVD OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE <br /> WAYZATA, MN 55391 CERTIFICATE HOLDER. <br /> NAME AND ADDRESS OF INSURED <br /> • PRESTIGE HEATING & AIR CONDITIONING, INC. THIS CERTIFICATE OF INSURANCE DOES NOT AMEND, EXTEND <br /> 7800 MAIN STREET N.E. OR ALTER THE COVERAGE AFFORDED BY ANY POLICY LISTED <br /> FRIDLEY, MN 55432 BELOW. <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. <br /> KIND OF POLICY POLICY EXPIRATION DATE LIMITS OF LIABILITY <br /> INSURANCE NUMBER (MO., DAY,YEAR) <br /> WORKERS'COMPENSATION UNTIL Statutory <br /> AND EMPLOYERS'LIABILITY 22X 09328 CANCELED MN $ 100,000 EACH ACCIDENT <br /> EACH OCCURRENCE AGGREGATE <br /> BUSINESS OWNERS' Bodily Injury and <br /> LIABILITY Property Damage <br /> (Combined) $ ,000 $ ,000 <br /> GENERAL LIABILITY Bodily Injury $ ,000 $ ,000 t <br /> ®Comprehensive General Liability <br /> IneludlnG products/completed 22X 09328 UNTIL <br /> operatidns CANCELED Property Damage $ .000 $ .00 <br /> ❑Comprehensive General Liability <br /> excludipaa products/completed <br /> operat Ens <br /> Bodily Injury and <br /> ❑Manufacturers'8 Contractors Liability Property Damage $ 500,000 $ 500 ,000 t$ <br /> ❑Owners'.Landlords'8 Tenants' (Combined) <br /> Liability <br /> ® NON OWNED t Applies to Products/Completed Operations Hazards. <br /> ❑ AUTOMOBILE #BI Aggregate not applicable to M 8 C or OL 8 T., <br /> AUTOMOBILE LIABILITY <br /> Bodily Injury <br /> ❑Owned(Basic Form) (Each Person) $ ,000 <br /> Hired <br /> Non-owned Bodily Injury <br /> (Each Occurrence) $ ,000 <br /> ❑Comprehensive Form Property Damage $ ,000 IE <br /> - i <br /> COMMERCIAL UMBRELLA <br /> Bodily Injury and <br /> Property Damage $ ,000 $ ,000 <br /> (Combined) t <br /> OTHER <br /> i <br /> Should any of the above described policies be cancelled before the expiration date thereof, the undersigned company will endeavor to give <br /> *( days) written notice to-the below named Certificate Holder, but failure to give such notice shall impose no obligation Or liability of*any kind <br /> upon the company. <br /> * 10 days unless different number of days shown <br /> NAME AND ADDRESS OF CERTIFICATE HOLDER <br /> DATE ISSUED: AUGUST 17, 10 <br /> • CITY OF ST. ANTHONY <br /> 3301 SILVER LAKE RD American Family AAutual Insurance CO. GL <br /> MINNEAPOLIS, MN 55418 AUTHORIZED REPRESENTATIVE <br /> Q1 i�� ✓� <br /> GINAL COPY �ICL-11781 Ed 2/83 <br /> ORI <br />