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-3 a <br /> 01COd <br /> NAME AND ADDRESS OF AGENCY <br /> Dolliff Insurance COMPANIES AFFORDING COVERAGES <br /> 2500 Dain Tower COMPANY <br /> Minneapolis, Minnesota 55402 LETTER A Transportation Ins. Co. (CNAID <br /> COMPANY B <br /> LETTER <br /> NAME AND ADDRESS OF INSURED <br /> COMPA <br /> Owens Services Corporation ETTERNY C <br /> 930 E. 80th Street <br /> Minneapolis, Minnesota 55420 LETTER 111.0 D <br /> COMPANY E <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 Limits o Liability in T ousan s <br /> LETTER EXPIRATION DATE EACH <br /> OCCURRENCE AGGREGATE <br /> GENERAL LIABILITY <br /> BODILY INJURY E 500 3 500 <br /> A ®COMPREHENSIVE FORM TBP 062248866 4-1-85 <br /> ®PREMISES-OPERATIONS PROPERTY DAMAGE $ 100 S 100 <br /> EXPLOSION AND COLLAPSE <br /> n(� HAZARD <br /> LPL! UNDERGROUND HAZARD <br /> G PRODUCTS/COMPLETED <br /> OPERATIONS HAZARD BODILY INJURY AND <br /> ®CONTRACTUAL INSURANCE PROPERTY DAMAGE $ S <br /> BROAD FORM PROPERTY COMBINED <br /> DAMAGE <br /> INDEPENDENT CONTRACTORS <br /> PERSONAL INJURY PERSONAL INJURY S 500 <br /> AUTOMOBILE LIABILITY BODILY INJURY S <br /> (EACH PERSON) <br /> A ® COMPREHENSIVE FORM BUA 062248867 4-1-85 <br /> BODILY INJURY $ <br /> n® OwNE' (EACH ACCIDENT) <br /> Lnn(J HIRED PROPERTY DAMAGE S <br /> ClLJ NON-0riNEC BODILY INJURY AND S S O O <br /> PROPERTY DAMAGE <br /> COMBINED <br /> EXCESS LIABILITY <br /> BODILY INJURY AND <br /> ❑ UMBRELLA FORM PROPERTY DAMAGE S S <br /> ❑ OTHER THAN UMBRELLA <br /> COMBINED <br /> FORM <br /> WORKERS'COMPENSATION STATU'ORY <br /> A and WC 062248868 4-1-85 <br /> EMPLOYERS'LIABILITY 8100 EACH ACCIDENTI <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES <br /> Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com- <br /> pany will endeavor to mail 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: October 5 19 8 3 <br /> City Of St. Anthony DATE ISSUED: l. <br /> 3301 Silver Lake Road <br /> St. Anthony, Minnesota 55418 <br /> AUTHORIZED REPRE SENTATI <br /> Dolliff Insurance <br /> ACORD 25(1.79) <br />