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AC"REP CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DD/YYM <br />3/25/2019 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Arthur J. Gallagher Risk Management Services, Inc. <br />2850 Golf Road <br />Rolling Meadows IL 60008 <br />INSURED <br />Minnesota Insurance Scholastic Trust <br />White Bear Lake Area Schools ISD#624 <br />4855 Bloom Avenue <br />White Bear Lake MN 55110 <br />COVERAGES <br />CERTIFICATE NUMBER: 504202733 <br />NAME: � � Katie Navin <br />PHONE FAX <br />L'C. tro. Esta 630-228-6665 (A/C, No: <br />E-MAIL <br />ADDRESS: katie—navinr ajg.com <br />INSURERIS) AFFORDING COVERAGE NAIC # <br />INSURER A: Underwriters at Lloyd's London 15792 <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />REVISION NUMBER <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR ADDLSUBR - <br />LTR TYPE OF INSURANCE - POLICY NUMBER fMM DDIYEYYY iMM/ D� LIMITS <br />A X COMMERCIAL GENERAL LIABILITY <br />_ <br />PK1019118 7/1/2018 7/1/2019 EACH OCCURRENCE $4,000,000 <br />CLAIMS -MADE FR OCCUR <br />DAMAGE TOIRENTED <br />PREM SES Ea occurrence, $ 1,000,000 <br />X $100,Oo0POOL SIR <br />_ <br />MED EX (Any one person) _ $ 5,000 <br />PERSONAL &ADV INJURY _ $4,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $ 8,000,000 <br />X POLICY ❑ PRO- � <br />LOC <br />__ — -- <br />JECT <br />PRODUCTS-COMP/OPAGG _ $4,000,000 <br />OTHER: <br />$ <br />A AUTOMOBILE LIABILITY <br />PK1019118 7/1/2018 7/l/2019 COMBINED <br />MBI EDtSINGLELIMITfEa $4,000,000 <br />X ANY AUTO <br />I <br />BODILY INJURY (Per person) $ <br />OWNED SCHEDULED <br />--- - <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) $ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE $ <br />_,IPer accidence____ <br />Comp/Coll Detl $1,000/$1,000 <br />UMBRELLA LIAB OCCUR � EACH OCCURRENCE $ <br />N <br />EXCESS LIAB - .. - <br />. CLAIMS -MADE AGGREGATE <br />DED RETENTION $ $ <br />WORKERS COMPENSATION PER OTH- <br />AND EMPLOYERS' LIABILITY YIN STATUTE j ER.. <br />ANYPROPRIETOR/PARTNERIEXECUTIVE E.L. EACH ACCIDENT <br />OFFICER/MEMBEREXCLUDED? NIA $ <br />(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ <br />If yes, describe under -- -- <br />DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ <br />A School Board Legal (Claims Made) <br />Sexual HarassmentlAbuse <br />PK1019118 7/1/2018 7/1/2019 Per OcclAgg ! $4M/$8M <br />i Included <br />i <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Non -Tort liability or Out -of -State Liability claims $4,000,000 Each Occurrence Limit; per Member District <br />Non -Tort liability or Out -of -State Liability Claims $8,000,000 Aggregate Limit; per Member District. <br />If holder is specifically listed as an additional insured refer to: Blanket Additional Insured per Certificates of Insurance Endorsement #21 <br />added 7/1/2018 <br />Evidence of Insurance regarding Oneka Elementary 5K Color Run on Saturday, May 4, 2019. Approximately 800 runners expected. <br />-- liAlY {.rCLW 111UN <br />City of Hugo <br />14669 Fitzgerald Avenue N <br />Hugo MN 55038 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />W •hats-ZU•Is AGORU CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />