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ACQ f CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 04/11/19 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Farm Bureau Commercial PHONE FAX c/o FBL Financial Group Inc. EAU, CA/C. No): 5400 University Avenue MA ADDRESS: West Des Moines. IA 50266-5997 INSURED COUNTY FARM BUREAUS OF MN ATTN DAVEJOHNSON 3080 EAGANDALE PL EAGAN, MN 65121-2118 INSURERS AFFORDING COVERAGE NAIL INSURER A : Farm Bureau Property & Casualty Insurance Company 13773 INSURER B : INSURER C : . INSURER D : INSURER E : COVFRAGES CFRTIFICATF Ni IMRFR• aFVICInM AIIIMDCD• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION 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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVQ POLICY NUMBER IMMIDDNYYYiMMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITYEl CLAIMS -MADE X OCCUR El CPP0016373 01/01/2019 01/01/2020 EACH RENC OCCURE $ 11000,000 AM {i PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 _ PERSONAL & ADV INJURY $ 1,000,000 GEWL AGGREGATE LIMIT APPLIES PER: X PRO - POLICY JECT F1 LOG GENERAL AGGREGATE $ 5,000,000 PRODUCTS - COMPIOPAGG $ 5,000,000 $ OTHER: AUTOMOBILE LIABILITY El ❑ COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) ANY AUTO S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident ( ) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ _ PROPERTY DAMAGE Per accident UMBRELLALIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LIAB _ $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- I AND EMPLOYERS' LIABILITY YIN STATUTE i ER E.L. EACH ACCIDENT $ - - - ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIAEl _ E.L. DISEASE - EA EMPLOYE (Mandatory in NH) If yes, describe under $ -- — - E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) CERTIFICATE IS ISSUED FOR THE WASHINGTON RAMSEY FARM BUREAU AND THEIR INVOLVMENT WITH THE BREAKFAST ON A FARM EVENT TO BE HELD ON SEPTEMBER 7, 2019. %,tK I IFIUA It: NULUtK CANCELLATION MIRON FARM 15250 HOMESTEAD AVE. N- HUGO, MN 55038 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE LONNIE MCLAIN 91988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD