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� ••�►, <br /> A�- CERTIFICATE 4F LIABILITY INSURANCE ���"�°°""""' <br /> THtS CERTIFICATE IS tSSUED AS A MATTER OF INFORMATION ONLY AND CONFER�NO RI6HTS UPON THE t�TIFlCATE FIOLDER THIS <br /> CERTIFICATE D�ES NOT AFFII�YIATNELY OR NEGATNELY/►#I�ND, EXTEND OR AtTER Tt1E GQVERACiE AFFORDED BY THE POt.�IES <br /> BELOW. THIS CERTIFICA7E OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BErYll�l THE ISSUING Ri13URER(S),AUTHORIZED <br /> REPRESENTATIUE OR Pt�DUCER,AND THE CERTIFICATE HOLDER <br /> IMPORTANT: If the oardflca�hoWsr is an ADDti10NAL INSURED,the pouc�►(iss)must be endoesad. N SU�tOCsATiON tS WANED,subjsct to <br /> tl�e terms and con�io�s of the Pot�aY�certain poDc�s may require an endo�sement A sta�en�ane on 1Ms certlflca�s doas not coMe�rfghts to tlre <br /> certiflcabe hotder ier lieu of such endoBeme s. <br /> � �oaacker�Cue 8 Husbn <br /> Laura Berth�sen 38'1-2330 � �8 382 7106 <br /> 509 W.Koenig St. <br /> PO Box 1228 Paooucat 4782 <br /> Grend Island NE 86802 s <br /> �sur�o •Scottedab Msuranc;e Co <br /> _______- --- .__ _.__ ____._ ___.._ .___.._ ___ ._.... -- <br /> Flreworks�More,inc.dba Fireworks Oudek, <br /> Emplre Menagement LLC dba S'tubb's Flre�rorlcs �; <br /> 7L0 East V�consin Ave p. <br /> R�dstown WI 54�52 <br /> R• <br /> COVERAGES CERTIFIGTE NUAI�It: RE1/ISIQN NUN�ER: <br /> THIS IS TO CERTIFY Tt�AT THE POLICIES OF INSURANCE USTED 80.0W HAVE BEEN ISSUED TO TifE II�lSURID NNNED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. N07WITHSTRNDING ANY REQUIREMENT,TERM OR COMDIT(ON OF ANY CONTRACT OR OTMER DOCUMENT WIiN RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREtN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDI110NS OF SUCH POLJCIES.LIMITS SHdWN MAY HAVE BEEN REDUCED BY PAID CLRJMS. <br /> � TYPE c1F INSIIRAlICE yp�g <br /> o��n�.u�n cH ur�Er►c� 5 000 000 <br /> A X c�.� �� CPS1828731 02-0�11 02-0�12 °'4A""�E T'°R�rrt� 550 <br /> X cwMs�n� �occua �� a,,. s 5 000 <br /> s n�ntr 5 000 000 <br /> 000 000 <br /> nec�Ec,�,���R n� �: aRoou�s-c��ac� s 5 000 000 <br /> Poucr �Q' � s <br /> �ur�un�unr co�n ar+ciF�d,wr = <br /> (Ea aodds� <br /> ANYAUTO BOD�YN�JRY(Pe►Oa�on) f <br /> ALL ONMED AUTOS �Y N�LIURY(Per aoeftlent) i <br /> S(:NEDlM.EO AIJfOS PROPHiiY OVUAA(iE <br /> HIREDAUTOS (pereoridw�t) S <br /> NON-0WN�AUTOS i <br /> i <br /> U1�111 LIAB �� EJ1G1 OCCURR�CE <br /> IXCE88 UAB �� A(�GitEOATE i <br /> DEDUCI7BLE <br /> YW�OOI�A710N WC87A?U- f7TH- <br /> AND�APLOY6t8'LI/�811J1Y � <br /> ���� EL EACH ACCIDENT <br /> OFF�CFRR�6ER DCCLUDED? N/A <br /> �''�� EL OISEASE-EA EMPL <br /> M deaclibe under <br /> EL DISEASE-Pa.ICY L�AfT <br /> O�PTION�OPERA710lIS l LACAl10q8/VBIIq.BB(AWeh ACORD 1C1.Ad�t Rrnwlot Se1wd�Ms,N moes apap Is�q�Y� <br /> Stand Location:Old Navarre Lanes.3423 Shoreline Drive,Wayzats,A�MI <br /> Additlonal�sureds:Brooks Investment LLC,City of Orono/Orono I�nicipalHy <br /> GERTIFICATE HOLDER CANCELL/�TIDN <br /> Brooks Investment LLC ��°F T��°������� <br /> 7HE EXPIRAl10N D1lTE 7f�. N0710E WLLL � OELIVERED iN <br /> ���1'�8�.Ale ACWRDANCE YNiN 7ilE POLJCY PROVI8101�. <br /> VII�011(i�/���7 AUTIORI�D�R�lITA7NE y <br /> �1011@: $�-t� /�'� <br /> Faoc: � . <br /> ��ses-soos acoRn coRPORnnoN. Aq�1�t�eser�rad. <br /> ACORD 25(200�/09) TM ACORD nams�d bgo ars�gistsred marks of ACORD <br />