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10-13-2003 Council Packet
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10-13-2003 Council Packet
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4gQflP. tCERTIFICATE OF LIABILITY INSUR mNCE <br />MOOUCtM <br />FEDERATED MUTUAL INSURANCE COMPANY <br />Horn* Office: P.O. Box 328 <br />Owatonna, MN 55060 <br />Phone: 507.455*5200 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RK3HTS UFON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR <br />ALTER THE COVERAGE AFFORDED SY THE POLICIES BELOW. <br />COMPANIES AFFORDINQ COVERAGE <br />COMVANV FEDERATED MUTUAL INSURANCE COMPANY OR <br />A FEDERATED SERVICE INSURANCE COMPANY <br />NIUWO <br />BECKER BROTHERS INC <br />FLOORS BY BECKER INC <br />825 FIRST ST NW <br />NEW BRIGHTON MN 55112 <br />1 <br />214-578-1 COM^AMV <br />B <br />COMPANY <br />c <br />COUAAMV <br />0 <br />TH8 IS TO CCPmFY THAT THE fOUCCS OF MSUIUNCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANOINQ ANY REOUIREMENT. TERM OR CONOfTlON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED lY THE POLICIES DESCRIBED HEREV4 IS SUBJECT TO ALL THE TERMS <br />EXCLUSIONS AND CONDITIONS OP SUCH POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAO CUIMS. <br />CO <br />LTH TYM OP MaURAMCt POUCY NUMtCfl poucr irrtcnvf <br />DATE IMM/OO/VYI <br />POUCV tVPIfUTlON <br />OATf CMM/DCVry)uurrt <br />QtROIAlUABIUTY <br />COMMIJICIAL OINCRAl UABAJTV <br />I CLAIMS MAOl OCCUR 1121646 <br />OWHIR-S A CONTRACTOR'S ROOT <br />aCNERAL AGGREGATE <br />RROOUCTS - COMR.OR AGO <br />10/01/02 10/01/03 RERSONAL a AOV INJURY <br />EACH OCCUWENCf <br />RIRE damage tAny ont fWH • 100.000 <br />2.000.000 <br />• 2.000.000 <br />• 1.000.000 <br />• 1; <br />MED EXR lAny on* p^rsowl <br />AUTOMOBIIE UAtlUTV <br />ANY AUTO <br />AU OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON OWNEO AUTOS <br />X <br />X <br />1121646 10/01/02 <br />OARAOf LIASIUTY <br />ANY AUTO <br />10/01/03 <br />COMBINEO SINGLE UMIT 1.000.000 <br />•OOILY INJURY <br />CR mt p#rion| <br />SOOILY INJURY <br />(Rfr Bcodtrit) <br />RRORfRTY DAMAGE <br />AUTO ONLY. EA ACCIDENT <br />OTHER than AUTO ONLY: <br />EACH ACDO^ <br />AOGREOATf • <br />EXCESS UAMJTY <br />UMBRaiA FORM <br />OTHCn THAN* UMCniLU FORM <br />1121647 <br />WORRm COIBRCNSAT10N AND <br />■MRtOYlRi* LUBRJTY <br />THE RRORRifTOR/ <br />RARTNERS/IXECUTIVE <br />OFFICERS ARE <br />NCI <br />EXCL <br />1121648 <br />10/01/02 <br />EACH OCCURR9CS <br />10/01/03 AOOREOAT1 <br />• 1.000.000 <br />• 1.000.000 <br />10/01/02 10/01/03 <br />WC STATU- <br />TQRVUMITS <br />I • <br />OTM. <br />ER <br />a EACH ACCIDENT <br />a DISEASE • ROUCY UMlT <br />a DISEASE • EA EMRLOYEE <br />500.000 <br />500.000 <br />500.000 <br />other <br />OESCRIFTION OF OFfRATlONS/lOCAnONSAlCHIClfS.'SRfCIAL ITEMS <br />Dew Corporation is listed as additional insured. <br />Ref: Navarre Fire Station, Orono, MN <br />CCNTIPICAT8 HOLDER i.■v>:« .< . <br />r'0?8i CANCflLAUPN <br />% <br />Dew Corporation <br />2125 Century Avenue <br />North St, Paul, MN 55109 <br />ACOKO 2B*S <br />IMOtAD MV 08 TMt MOVt DWCWWD POUCCS W CANCIUIO OIPOIII TM. <br />CXRIAAT10N DATE TmEIISOF. THE iBtURlO COMRANV WIU BCXmOONOnBr MAH <br />JQ, DAYS WRrrTEN NOTICE TO THE CERTIFICATE HOiOiR NAMIO TO THE urr. <br />■XX <br />AUTHORiaO REFREinTATfVS^ <br />• ACbRO'CCR^tiOM' 108^
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