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<br /> THIS CERTIFiCATE fS l83UEE5 AS A MAT'T�R 09�E�IFO�dIVEATtON ONLY ASVCJ CONFERS NO RIGHTS IiPON THE CER'fBFICAI�E:HOLDGFd.THlS
<br /> CERTIFICATE DflES NOT AFFIRMA7IVELY Ofd NEGA7EVEE.Y A3�IIIEND,EXTEND OFt AL7ER THE COVERAGE AFFQRDED�Y'3"ItE PQLICIES
<br /> BELpt^J. THBS CERTIFICATE t3F INSUl2ANCE DOES NOT COtdST1TiJTE 6E CONSRACT BE7WEEN THE IS5lJIt�G lNSURER(S$,RUTHqi21ZED
<br /> REPRESENTAT'EVE QR F'RObUCER.AND THE GFFtTiF'ICATE Hfll_E�ER.
<br /> INiPQRTANT: if the certificate haidsr is an AI3CSBT9(7�lR�l.I�1SUC��D,the policy{iesp must be endorsed. If SUBROGATION IS WAlVED,subject to
<br /> 4he terrns and canditians of the poiicy,certain pplicses rraay require an endorsement. A siatement on Lhis certificate does nat confer rights to the
<br /> certificate holder in tieu of such endursement(s).
<br /> PRODUfER C4NTAC7
<br /> r;AMF: Jennifer Winkels
<br /> Casualty Assurance of Chask�, LLC Prio�;e--- -- --- ---- - -- -_.__._ _ Faz -- -- ---- - --
<br /> 1 Q1 W@S4 Tlll!'d Si 1rSl�.�s_���: (952j448-3800 ---------__-._.:iaic„tio�: f952)448-3304
<br /> Chaska, MN 55318 -
<br /> n�oRess: info(a�caminnesota.com
<br /> INSURER(�AFFORDWG CI�VERNGE__.._________�,__NAlC Jt
<br /> - License#: 40178238 -— -r
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<br /> _____ ��as��R�Ho,. Westerr�.Nat�onaE_I_ns G_r__ou�_________ ;
<br /> wsukeo
<br /> I'JSURER B: �
<br /> ----- ------
<br /> �---- ----- �----- ---
<br /> J S Stewvart�omp�r�ie�, Sf�C INgIt�ERC: _
<br /> 11099 L�mant Ave IV� ivsurxEr��:
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<br /> t�anover, MN 55341 IVSURER�: i
<br /> INSURER F: �'
<br /> COVERACiES CERTIFiCAT�idI9NtB�i�� OQ048683-96itlG74 RE\OESIOPP Nl1Pu16�R: 57
<br /> THIS IS T�:�C:^RTIFY THAT THE POLICIES 01=INSURR�J�..�LIST�D 3ELG4N HA`JG EtEEN iSSUED T�THE ir�iSUR=C NAMEU RSQVE rOR TH�FCLICY PCRICD
<br /> INDiCATED. NCT�THSTAND�NG ANY REQUIF'c�MFN�,TERM OR GONDITIqN OF AhiY CGNTRACT GR�?hEP,iUC:JMENT 4'4'ITH REtif-'ECT TG WH!CH THIS
<br /> i,ERTIFiCATE MA'd BE iSSUEC;iR CJ!Al'PERTAIN,THE INSURAIICE AFFGRDcD f�tY THE POLICIES:�ESCRIBrD HEREI�I iy SIJB.;EC'-TC�ALL THF_.TERMS,
<br /> FXCLUSICN;AND CC)NUiTiQNS QF�UCFI F�OLICI�S.LIPdI1:S SHON�N MAY�IAV�BEFN RED'JC.ED BY PAiO i;LAiM,�,'.
<br /> :NSR ADDLSU6R �, POLICY EFF POLICY EX� ' – �-�� -------- ...---�--_.... ------ ----------------
<br /> L7�H TYPE OF INSURANGF �I FaOLiCV NUNBER '� �MMiL'U/YYYY MM1!iDD,'YWV � I_3MIFS
<br /> CENE'r2Al i.lA91LITY � Y � �,. i EACH OCCURREhGE I$ �I OOO OO�I
<br /> A ' 'CPPOa7827604 45i2212013 CES/22/2094
<br /> �DAMAGE TO RENTED ����-+��� � � 4 �� �
<br /> _ IABILITY ; � ; �PREMI E,{caor��rran�eL_ �$ _ �Qa�OQ�---
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<br /> �'�, ' ,CLAIMS-MADF '�� �(;OCCUR � � '�,MED EXP(Any one person) i$ '�Q�Q{)(�
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<br /> . _ - ___ ,_- . __ ' ' PERSON4 F�AiJVIN1URY__ I$.. __._�IyOO�IE�OO---
<br /> I �'� �. GENERAL AC�GREGATF I s ... __Z1pQQ,tipp__.
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<br /> ELIM�TAPP�IESPER: ' �� Ii '�, i PRODUCTS-COMP/OPAGG i S Z�OOO��QO
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<br /> �� ��� PO�I(;1'��� A�'�JF�^i ; 'LOC F iI � : ;g
<br /> � ,;AUT0,47081LELIABiLIIY� '', ^ �^�7�?Q��g'�7�^�1�q, ^ ��{jra(ZyzO'E� Q$/2�/2Q'�d'�,L�rlBINEDSINGLELIMIT ;
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<br /> � � ANY AUTO i I �'� BpDILY INJURY(Per person) I S
<br /> � ALLOVINED SCNEDULEU ''� ' : � � �� ��-� �-�- -
<br /> � AUTOS �AUTOS �' � ; '�, BODILY tP JJRY(Per accidert) $
<br /> ' NON-C'vVNED I, '� ' I PaOPERi1 DAMAGE�- -----
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<br /> q ', u!�aRe��a uaa X occu� ' ---------------- �s 1 000 000
<br /> , �'��, �J��E�Q7����E}� �'�SbJ22/ZO'I3 QSI22/YU'IA!EACH OCCURRENCE ----'-----'-----
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<br /> ; EXCESS LIAF) CLAIF.^SI�IADE�� '�, A!'GR�G.4'E $ �I yOE�OiUOO
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<br /> ANY ROPP FTnR/PPRTPdERIEXcCUTNE �����A E l.E�+CH AC�ID NT yS rJOvjAOI�
<br /> OFF�ER MEM1 B R E�"_JOED7 � - � � -- �----�
<br /> �Ma;?daicry m NH� � '� � ��, E.l.DISEASE-EA EMPLOYcry$ �QQ�Q��
<br /> I`yes,Aescribe ur,der , . .. ....... I ....... ...
<br /> �'�, L`ESCRIPP,OF4 OP OPERAT�CNS belcw ' _ ' � �' �'� E.L.DISEASE-POLiCY LiMIT�$ �SDQ�OOO
<br /> DESi.R.IP710N OP CPERATiONS!LOCATiONS I VEMICLES(Attach ACCIR'b 101,Addi4iural Remarks Schedale,if more spaca is requirxdj
<br /> CERTiFiCATE HOLDER CANCELLA,TION
<br /> SHQULD kNY OF 7HE RBOVE RESCRIBED POL.ICIES BE CAWCELLED BEFGEtE
<br /> THE EXfiIRAT10N DATE THE32EGF,NOTfCE WiLL BE DELIVE92ED IN
<br /> CEty Q�OI`C?t1K3 ACCORDA'�CE U�IITH THE POUCY PROVBSIQ�SS.
<br /> �Q $4JX$�
<br /> �'�{$�,�� �a�/� M� ���`l,'� AIJTH01212EDRE.z'RESENTATIVE
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<br /> �u:19B�-2010 ACC3RD CORPQRJ'+T�Q�E. Alt rights reserved,
<br /> ACQRD 25(204p10�i Yh�ACc?R�na�eas and i�g�are regis#ered msrks of AC{}�p
<br /> Frintzd by Jr�t�N or,May 2C1,2013 at O�:Q7Pfv1
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