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,4co� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) ` ' io/la/zoii ..►.%" THIS RTIFICATE 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 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 1-952-358-7500 CONTACT NAME: Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX A/C No Ext): NC No): 3600 American Boulevard west E•MAIL ADDRESS: Suite 500 — B100miRgtOn, MN 55431 INSURER(S)AFFORDING COVERAGE NAIC# _ _ __ . _. __ INSURERA: GENERAL CAS CO OF WI 24414 INSURED INSURER B: Glowing Hearth & Home, LLC AMDS, LLC INSURERC: 100 Eldorado Di'ive INSURER D: Jordan, MN 55352 INSURERE_ _ INSURER F: COVERAGES CERT�FIC,!!TF NUMSER' 23624141 REVISION NUlUIBFR: 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� ADDLrSUBR�— �OLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER � MMIDD/YYYY MMIDD/YYYY I LIMITS A GENERaL LIABILI7Y � �CCS0352176 i 10/22/1 10/22/12I EACH OCCURRENCE $ 1,000,000 X �DAMAGE TO RENTED - COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 CLAIMS-MADE � OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERALAGGREGATE $ Z.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: i PRODUCTS-COMP/OP AGG $ 1,000,000 I X� POLICY PR� �—I LOC j I I I I $ A AUTOMOBILE LIABILITY CBA0352176 COMBINED SINGLE LIMIT I Ea accident $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED ' —� SCHEDULED BODILY INJURY Per accident $ AUTOS � J AUTOS ' ( ) HIRED AUTOS � I NON-OWNED PROPERTY DAMAGE I AUTOS � Per accident $ $ A X I UMBRELLALIAB X OCCUR CCU0352176 10/22/1 10/22/12 EqCHOCCURRENCE $ 2,000,000 � EXCESS LIAB CLAIMS-MADE I I I_. ._ _—_._ _. . AGGREGATE $ 2,000,000 ' �I DED �I �� RETENTION$ I � $ WORKERS COMPENSATION 'I WC STATU- I OTH- A ANDEMPLOYERS'LIABILITY Y�N I�C0352176 10�22�1�1 10�22/12 X T IMIT � ANYPROPRIETOR/PARTNEWEXEWTNE I E.L.EACHACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED7 � N�A� �I I (MandatoryinNH) E.L.DISEASE-EAEMPLOYE $ 100,000 If yes,descnbe under ---- —---- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I $ 500,000 � I j � � DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Orono THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P 0 Box 66 AUTHORIZED REPRESENTATIVE 2750 Relley Parkway Cryatal Bay, l�T 55323-0000 �� `��✓ USA l� O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/OS) The ACORD name and logo are registered marks of ACORD bikiahatin