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FROM :KOESTER INSSVCS FAX N0. :952-431-2900 Apr. 18 2013 12:11PM P1 <br /> NI`I V«"�' <br /> A��" CERTIFICATE OF LIABILITY INSURANCE °"oa`�si13Yn <br /> THI�TIFICATE 19 IS3UED AS A MAT7ER OF INFORMATION ONI.Y�X END OR AITER T'HE C VERAGE A FORDEDABY THE POLICHES <br /> CERTIFICATE DOES N07 AFFIRMATIVE�Y OR NEGATIVELY AMEND, <br /> 6ELOW, THIS CERTIFICATE OF INSURANCE DOES N07 CONSTITUTE A CONTRACT BETWEEN THE 188UING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRO�UCER,AND THE CERYIFICATE HOLDER. <br /> IMPORTANT: H tho celtiflcate holde� ie an ADDITIONAI. INBURED, the pollcy(lesl rnu9t be endorsad. Ii BUBROOA710N 19 WAIVED, 9ubject to <br /> the earms and condiNons of tNe pollcy,cortain pollcle9 may requlra an endorsemen4. A stakament on this csrtlHcatA doee not confar rishts!o the <br /> cartlilaate holder In Ileu oi sucN andor9ement s� A� <br /> vRovucEa 952-896-8818 � . - <br /> Northem Capital Commercial 952-829-0462 P„�NE " F� � � <br /> Nortbern Capft�l Ins Op dba �'�� <br /> MAI <br /> P.O.Box 9396 " <br /> MIf1119a�70II9� MN SS444�396 INBURER S AFFORDING COVERAGE NA1C M <br /> Koe9ter Insurance Sarvlcee,ln 14184 <br /> iNeua�cA:ACUITY Insurence , . <br /> weur�o Angell Alre,inc, iNsunEa s: - <br /> 12253 Nlcollet Avc. �NauaER c: _„ <br /> Burnsville,MN 55337•1650 INBUR R D; ' - <br /> u,suAea : <br /> COVERA(3ES CERTiFlCATE NUMBER: REVISION NUMBER: <br /> THIS 13 TO CERTIFY THA7 THE POL.ICIE9 OF INSURANCE LI3TED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THe POLICY PERIOD <br /> INDICA��. NOTwITMS7AN�ING ANY R�Qu1RflMENr,TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMEN7 WITH RESPECT TO WMICH TN�S <br /> CERTIFICATE MAY BE 19SUE0 OR MAY PERTAIN, THE INSURANCE AF�ORDEO eY THE POIICIE3 DESCRI6ED HEREIN 19 SUBJECT TO ALL THE 7ERM9, <br /> EXCLU310N9 AND CONDITION3 OF SUCH POLICIES.LIMIT9 SHOWN MAY WAVE BEEN 12EDUCED BY PAID CLAIMS. , , <br /> INSR 1. V ��� C CY EFF OLJCV LIMITB <br /> rPe OF INeUw►NC! 1.000,00 <br /> ocNewu unewiTM 6ncH occ;URr�cE S <br /> L52178 12124J12 12l24113 p Eg Ee n� S � 100�00 <br /> A X COMM�CW�OENERA�UnBIUTY 5,00 <br /> CWMS-MAOE I�OCCUR M6P ExP An onv ereon i <br /> P�R80Nn�8 AbV INJURY S 1�OOO�OO <br /> " " GENERALAGGREOATE $ � Z,OOO� <br /> GENL AQC�IiEOn�LIMIT APf'LIES PER: <br /> PRODUCTs-COMPlOP a00 a 2,000,0 , <br /> a <br /> POUCY °R�' L C 1,000,00 <br /> �uroMoei�eu�e�m ee.c � � u,. <br /> A X ANY AUTO Ls2�79 12/24/12 12l24/13 40DILv INJURV l��Dereon} s <br /> AI.I.UWNED 8CIIEOULED BODILY INJURY(Pef aoddenl? � <br /> AUT08 AUTOS a <br /> NON-O�NNEO e�r ec�den <br /> X HIRED AUT08 x AUT09 � �. <br /> X UMeRELLA LY16 X oCCUR EJ�CM oCCUFRENCE S ' 2,000,00 <br /> q exceaeune CLA�MB-MADE �5z�7� 12I2M12 1?J24l13 aco�oarE s�_ 2,000,00 <br /> D N <br /> WORKfiRBCOMCRN5AT10N X WC3TA U- OTH- <br /> ANDEMPLOYER9'LIABI�ITY Y/N L32178 �2�4M2 �2l24/�3 E•L�F,ACNACCIDENT S 500,00 <br /> A �NYPROPW6fOWPARTNEWEX6GITWE � N!A <br /> OFFICEPrMHh1eER ExCLUDEv'f E.L�D�BEASE•EA EMPLOYE i SOO,OO <br /> (Manaarory�n NM) <br /> H e deeoriEo unr PE E�L.��9EA9E•POLICY LM�IIT T ���0 <br /> DE9CRIPTION OF OP[RATION91 LOCA710N8/VEFiICIFB�Altaah ACORD 101,Addlllonal RemeMs 9ehvduk,If inera ep�a k roqulrod) <br /> C R FICA �CE <br /> ORONO-- <br /> sNOULD ANY OF THe AB01/E DE8CRIBED POUCIES BE CANCELLED BEaORE <br /> TH6 EI�PIRATION DATE TNEREOF, NOTICE WILI 6E OELNERED IN <br /> Clty Of 0�0110 ACCORDANCfl WIYN TH�POLICV PROVISION$. <br /> 2750 Kelley Parkway <br /> P.O.BOX BB AUTNORREDR6PREHENTA7NQ <br /> Crystal8ay,MN 55323 <br /> ¢�.�<..,�. Cr•.�C'�-e..u�� <br /> �/ <br /> �1888.2010 ACORD CORPORATION. All rights reserved. <br />