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612-893-9218 <br />CORpOF~TE 4 INS AGENCY <br />7220 METRO BOULEVARD <br />EDINA MINNESOTA 55439 <br /> <br /> :, <br /> <br />THiS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND <br />CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE m <br />DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br /> m <br />POLICIES BELOW. <br /> <br />COMPANIES AFFORDING COVERAGE <br />TRANSCONTINENTAL INS. COMPANY I <br /> <br /> COMPANY ~ · · ,... : '- <br /> <br /> COMPANY <br />l~d:S~ LTONS CLUB Lsr~R C <br />Bo~ 771 ................................................................................................................................................................... <br /> COMPANY n <br />A~okz ~ 55303' ~ <br />~T~: Thomas Kuj awa ................................................................................................................................................................. <br /> COMPANY <br /> <br /> ~IS IS TO CERTI~ ~AT ~E POLICIES OF INSURANCE LISTED BELOW HAVE GEEN ISSUED TO ~E INSURED NAMED AGOVE FOR THE POLICY PERIOD <br /> JNDJOA~D. NO~J~STANDING ANY REGUIR~ENT, ~RM OR CONDITION OF ANY OONTRACT OR O~ER OOCUME~T WITH RESPECT TO WHICH <br /> CERTIFICA~ MAY BE iSSUED OR MAY PERTAIN, ~E INSURANCE ~ROED GY ~E POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. <br /> ~CLUSIO~S AND CONOITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED 8Y PAID <br /> <br /> ~P[OF INSU~ECE POLi~Y NUMBER LIMITS <br /> <br />GENERAL LIABILITY <br /> <br /> iOWNER'.~ & CONTRACTOR'S PROT. <br /> <br />AUTOMOBILE L~BILITY <br /> ANY AuTO <br /> <br /> ALL OWNED AUTOS <br /> <br /> HIREO AUTOS <br /> NO,q-O1Ai~N EO AUTOS <br /> GARAGE UABIUTY <br /> <br />i OTFIER THA~ UMGRELLA FORM " <br /> <br />WORKEr'S COMPEN'~AT[ON <br /> £MPLOYER$' LIABILITY <br /> <br />A LLP 13337268 <br /> <br />OTHER ~- <br /> LIQUOR <br /> LIABILITY <br /> <br />10/01/95 <br /> <br />GENERAL AGGREGATE <br /> <br />PERSONAL & AOV, INJURY <br /> <br />EACH OCCURRENCE <br /> <br />80OILY iNJURY <br />(Per preen) <br /> <br />BODILY INJURY <br /> <br />PROPER~ OA~GE <br /> <br />~C. ~CCURE,CE <br /> <br />AGG~E~TE <br /> <br /> ~ STATUTORY <br /> ! o <br />EACH ACCIDENT <br /> <br />o,sEAsG.PoucY UM,T <br /> <br />see below <br /> <br />OE.~CR[PTION OF OI~ERAT1ON$/LOCAlqONSNEFIICLES/:SPEClAL ITEMS <br /> LIQUOR LIABILITY AS FOLLOWS: <br /> $1,000,000 BODILY INJURY EA.PERSON/$1,000,O00 BODILY INJURY EA. 0C0/$1,000,000 <br /> PRORERTY DAMAGE ~. 0CC/$1,000,000 LOSS OF MEANS OF SUPPORT EA. PEPJ$1,000,O00 <br /> LOSS-OF MEANS OF SUPPORT EA.OCCP$1,000,OOO POLICY AGGREGATE <br /> <br /> - iilii SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> CT-TM O~ "[~/LI~SEY !!iiii EXPIRATION OATE'[HEREOF, THE ISSUING COMPANY WILL ENOEAVOR TO I <br /> <br />15 i53 Nowthen Blvd NW !fii~ii: MAIL 1il .. DAYS WRITTEN NOTICE TO THE CERTIFtCATE HOLOER NAMED TO THE <br />Ramse,, MN 55303 ihi. LEFT BUT FAILURE TO MAIL SUCH NOTICE SIJAI[L IMPOSE NO OBLIG_ATION OR~ .. <br /> ,7 ?i::v.-. ' ~ ~ <br />A.'I'~N' 'Ea."'-, i:~(~.~.LIABILITY OF ANY KINO UPON~HE"GO.M~(I~ ITS AGENTS OR <br /> <br /> <br />