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FOR INFORMATIONAL PURPOSES ONLY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE J Voerster /CARLEY BILITY INSURANCE 11/1 /20 a ' AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 'E A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED policy(les) must be endorsed. If SUBROGATION 1S WAIVED, subject to Tdorsement. A statement on this certificate does not confer rights to the CONTACT NAME: Certificate Department PHONE (952)707 - 8200 FAX (952)990 -0535 mm No E #f: IAtC, Noi: E -MAIL ADDRESS: certificatesekainsurance.corn PRODUCER 00006299 CUSTOMER ID 9: INSURER(5) AFFORDING COVERAGE NAIC 9 INSURERA Insurance 22543 INSURER B : OCCUR INSURER C : INSURER D : X INSURER E : $ INSURER F : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY LIMITS SHOWN MAY HAVE BEEN REDUCED POLICY ISSUED TO CONTRACT THE POLICIES BY (MM!DD 11/18/2010 THE INSURED OR OTHER DOCUMENT DESCRIBED PAID CLAIMS. (MMIDDIIYYYY) /2011 NAMED ABOVE FOR THE 1MTH RESPECT HEREIN IS SUBJECT TO LIMITS EACH OCCURRENCE POLICY VhKIUU TO WHICH THIS ALL THE TERMS, $ 1,000,000 INSR LW TYPE OF INSURANCE ADDL y VD A GENERAL UAS I LITY COMMERCIAL GENERAL LIABILITY OCCUR BP- 003156589 -9 X DAMAGE PREMISES (Ea occurrence) $ 250, 000 CLAIMS -MADE X MEDEXP(Anyoneperson) $ 5.000 PERSONAL 8 ADV INJURY $ Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n JE T fl LOC PRODUCTS -COMP/OP AGG $ 2, 000, 0 0 0 $ X A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS A 003156590 - 9 11/18/201011/18 /2011 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X $ X $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CET 003156592 11/18/2010 11/18/2011 EACH OCCURRENCE $ 5, 000, 000 AGGREGATE $ . 5,000,000 DEDUCTIBLE RETENTION $ 10,000 $ X $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS Y! N N/A RC 003156591 - 9 11/18/2010 Y WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 500,000 N E.L. DISEASE - EA EMPLOYEE $ 500, 000 below E. L. DISEASE - POLICY LIMIT 5 500,000 B Professional Liability LHR724124 11/18 /201011/18/2011 Each Claim Aggregate 2,000,000 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, IT more space is required) ACORN CERTIFICATE OF LIA THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITU REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the the terms and conditions of the policy, certain policies may require an e certificate holder in lieu of such endorsement(s). PRODUCER Kraus- Anderson Insurance 420 Gateway Boulevard Burnsville DIN 55337 -2790 INSURED Landform Professional Services, LLC. 105 Fifth Ave. South Suite 513 Minneapolis COVERAGES ACORD 25 (2009/09) I NS025 (200sos) MN 55401 CERTIFICATE NUMBER:10 -11 Certificate The ACORD name and logo are registered marks of ACORD REVISION NUMBER: -2009 ACORD CORPORATION. All rig reserved.