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R. Brouillette Agency, Inc. <br />1005 West Franklin Avenue <br />Minneapolis, Minnesota <br /> <br />CERTIFICATE OF INSURANCE <br /> THIS CERTIFICATE I$ ISSUED AS A HA'II'ER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br /> 55405 COMPANIES AFFORDING COVERAGE <br /> <br />COMPANY <br /> A <br /> <br />iNSURED .......................... ~, COMPANY <br />J~T Enterprises, Inc. B <br />dba: M & L Liquors COMPANY <br />5900 - 167th Ave. N.W. C <br /> Ramsey, ~ 55303 . COMPANY <br /> ~ D <br /> <br />Park Glen National_Insurance_Co <br /> <br />COVERAGES <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEN'I' W(TH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br /> <br />CO TYPE OF INSURANCE <br />LTR; <br /> <br />GENERAL LIABILITY <br /> <br /> ~COMMERCIAL GENERAL LIABILITY <br /> j J CLAIMS MADE ~ OCCUR <br /> i OWNER'S &CONT PROT <br /> <br />ALII <br /> <br />~MOStLE LIABILITY <br /> <br />ANY AUTO <br /> <br />ALL OWNED AUTOS <br /> <br />SCHEDULED AUTOS <br /> <br />HIRED AUTOS <br /> <br />NON-OWNED AUTOS <br /> <br />GARAGE LIABILITY <br /> i ANY AL'TO <br /> 'i <br /> <br />EXCESS LIABILITY <br /> <br /> ; UMBRELLA FORM <br /> <br /> OTHER THAN' UMBRELLA FORM <br /> <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABIL]TY <br /> <br />THE PROPRIETORf ' INCL <br />PARTNERsfE XECUTIVE <br />OFFICERS AR.:: ' EXCL <br /> <br />POLICY NUMBER <br /> <br />POLICY EFFECTIVE <br />DATE (MM/DD/YY) <br /> <br />POLICY EXPIRATION LIMITS <br />DATE (MM/DD/YY) <br /> <br />i PRODUCTS-COMPIOP AGG i $ <br /> <br />EACH OCCURRENCE I $ <br />FIRE DAMAGE (Any c, ne lire) ' ~. <br />MED EXP {Any one pe~sonl ', ~ <br /> <br />'~ COMBINED SINGLE LIMIT <br /> <br />BODILY INJURY <br />('Per bersom <br /> <br />BODILY INJURY <br />(Per acc~oen~} <br /> <br />PROPERTY DAMAGE <br /> <br />AUTO ONLY - Ea ACCIDENT <br /> <br />OTHER THAN AUTO ONLY: <br /> <br /> EACH ACCIDENT <br /> <br />AGGREGATE <br /> <br />EACH OCCURRENCE : ~ <br />AGGREGATE '. $ <br /> <br /> ' STATUTORY LIMITS <br /> <br />EACH ACCIDENT <br /> <br />DISEASE - POLICY LIMIT <br /> <br />DISEASE - EACH EMPLOYEE <br /> <br /> O~ER <br /> <br />A Liquor Liability ~LL940548 <br /> <br />10/17/94 <br /> <br />7/[/95 <br /> <br />$500,000 BI Per Person <br /> 500,000 BI Per Common Caus~ <br /> 500,000 PD Per Common Caus~ <br /> <br />3ESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES,SPECIAL ITEMS <br /> <br />$500,000 Loss of Means of <br /> 500,000 Loss of Means of <br /> 500,000 Policy Aggregate <br /> <br />Support Per Person <br />Support Per Com. mon Cause <br /> <br />3ERTtFICATE HOLDER <br /> <br />City of Ramsey <br />15153 ]~o~,then Blvd. <br />P~msey, b~ <br /> <br />55303 <br /> <br /> CANCELLATION <br /> <br /> SHOULD ANY OF THE ABOVE DESCRIE~ED POLICIES BE CANCELLED BEFORE THE <br /> <br /> EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br /> TEN DAYS WRI"i-TEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LE~', <br /> BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGA'T/ON OR LIABILITY <br /> <br /> OF AN~ KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br /> i~THOR~--R~.PRESEN*A:r,v£ ~ ' / " <br />~ - ' ff (~ACORD CORPORATION 199'3' <br /> <br /> <br />