Agenda - Council Work Session - 05/07/2013

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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 TYPE OF INSURANCE ADDL INSR SUER WVr1� POLICY NUMBER POLICY EFF rMM DD /YYYYI POLICY EXP (MMIDri/YYYYI LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 680386D3628 12/18/12 12/18/13 EACH OCCURRENCE $ 1,000 000 PREM SES (Ea occurrence) $ 300,000 CLAIMS -MADE X OCCUR MED EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: — 1 POLICY PRO JFCT LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS BA386D3770 12/18/12 12/18/13 COMBINED SINGLE LIMIT (Ea accident) 1 000 000 $ s s BODILY INJURY (Per person) $ BODILY INJURY Pdent ( er accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE ISFCUP973H2726 12/18/12 12/18/13 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED 1 X RETENTION $ 5000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A ICUB386D371A 12/18/12 12/18/13 x WCSTATU- TORY LIMITS ER ER E.L. EACH ACCIDENT $ 500,000 E . DISEASE EA EMPLOYEE $ 500,000 E DISEASE - POLICY LIMIT $ 500,000 am 1 Property Prof Liab 680386D3628 LHX980753600 12/18/12 01/05/13 12/18/13 01/05/14 Contents 625,022 Prof Liab 1,000,00C DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 4WRE COVERAGES CERTIFICATE HOLDER FYI CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE 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 RJF Minneapolis 7225 Northland Dr N #300 Minneapolis, MN 55428 Mindy Carlson INSURED Ratwik Roszak & Maloney PA 730 2nd Ave S #300 Minneapolis, MN 55402 763- 746 -8000 CERTIFICATE NUMBER: FYI.... CONTACT Colleen een Johnson PHONE 763- 746 -8524 E-MAIL • ohnsonc r a ADDRESS; I fencies.com �� g FAX 763 -7 INC, No): INSURER(S) AFFORDING COVERAGE INSURER A : Travel ers Insurance Co INSURER B: Hanover Insurance Company INSURER C: INSURER D: INSURER E: INSURER F: 46 -8624 NAIC # 25658 36064 CANCELLATION • RATWROS OP ID: C2 DATE (MM /DD/YYYY) 12/28/12 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 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Attachment 2