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CERTIFICATE OF INSURANCE <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br /> THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. <br /> <br />NAMEANDADDRESSOFAGENCY <br /> <br />Preferred RiskMutual <br />Richard G. Jansma <br />8833 Central AVe. <br />Blaine, MN ~5~ <br /> <br />NAME AND ADDRESS OF INSURED <br /> <br />Victorious Jesus Church <br />15551 Potassium St. <br />Ramsey, ~ 55303 <br /> <br />This Certificate of Insurance neither affirmatively nor negatively <br />amends, extends or altqrs the coverage or any provision of <br />Policy No. '~ E~,3 i BBued by <br /> <br />This is fo certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. <br /> <br />TYPE OF INSURANCE <br /> <br /> GENERAL LIABILITY <br />../ COMPREHENSIVE FORM <br />PREMISES -- OPERATIONS <br />[] EXPLOSION AND COLLAPSE <br /> HAZARD <br />[~ UNDERGROUND HAZARD <br />,~ PRODUCTS/COMPLETED <br /> OPERATIONS HAZARD <br />/ CONTRACTUAL INSURANCE <br /> BROAD FORM PROPERTY <br /> DAMAGE <br />[] INDEPENDENT CONTRACTORS <br /> P <br /> ERSONAL INJURY <br /> OTHER <br /> <br /> AUTOMOBILE LIABILITY <br />[] COMPREHENSIVE FORM <br /> OWNED <br /> HIRED <br /> <br />[] NON-OWNED <br /> <br />EXCESS LIABILITY <br /> <br />UMBRELLA FORM <br /> <br />WORKERS' COMPENSATION <br />and <br /> EMPLOYERS' LIABILITY <br /> <br />COMPANY AFFORDING <br /> COVERAGE AND <br /> POLICY NUMBER <br /> <br />/ Preterred Risk Mutual <br />~ Midwest Mulual <br /> <br />Policy ~~ <br /> <br />;~ Prelerred Risk Mutual <br /> <br />~_~ Midwest Mutual <br /> <br />Policy# <br /> <br />,'- Preferred Risk Mutual <br /> <br />Policy <br /> <br />"~ Preferred R~sk Mulual <br /> <br /> POLICY <br />EXPIRATION DATE <br /> <br />2-I-90 <br /> <br />Limits o! Liability in Tnouianct$ lO00) <br /> <br />BODILY INJURY <br /> <br />PROPERTY DAMAGE <br /> <br />BODILY INJURY AND <br />PROPERTY DAMAGE <br />COMBINED <br /> <br /> EACH j <br />OCCURRENCE <br /> <br />AGGREGATE <br /> <br /> I <br />$ I, 000,0001 ~3,000,000 <br />$1,000,0001 s3,000, O00 <br /> <br />$ $ <br /> <br />'APPLIES TO PRODUCTS/COMPLETED <br />OPERATIONS HAZARD <br /> <br />BODILY INJURY <br />(EACH PERSON) <br />BODILY INJURY <br />{EACH OCCURRENCEI <br /> <br />PROPERTY DAMAGE <br /> <br />BODILY INJURY AND <br />PROPERTY DAMAGE <br />COMBINED <br /> <br />BODILY INJURY AND <br />PROPERTY DAMAGE <br />COMBINED <br /> <br />~ 3,000, 000 <br /> <br /> Policy .e <br /> <br /> OTHER <br /> <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES <br /> Church seduces and other relatedac~w_~e~~ '""' <br />conducted at certificate holder ad~ress, which premises are beS_~g rented. <br /> <br /> Cancellation: Should any of the above aescrioed policies he canceliec before the expiration date thereof, the issuing company will <br /> endeavor ~o mail 30 days 'Iunless otherwise indicated below) written notice to the below named certificate holder, but <br /> failure to mail such notice shall impose no obligation or liability of any kind upon me company. <br /> <br /> 'Optional number of days written notice applicable in lieu of above only if indicated: <br /> <br />$.A.3?.C~.B254 19&2' <br /> <br />NAME AND ADDRESS OF CERTIFICATE HOLDER: <br /> <br /> City of Ramsey <br /> 15153 Non, hen B~_vd. ~ <br /> P~nsey, ~ 55303 <br /> <br />DATE ISSUED: - ~ x <br /> <br /> yAUTHOR!ZED REPRESENTATIVE <br /> <br /> <br />