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INSURANCE BINDER <br />DATE (MM/DD/YYYY) <br />06/15/2021 <br />THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. <br />PRODUCER <br />Mercer Consumer, a service of <br />Mercer Health & Benefits Administration LLC <br />PO Box 310179 <br />Des Moines, IA 50331-0179 <br />COMPANY <br />Berkley Insurance Company <br />BINDER # <br />EFFECTIVE <br />DATE <br />TIME <br />EXPIRATION <br />DATE TIME <br />06/14/2021 <br />12:01 <br />AM <br />❑ PM <br />07/14/2021 <br />® 12:01 AM <br />❑ NOON <br />PHONE <br />(NC, No, Ext): <br />CODE: <br />AGENCY <br />CUSTOMER ID KN109593 <br />800-435-7904 <br />FAX <br />(A/C, No): <br />I SUB CODE: <br />INSURED Holstad &Knaak, PLC Attorneys at Law <br />THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY PER <br />❑ EXPIRING POLICY #: PLP-1382855-P5 <br />DESCRIPTION OF OPERATIONS/VEHICLES/PROPERTY (Including Location) <br />COVERAGES <br />LIMITS <br />TYPE OF INSURANCE <br />PROPERTY <br />CAUSES OF LOSS <br />1 ❑ BASIC ❑ BROAD ❑ SPEC <br />I ❑ <br />GENERAL LIABILITY <br />COVERAGE/FORMS <br />DEDUCTIBLE <br />COINS °Io <br />AMOUNT <br />❑ COMMERCIAL GENERAL LIABILITY <br />❑ ❑ CLAIMS MADE ❑ OCCUR <br />RETRO DATE FOR CLAIMS MADE: <br />EACH OCCURRENCE <br />DAMAGE TO <br />RENTED PREMISES <br />MED EXP (Any one person) <br />PERSONAL & ADV INJURY <br />GENERAL AGGREGATE <br />$ <br />PRODUCTS COMP/OP AGG <br />VEHICLE LIABILITY <br />❑ ANY AUTO <br />❑ ALL OWNED AUTOS <br />❑ SCHEDULED AUTOS <br />❑ HIRED AUTOS <br />❑ NON -OWNED AUTOS <br />VEHICLE PHYSICAL DAMAGE <br />DED <br />❑ COLLISION: <br />❑ OTHER THAN COL.: <br />GARAGE LIABILITY <br />❑ ANY AUTO <br />EXCESS LIABILITY <br />❑ ALL VEHICLES ❑ SCHEDULED VEHICLES <br />COMBINED SINGLE LIMIT <br />BODILY INJURY (Per person) <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />MEDICAL PAYMENTS <br />PERSONAL INJURY PROT <br />UNINSURED MOTORIST <br />❑ ACTUAL CASH VALUE <br />❑ STATED AMOUNT <br />El <br />$ <br />❑ UMBRELLA FORM <br />I ❑ OTHER THAN UMBRELLA FORM <br />WORKER'S COMPENSATION <br />AND <br />EMPLOYER'S LIABILITY <br />RETRO DATE FOR CLAIMS MADE: <br />AUTO ONLY - EA ACCIDENT <br />OTHER THAN AUTO ONLY: <br />EACH ACCIDENT <br />AGGREGATE <br />EACH OCCURRENCE <br />AGGREGATE <br />SELF -INSURED RETENTION <br />❑ WC STATUTORY LIMITS <br />E.L. EACH ACCIDENT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. DISEASE POLICY LIMIT <br />I SPECIAL <br />/ 'CONDITIONS/ <br />`OTHER <br />COVERAGES <br />IAME & ADDRESS <br />Lawyers' Professional Liability <br />Claims Made Retro Date Full Prior Acts <br />Policy # PLP-1382855-P7 <br />Per Incident $2,000,000 <br />Aggregate Limit $2,000,000 <br />Deductible PC $5,000 <br />Includes form <br />binder is subje <br />this binder is n <br />s and endorsements as listed on the quotation accepted on 06111/2021. This <br />ct to receipt of premium in full by 07/14/2021 or within 30 days, otherwise <br />ull and void. <br />Holstad & Knaak, PLC Attorneys at Law <br />`4501 Allendale Drive <br />Saint Paul, MN 55127 <br />MORTGAGEE <br />LOSS PAYEE <br />FEES <br />TAXES <br />ESTIMATED TOTAL PREMIUM <br />ADDITIONAL INSURED <br />12,495.00 <br />LOAN # <br />AUTHORIZED REPRESENTATIVE <br />ACORD 75 (2010/04) <br />PAGE 1 of 2 0 ACORD CORPORATION 1993-2010. All Rights Reserved. <br />The ACORD name and logo are registered marks of ACORD <br />