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4 �® CERTIFICATE OF LIABILITY INSURANCE <br />MT1812OD zo m <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS, AUTHORIZED <br />REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, Me policy(ies) must have ADDITIONAL INSURED provisions or be endoreed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an andomement. A statement on <br />this Certificate does not confer rights W the certificate holder in lieu of such endomement(s). <br />PRODUCER <br />Arthur J. Gallagher Risk Management Services, Inc. <br />4 — 13th Ave N. <br />Waite Park MN 56387 <br />MMF T Melissa Anderson <br />NtowE FAx <br />No EM n 320.258-9379 xd <br />nourtalss: melissa Anderson a' .cnm <br />INSUREPPI AFFORDING COVERAGE <br />NAICe <br />INSURERA [ United Fire $ Casualty Company <br />13021 <br />INSURED SENTSHE41 <br />INSOREAB: <br />Sentm-Sofa Sheetmetal, Inc. <br />3075 3rd St. S. <br />IxsuRERc: <br />IxsuRER o: <br />P.O. Box 400 <br />Waite Park MN 56387 <br />IxsuRER E: <br />INSNRER F: <br />COVERAGES CERTIFICATE NUMBER: 4Ag287114 RFVIRICIN NUMRPR <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 DOCUMENT WITH 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 />IL. <br />TYPEOFINSUMME <br />MIX <br />PoDCYHUMBER <br />POLICYEFF <br />MMm <br />PODGY RP <br />MMN <br />umn <br />A <br />Y <br />Y <br />5047M15 <br />1HY1020 <br />1fl2021 <br />EACHOCC. URRENCE <br />$1,000,000 <br />VXCMIMERCIMILGENERALLIABADY <br />CIAIMS-MADE O OCCUR <br />PREMISES Ea Damance <br />$100.000 <br />MED IDN(A sr <br />$5.000 <br />co OP <br />OS 014 <br />PERSOML&ADVINJURY <br />$1,000,000 <br />GEN'LAGGREG9TEUMITAPPLISI <br />POLICY Z%?f LOC <br />GENEMLAGGREGATE <br />$2.000,000 <br />PRODUCTS -CWRIDP AGO <br />$2.000.000 <br />$ <br />OTHER <br />A <br />AUTOMDBIIEUNUILITY <br />Y <br />Y <br />604T0915 <br />""CO20 <br />11112aO <br />E68BOWU ING DMn <br />$1,pro ,GGD <br />X <br />BODILY IWURY(Per ry,son) <br />$ <br />ANY AUTO <br />CYNED <br />AUTOS ONLY ALTO <br />BODILY IWURY(Px xtiEmp <br />f <br />X- <br />HIRED X NONNNNED <br />AUTOSONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Paem1E¢nl <br />$ <br />X <br />S <br />]imm9 <br />A <br />X <br />DMBREW LAB <br />N <br />OCCUR <br />Y <br />Y <br />60470915 <br />1111204 <br />111=21 <br />EACH OCCURRENCE <br />$5,000,WO <br />AGGREGATE <br />$5,p00,WU <br />EXCE93uAB <br />CLAIMSAIADE <br />DEO <br />I X <br />I RETENTIONS 1 o wro <br />$ <br />A <br />MMEEM COMSUAT rY YIN <br />ANYPRWBETORPARTNERaMCUTNE <br />OFFICE <br />NIA <br />Y <br />SM70915 <br />11112MO <br />1I10021 <br />X PFgTUIE <br />ELEACHACCICENT <br />E1.flOD,000 <br />ELOIBEASE-EAEMPLO <br />31.000,000 <br />elyan4abry1nxR1 <br />DE3ARIPDON OF OPERATIONSbelaw <br />ELDISEASE-POUCYUMIT <br />$1,000,000 <br />A <br />Leaseddxmmx ERui <br />Inns. Per <br />60470915 <br />1I112020 <br />1MAM21 <br />UR Usi, <br />IMI FII <br />$150,000 <br />$500,000 <br />DESCRIPTION OF OPERATIONS I LOCATONS I VEHMLES 1ACCRO let. A44NIone Ren,arts ScRMule, One es stetted M mart apece Is nwWreE) <br />RE Job: Elk River Ice Arena and Lion John Waicht Pare Facilities, 1000 Schaal St NW, Elk River, MN 53330 <br />RJM Construction, LLC (General Contraction), City of Elk River, MN (Owner) and 292 Design Group (Architect) are included as Additional Insured on the <br />General Liability policy for ongoing 8 completed operations; and are included as Additional Insured on the Auto Liabillty policy. The insurance provided in the <br />General Liability policy applies on a primary and non-contributory basis. Waiver of Subrogation applies for Auto Liability, General Liability S Work Comp for the <br />General Contractor and City of Elk River, MN when required in written contract. The Producer will endeavor to mall 30 days written notice to the Certdicate <br />Holder named on the Candidate if any policy listed on the certificate is cancelled prior to the expiration date. Failure to d0 so shall impose no obligation or liability <br />Of any kind upon the Producer or otherwise alter the policy terms. Coverages apply when required by written contract. <br />$342,000 of coverage applies for materials being stored at A8B Welding, 8021 1 Nth Ave NW, NOW Then, MN 55330. <br />6EK I IYICA I L RULUER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />City of Elk River <br />13065 Orono Parkway NW <br />Elk River MN 55330 AurxDRMEDREPRE$ExTATNR <br />�ka.r�tiLa�� <br />61988-2015ACORDCORPORATION. All rightsmserved. <br />ACORD 25 (2015103) The ACORD name and logo are registered marks of ACORD <br />