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,a`oRO© CERTIFICATE OF LIABILITY INSURANCE <br />6/2021 M/DDIY YYY) <br />2/2DATE (MMIDDfY <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 INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Marsh & McLennan Agency LLC <br />6160 Golden Hills Drive <br />Minneapolis MN 55416 <br />CONTACT <br />NAME: Kasl Helllg <br />PHONE FAX <br />A/c No Ext: A/c No: <br />ADDRESS: kasi.heilig@marshmma.com <br />INSURERS) AFFORDING COVERAGE <br />NAIC # <br />INSURERA: National Union Fire Ins Co Pittsbur hPA <br />19445 <br />INSURED WSBASSOCIA <br />WSB & Associates, Inc <br />701 Xenia Ave So., Suite 300 <br />INSURERB: QBE Specialty Insurance Company <br />11515 <br />INSURERC: Princeton Excess & Surplus Lines Ins Co <br />10786 <br />INSURERD: <br />Minneapolis, MN 55416 <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER:2031897614 REVISION NUMBER: <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 V\1TH 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MMID <br />POLICY EXP <br />MMID <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />GL5425678 <br />3/1/2021 <br />3/1/2022 <br />EACH OCCURRENCE <br />$2,000,000 <br />CLAIMS -MADE 1XI OCCUR <br />'REM SES Ea occurrence) <br />$ 100,000 <br />MED EXP (Any one person) <br />$ 25, 000 <br />PERSONAL & ADV INJURY <br />$2,000,000 <br />AGGREGATE LIMIT APPLI ES PER: <br />GENERAL AGGREGATE <br />$4,000,000 <br />GEN'L <br />POLICY [X ] ECT El LOC <br />PRODUCTS -COMP/OPAGG <br />$4,000,000 <br />$ <br />OTHER <br />I <br />A <br />AUTOMOBILE LIABILITY <br />CA4693553 <br />3/1/2021 <br />3/1/2022 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$2,000,000 <br />BODI LY I NJURY(Per person) <br />$ <br />X ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />C <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />82A3FF000283401 <br />3/1/2021 <br />3/1/2022 <br />EACH OCCURRENCE <br />$5,000,000 <br />AGGREGATE <br />$5,000,000 <br />EXCESS LAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />WC015853268 <br />3/1/2021 <br />3/1/2022 <br />X PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? [N] <br />N/A <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />I <br />I <br />I E.L. DISEASE- POLICY LIMIT <br />$ 1,000,000 <br />B <br />Excess Liability <br />MQSX0000715201 <br />3/1/2021 <br />3/1/2022 <br />Each Occurrence <br />$5,000,000 <br />Aggregate <br />$5,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD '101, Additional Remarks Schedule, may be attached if more space is required) <br />This insurance is issued pursuant to the Minnesota surplus lines insurance act. The insurer is an eligible surplus lines insurer but is not otherwise licensed by <br />the State of Minnesota. In case of insolvency, payment of claims is not guaranteed. Company B and Company C are subject to statutes and regulations of <br />surplus lines carriers. <br />Evidence of Insurance <br />CERTIFICATE HOLDER 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 />ISSUED FOR INFORMATIONAL PURPOSES ONLY <br />AUJj ORIZ€D REPRESENTATIVE <br />rV�r� <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />Proposal for Urban Expansion Services Expansion Study for Elk River Certificate of Insurance 15 <br />