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ACOREP CERTIFICATE OF LIABILITY INSURANCE 3/5 DATE/2014/DD/YYYY) 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 CONTACT NAME: Peggy Lund RJ Ahmann Company PHONE 7555 Market Place Drive E-MAIL o Exv:952 947 9700 FAX No):952-947-9793 Eden Prairie MN 55344 ADDRESS:plund @rja.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Continental Casualty Company 11111 INSURED MARKS12 INSURER B:Western National Mutual 15377 Mark Sand&Gravel Co. INSURER C: 525 Kennedy Park Road INSURER D: Fergus Falls MN 56537 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2036424575 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVNTHSTANDING 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 AWL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS B GENERAL LIABILITY Y Y CPP1056859 5/1/2013 5/1/2014 EACH OCCURRENCE $1,000,000 X DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $300,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) _ $10,000 X ND Stop Gap PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 7 POLICY X PEA LOC $ B AUTOMOBILE LIABILITY Y Y CPP1054465 5/1/2013 /1/2014 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS _ AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accident) $ B X UMBRELLA LIAB X OCCUR UMB1074612 5/1/2013 5/1/2014 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED X RETENTION$10,000 $ B WORKERS COMPENSATION Y WCV1006845 5/1/2013 5/1/2014 X WC STATU- X OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 A Excess Liab L5085881423 5/1/2013 5/1/2014 Occurrence 10,000,000 Aggregate 10,000,000 Retention 0 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) THE FOLLOWING FORMS APPLY TO THE NAME(S)&PROJECT BELOW ONLY IF REQUIRED BY WRITTEN CONTRACT OR AGREEMENT: GEN LIAB:WNGL72&WNGL73 Primary& Non-contributory Additional Insured Ongoing&Completed Operations; WNGL39 Waiver of Subrogation; CG2414 11/85 Waiver of Governmental Immunity, CG2417 Railroads-Contractual Liability/AUTO LIAB: CA2048 Additional Insured;WNCA22 Waiver of Subrogation/WORK COMP:Waiver of Subrogation Project:JOB 003, Projects SC-0957(062), SC-0946(063)&SU-8-984(149)152-Cass County/The State of North Dakota, its agencies, officers and employees(State)and the Cass County CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cass County ACCORDANCE WITH THE POLICY PROVISIONS. 1201 W Main Ave West Fargo ND 58078 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD