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<br /> -''J—""N1 ALLTERR-01 DEJE
<br /> A4CCPR© CERTIFICATE OF LIABILITY INSURANCE DATE(MM/b0fYYY)
<br /> 7/2/2013
<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 be endorsed. If SUBROGATION IS WAIVED, subject to--
<br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder In Ileu of such endorsement(s).
<br /> PRODUCER (701) 277.1710 CONTACT ---' - ___
<br /> j NAME: Davin Gaard
<br /> TCI Insurance PHONE P X701)277.1710 —�--- PAX No 701 277.9068
<br /> PO Box 680 !M JL 1 —T j ___
<br /> West Fargo,ND 68078-0680 ADDRESS dgaard @tciteam.com _ I
<br /> INSURERS)AFFORDING COVERAGE 1. NAIL p
<br /> INSURER A:United Fire&Casualty Company
<br /> INSURED �—
<br /> All Terrain Grounds Maintenance Inc. INSURERS;
<br /> 4663 13th Ave N
<br /> INSURER c: ___
<br /> Fargo, ND 58102 INSURER D:
<br /> INSURER E: �_ _a__� -
<br /> _INSURER f t ._
<br /> �I
<br /> COVERAGES CERTIFICATE NUMBER: 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 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 POLiCIE$ LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> ILTR TYPE OF INSURANCE ADDL SUNK POLICY Or rouc'EXP
<br /> INSR INVD POLICY NUMBER (MMn/oPfYYYY) (MM/DDIYYYYI LIMITS
<br /> GENERAL UABILITY
<br /> (EACH OCCURRENCE s 1,000,000
<br /> A X I CDMMFRDIAL GENERAL LIABILITY 803853$9 7/31/2013 7/31/2014 ' DAMAGE TO RENTED
<br /> PREMISES(Ea occurrence), i$ 100,0001
<br /> CLAIMS-MADE X 1 OCCUR I MED EXP(Anyone person) I S 5,000
<br /> PERSONAL A ADV INJURY 1 $ _ 1,000,000)
<br /> I i i GENERAL AGGREGATE 1$ 2,000,0001
<br /> GENt AGGREGATE LIMIT APPLIES PER' 1 PRODUCTS,COMP/OP AGG S 2,000,000
<br /> ---w1 PRO- (" _
<br /> 4 X j POLICY I JECT 1 , LOC J - I i I 1$ I
<br /> ,AUTOMOBILE LIABILITY + COMBINED SINGLE LIMIT 1,000,00Q'I
<br /> ` (Ea accident)___ I s
<br /> A X ANY AUTO 60385389 1 7/31/2013 7131/2014 BODILY INJURY(Per person) I$
<br /> ALL OWNED SCHEDULED 1 BODILY INJURY(Per accident)1 S
<br /> AUTOS AUTOS _
<br /> NON-0WNED PROPERTY DAMAGE
<br /> I—I HIRED AUTOS —I AUTOS (PERP,PCIDENT) (S
<br /> X UMBRELLAUAB X OCCUR _ EACH OCCURRENCE 15 1,000,000
<br /> A EXCEBBLIAB CLAIMS-MADE! 60385389 7/31/2013 7/31/2014 hAGGREGATE s 1,000,000
<br /> DED ! I RETENTION$ - ) 1S
<br /> WORKERS COMPENSATION 1 WC STATU- .0TH-1 �`
<br /> AND EMPLOYERS'LIABILITY y/N I J WRY LIMITS ER _,
<br /> ANY pRopRIET0R/PARTNERJExECUTivSri E.L.EACH ACCIDENT
<br /> OFFICERM(EMBER EXCLUDED? Ni A $
<br /> (Mandatory In NH) I I E.L.DISEASE-EA EMPLOYEE,_1,
<br /> If yes,describe under i
<br /> DESCRIPTION OF OPERATIONS below EL.OISEASE•POLICY LIMIT $
<br /> A ND Employer Liability 160386389 7/31/2013 7/31/2014 $1M/Acc'S1M/Employee S2M/Aggregate
<br /> I I
<br /> I , 1 I
<br /> i i I I
<br /> .—
<br /> DESCRIPTION of OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,AddldGnat Nemarke Schedule,If more spaoc IF required!
<br /> {
<br /> I I
<br /> _ .—�.. __ �. - .- .. —. , J____.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> All-Terrain Grounds Maintenance Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 4663 13th Ave N ACCORDANCE WITH THE POLICY PROVISIONS
<br /> Fargo, ND 58102- AUTHORIZED REPRESENTATIVE
<br /> ©1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 26(2010/06) The ACORD name and logo are registered marks of ACORD
<br />
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