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<br /> , <br /> ! <br /> am NORTH DAKOTA INSURANCE RESERVE FUND <br /> P.O. BOX 2258 <br /> BISMARCK, ND 58502 <br /> ....-... ,. ''MAMEDMEMBER'' "i,','i':""':'~""'"",.,'..,"""""":' 'i",""','..," ..' 'i' ,,'..'.',.'.i <br /> CASS COUNTY DAWSON INSURANCE AGENCY INC <br /> MIKE MONTPlAISIR. AUDITOR PO BOX 1958 <br /> PO BOX 2805 FARGO NO 58107-1958 <br /> FARGO. ND 58108 <br /> PHONE NUMBER: 701-237-3311 <br /> , CONFIRMATION OF COVERAGE <br /> THIS CONFIRMATION OF COYERAGE IS ISSUED AS A MAllER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CONFIRMATION <br /> OF COVERAGE HOLDER. THIS CONFIRMATION OF COVERAGE DOES NOT AMEND, EXTEND. OR ALTER THE COVERAGE AFFORDED THE <br /> NAMED MEMBER. <br /> THIS IS TO CERTIFY THAT THE MEMORANDUM OF COVERAGE LISTED BELOW HAS BEEN ISSUED TO THE NAMED MEMBER SHOWN ABOVE. <br /> IF At'" MEMORANDUM OF COVERAGE LISTED BELOW BE CANCELLED DURING THE COVERAGE PERIOD, THE NORTH DAKOTA INSURANCE <br /> RES ';I'VE FUND WILL PROVIDE THE CONFIRMATION OF COVERAGE HOLDER A THIRTY (30) DAY iWTICE OF CANCELLATION. <br /> f---. , <br /> COVERAGE MEMORANDUM COVERAGE PERIOD LIMIT OF LIABILITY <br /> NUMBER FROM TO EACH PERSON EACH OCCURRENCE <br /> "liAS/UTI' <br /> , <br /> IXI PREMISWOPERATlONS , GL 98719 08/0112005 08/0112006 $2,000.000.00 $2,000,000.00 <br /> o GOVERNANCE : <br /> o PROFESSIONAL SERVICES, <br /> , <br /> AUTOMOBilE UABIL.ITY . <br /> . <br /> IXI ANY AUTO . BA43219 0810112005 08/01/20D6 $2,000.000.00 $2.000.000.00 <br /> o ALL OWNED AUTOS , <br /> , <br />I IX] HIRED & NONOWNED AUTOS <br /> D DESCRIBED AUTOS . <br /> , <br /> o OTHER COVERAGE <br /> . <br /> . <br /> OESCRIPTIONS OF OPERATIONS, LOCATIONS, AUTOS. OR SPECIAL ITEMS. <br /> , <br /> CONFIRMATION OF COVERAGE HOLDER <br /> STATE OF NORTH DAKOTA <br /> NO DEPARTMENT OF TRANSPORTATION <br /> 60B EAST BOULEVARD AVENUE <br /> BISMARCK. ND 58505-0700 : <br /> ATTN: DAWN OLSON, TRAFF1IC SAFETY MGR AUTHORIZED REPRESENTATIVE ISSUE DATE <br /> , \jj.~ ,,~~, ffin.~ 12106/2005 <br />