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<br />COMMON POLICY DECLARATIONS <br /> <br />INSURED COPY 9 YIF <br /> <br />POLICY NUMBER: CG66200 <br />REVISION EFFECTIVE: 12/01/06 <br /> <br />~ <br /> <br />NORTH STAR MUTUAL <br />INSURANCE COMPANY <br />BOX 48 COTTONWOOD, MINNESOTA 56229-0048 <br /> <br />NAMED INSURED AND MAILING ADDRESS <br /> <br />AGENT AND ADDRESS <br /> <br />1122 <br /> <br />FERCHO FAMILY FARMS LLLP <br />% W FERCHO MANAGING PARTNER <br />4903 ROSE CREEK PARKWAY <br />FARGO, ND 58104 <br /> <br />WARNER AND COMPANY <br />318 BROADWAY <br />PO BOX 1470 <br />FARGO ND 58102 <br /> <br />(701) 237-6414 <br /> <br />POLICY PERIOD: FROM 1/01/07 TO 1/01/08 AT 12:01 A.M. STANDARD <br />TIME AT YOUR MAILING ADDRESS SHOWN ABOVE. <br /> <br />This replaces all previously issued policy declarations, if any. In return for the payment of the <br />premium and subject to all the terms of this policy, we agree with you to provide the insurance as <br />stated in this policy during the policy period shown above. <br /> <br />THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS <br />INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. <br /> <br />BILL TO: INSURED <br /> <br />TOTAL ANNUAL PREMIUM <br />PREMIUM AUDIT <br />ADJUSTED PREMIUM <br /> <br />PREMIUM <br />$ 173.00 <br />$ 0.00 <br />$ 173.00 <br />PERIOD: ANNUAL <br />25.00 <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />CERTIFIED TERRORISM COVERAGE (SEE DISCLOSURE NOTICE) <br /> <br />(THIS IS NOT A BILL; STATEMENT WILL FOLLOW) <br />CHANGE REQUEST: CODE 76750 IS ADDED, FORM CF935 IS ADDED, PREMIUM IS AMENDED. <br /> <br />Your policy is subject to the forms/endorsements listed below-any new or revised <br />forms/endorsements are attached and now apply. (If this is a renewal certificate or a revision, only <br />the new or revised forms/endorsements are attached.) Current policy forms are available on request. <br /> <br />IL0017(11-98) <br />CF1806(01-05) <br />CG0067(03-05) <br />CG2167(12-04) <br />IL0021(07-02) <br />IL0165(07-02) <br /> <br />CF1736(01-07) <br />CF1557(11-05) <br />CG2147(07-98) <br />CG2186(12-04) <br />CF-935(11-05) <br /> <br />IL0234(12-03) <br />CF-846(08-00) <br />CG2155(09-99) <br />CG2196(03-05) <br />CF-936(11-05) <br /> <br />IL0003(07-02) <br />CG0001(12-04) <br />CG2160(09-98) <br />CG2279(07-98) <br />CG2104(11-85) <br /> <br />PROCESS DATE: 12/12/06 <br /> <br />24 <br /> <br />CONTINUED ON REVERSE SIDE <br />