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2002-05-22 LaTour Certificate of Liability InsuranceACORD CERTIFICATE OF LIABILITY INSURANCE, DATE(MM/DD/YY) TTE01 05/22/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Pierce Agency, Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P . O. Box 418 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Litchfield MN 55355 Phone:320-693-6115 Fax:320-693-3452 INSURED LaTour Construction, Inc. 2134 Co. Road 8 NW Maple Lake MN 55358 INSURERS AFFORDING COVERAGE INSURER A: Western National Mutual INSURER B: INSURER C: INSURER D: ' INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITN RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MA'Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AL L THE TERMS, EXCLUSIONS AND COi~DiTiO NS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER LTR POLICY EFFECTIVE POLICY EXPIRATION ~. LIMITS DATE (MM/DD/YY) ' DATE (MM/DD/YY) GENERAL LIABILITY - ~ EACH OCCURRENCE 5 1 , OOO, 000 A $ COMMERCIAL GENERAL LIABILITY CP300001494 06/04/01 06/04/02 ;FIRE DAMAGE (Any onefirej $ 50,000 CLAIMS MADE X OCCUR MED EXP (Any one person) ~ 5 5 , 000 A X Includes X,C,U CP300001494 06/04/01 ' 06/04/02 : PERSONALBADVINJURY 51,000,000 X RR Protective Lia CP300006269 05/06/02. 05/04/03 'GENERAL AGGREGATE 5 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG 5 2 , OOO , 000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY ' I COMBINED SINGLE LIMIT 5 1 , 000, 000 A X ANY AUTO CA300001912 06/04/01 06/04/02: (Ea accident) ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS ~ (Per person) X HIRED AUTOS BODILY INJURY 5 X NON-OWNED AUTOS - ~ (Per accident) PROPERTY DAMAGE ' 5 (Per accident) GARAGE LIABILITY -AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC 5 AUTO ONLY: AGG 5 EXCESS LIABILITY ~ ;EACH OCCURRENCE 5 2 , 000 , OOO A -OCCUR CLAIMSMADE CU300000697 06/04/01 ~ 06/04/02 AGGREGATE 5 2,000,000 5 DEDUCTIBLE 5 RETENTION 5 ~ 5 WORKERS COMPENSATION AND ~ TORY LIMITS , ER ~' A EMPLOYERS'LIABILITY WC3000O1126 05/28/01 05/2$/02 '. E.LEACHACCIDENT ~ 5 500,000 ~~ ~ E.L. DISEASE - EA EMPLOYEE ~ 5 500 , OOO E.L.DISEASE-POLICY LIMIT ~ 5 500,000 OTHER A Instal.Floater IM300001850 06/04/01 06/04/02` 50,000 A Rented Equipment IM300001850 06/04/01: 06/04/02' 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate holder is named as additional insured as well as SEH, PO Box 1717, St. Cloud, MN 55302 in regards to 2002 NW Commercial Park. CERTIFICATE HOLDER 3[ ADDITIONAL INSURED; INSURER LETTER: CANCELLATION City of Albertville 5975 Main Ave. NE PO Box 9 Albertville MN 55301 ACORD 25-S (7/97) ",Should any lat' th~1bQYa tlescrll:md Policiu;s l)4 rctutarially Ghftn~: su~pcutlt:A, (>e Ci1l1GGIC~,1 ~14~OCt'1 [11C GX~~t'p.l1PQ (~iitfa (11f;fuQC, Dc fail 14 ~~ rl:+ntt~ved uE~an their axX>irnti4n, chi i9suln~ sora(~a.ny will mail ~Q d.:;y~ oriac wriuan nut'tce [o Iht; nurnccl crr(_iC~a(a tz lar." AUTHORIZED REPRESENTATIVE David W. Pierce CI ©ACORD CORPORATION 1988 AcoRD. CERTIFICATE OF LIABILITY INSURANCE, DATE(M61/DD/YY) TTE01 05/06/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Pierce Agency, Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P . O. Box 418 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Litchfield MN 55355 Phone:320-693-6115 Fax:320-693-3452 INSURED LaTour Construction, Inc. 2134 Co. Road 8 NW Maple Lake MN 55358 '~ INSURER A: INSURER B: 'i INSURER C: INS RERU D: INSURER E: INSURERS AFFORDING COVERAGE Western National Mutual r V V C ^A~i G.7 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD {NDICATED. NOTWITHSTANDING 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 CONDITI ONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRI-------------- j TYPE OF INSURANCE POUCY NUMBER LTR '^ ------- DATE MM/DDCTIVE 'POLICY EXPIRATION --------"----_-- _-- i '~ DATE MM/DD LIMITS '. GENERAL UABILITY ~, ~', EACH OCCURRENCE ! $ 1 , OOO, OOO X CO MMERCIALGENERALLIABILITY CP3000O1494 O6/O4/O1 I' O6/O4/O2 ~I FIRE DAMAGE (Any one fire) '~, $$ 5Q,000 ~~, CLAIMS MADE ~ $ ~ OCCUR - - _ _, F r MED EXP (Any one person) -- --- i $ 5 , Q 00 A X Includes X,C,U CP300001494 06/04/01 '', 06/04/02 ' PERSONALSADVwJURV ' $ 1,000,000 Coverage __ ~ GENERALAGGREGATE ---- i $ 2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: ' ~ -- ~ '. '. PRODUCTS -COMP/OP AGG ' ' :~ $ 2 , 000, 000 ~, PRO- ' : POLICY , - ---'-- , '~ ; AUTOMOBILE LIABIUTV i ~ A X ANY AUTO CA300001912 ' COMBINED SINGLE LIMIT 06/04/01 06/04/02 ', (Eaaccidenq ~ $ 1 OOO OOO i ALL OWNED AUTOS BODILY INJURY ~ $ SCHEDULED AUTOS . (Per person) X HIRED AUTOS `--_--- --___-- ----- ----- - _ ~- ~ X NON OWNED A T BODILY INJURY P id t ~ $ - U OS er acc ( en ) . ___ - ------ ." - ---.- -_- __ PROPERTY DAMAGE $ (Per accident) .. GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ' $ ANY AUTO _. --~ . ----- -- ', OTHER THAN EA ACC --- ___ -- , $ ---- - - 'AUTO ONLY: AGG $ EXCESS LIABILITY -_ - ', ,EACH OCCURRENCE $ 2 , OOO, OOO A OCCUR CLAIMS MADE ' CU300000697 r-- -------- -- 06/04/01 ' 06/04/02 AGGREGATE - ---_.__... --------.._---_ $ 2,000,000 `$ DEDUCTIBLE '---.. _._----- ---__.. _. ..---- _.. RETENTION $ $ WORKERS COMPENSATION AND ' '. TORY LIMITS ER EMPLOYERS LIABILITY A WC300001126 _.._.- ------------------ 05/28/01 OS/2$/02 E.L. EACH ACCIDENT ---_-_ _._..... $ 500,000 E.L. DISEASE-EAEMPLOYEE -. $ SQQ,000 E.L. DISEASE -POLICY LIMIT $j00, QQQ OTHER A Instal. Floater IM300001850 06/04/01... 06/04/02 50,000 A Rented E ui ment IM300001850 06/04/01 06/04/02 100,000 DESCRIPTION OFOPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The certificate holder RLK Kuusisto and SEH are named as additional insureds in regards to 2002 Northwest Commercial Park, Albertville, MN. --••••••-•-•-••----•• ~, i ,.,...,,nv,...u,wvncu, mauncn ~ci~cn: ~.N17~.GLLAlIV1Y ALBERO 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL EI~Nt1p7I1L]OXIL ~~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT F~16BYKdLL City of Albertville 5 9 7 5 Main AVe . NE PO BOX 9 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Albertville MN 55301 REPRESENTATIVES. 1 AUTHORIZED REPRESENTATIVE ~~~'~'9~~ ~/Q David W. Pierce C i~ '"`'"^" "'~ ~~/y~~ ©ACORD CORPORATION 1988 05-17-02 15:02 LATOUR CONSTRUCTRUCTION ID=3209636017 P.02 MF,Y-14-2002 TU£ 04:39 PM ~I£RCE f~ENCY 1NC, FAX N0. 1320693352 P. aI a r~5u~~ ~ gir~a~~ - ~~ R>tT@ 05/1&/02 rti1S BINDER IS A 7~Y ofiARY 4AtSt1FiANC:t HFAkC'T, SUBJECT TO THE c01'IOmoN5 SHOWN! ON ThIE R>=VERSE SIDE QF THIS FoRY. Ptioouc~ - __.. _~__..~----~--._.__._ .... __ I w~~t~Ql 3Za..693-6115 _ ~~ ---70JUnER,i- - 2717 - ---- - 32Q-693-3452 ' ~ WeaLern gationsl DluLUal Pierc6 Agency, IoC_ i - -'QFFEC'nvE ' . • .... _ .. _.. _ -. ..p(PIfJ.TVON .. - - - pAT>(_ __ TIIAE _ 607E rlilE - --- -- - - P.O. Sox 418 X I ~^. ~ ,:-o,.~Ja ~ I.itchfielJ3 ZCAT 5355 05/06/02 1250] ~ '~.+ 05/06/03 ~corJ flAYla 6i. Pierc CIC Cone: ; Jlta cto t; ~ THIC GINOiR IS ISSIiED YO ExTE~f) CO~£pACi IN YHe AsOVt: J:AFtE. C4MP.tti-r Phi r7fPcRInJG POLL tr APPLIC$T IOl~ C~ia~iLER 16: '1,A~$ 1 OE3CRIPf10N Or OVGRAYIOWiNRN1Ci.E5lPAOPEgYY ¢ndudirlp 6xacbN IILUAED pwstex of railroad: &u>^liggton NwrtherJa s t.atour Co structi.on Tn c. Dante Fa RR; track I.ocatioua City pf 213 Co. , ad 8 1tT4P ~ lllbostV~.l,1e, bdNy Amount o£ work: 513,020 Yiaple Lsk }t!1 55358 W VGISFiI]CJ 1 1 tIIITC TVAE OF t _ . _.-_._.__.._-..___. E COVERArfJfORMS . OMri7Gf1ULE ~ CCIttS ~r ~ I AJJO UN7 QR006R7V CAV5E30F 1 `a . ........ .. .. .... -... _ _ ._.. ... _..._ . .. .. ~ ~ ..... = dA$IC ~ ~ 6ROAD ' ~ ~PG.^. 1 i I cacao. uAeaurv j EA:,H OGCURFL~NCC `. Z I pOO, OOO . _ ,-C4YN.cAG1AL t3ENER4 LiA2:UTV ' - Hh'E O.Mt~iGE taffy one ntaj S ' CLLIMS MA:]E J OCCUR ~ M~ EY iAny one perar,t) v X FR FJCOtecti a vEq~oNaLnAGVLUJUFV . ... _.. ! oGNCwkaaG5E5~TE s (.040, 040 ~ R~TROOA FORC'..AtMSSyt~E: i F'>KCDUCTS-CCMPtQ?A6G S AUYOnO81LF 1W81L1T'Y - -- ~ COIA61NE0 TINGLE LIMIT , i _ pNV aUTO ~ • t1o41t-Y tDLURY_tPer y~r•_on) _. _ --.. .-. - --- . . ' •4U.OWAE'~A:IY68 ~ 60DILY'NJUkv ~PJ~1'Cl~.~t) $ • ' rAOGEirT'~-DAM.~CE ' MFDtG69t'/fAENTS -I NJN-OW~EDaUTD° -... -- ~ ----------- ----. . ~ A_~~onaL tnUtJRV FROT , .....-------°-------1 - ---- e ~ { j ~ unL~suat~MOror,laT _. _ ...---------.._ s aura PHYSICat oai{AGE Epl)CT7p>r -~ ~ ' AJ_Y ...... CLES sG1rE0ULE6 Ve~tlCteS ~W ..._ ACTl1AL GSH vawF_ ~ COLU~cpa. _ •--..- .. _ . i _ _ 1 : SraTEP aMO~p' -- - s OTHER 7H.VJ CCL i ry- _. .__ ..__.. _-.___ .... . CiY:•C~ . 6~G~ i.i~PtUTY . . _. - t ~ ~"~~ AUTQ ONLY • EA.J:.CCIPEUi . . - a ~y •-- hNV AUTD ~ _ .. . .._ ... -.. _...... .. 07i~R THAV 4cJT0 ONLY. ... . _.. -......_ AGvFEGATE S EXCESS l1A&LJTv "'-" __ _ ._.- _-... _- flCLLFW',EHCfi f Ai N UM9R~LLA FQRM _ i+~16~[OAT? ,. 0Th=R7+atil:M$R'e~ PORN ~R!THODA f06C1i11VdSIkADE SCL;-tNSUFiEDP.:TEMT+CN y r ^ 'A'C STATuTOA'r ~IM:Y~ -.. WOAJ(EA-$COMiaFJt aT10N _ ~ E ~tCH ,~CCI~EA7 5 Afv6 _ _. .. -. .... - . E'YrLOyER'S Lla)3 JTY I ~ E.L ~J=ASE • ~A J:JIP40VCE 5 e 1. asE:~,E -r^oucv uW T s ~P[GIAL ~ Fr~S fi O ~TIpN3' TAJC.ES COVERAGES . Esn L1ATED TOT:.L ~FE`a:UM S a KVVRGi]J ~ I ylOArORCEE ~ ACOlTt4w: ~nsJrtEo ~OEB PAYCE t IOAA i_ . ' ' -.. -_ __ ._-. ..._ . StAl7)pi3Cl; C~ obal SOrviCJBB IACi, Pertait Se i,ceo p~Tl,lolJ¢Fn RevJ~esE~rr.1NE 5650 p Riv rsiac pr., st lal G~G~ _~L%f/~, Ft T~orth 75137 'r~ David M. pieYCe, CI ACBRD 755 (1/90) TE: IYPQRTANIT STATE fNFORilAT10N ON RrrVER3E SIDE ~ ACOFiD GORPOF'tAT10N 1993 05-14-82 115:33 RECEIVED FROM:132&6933452 P.01 05/17/02 FRI 14:57 [TX/RX NO 5954] MAY-14-2002 TUE 04:39 PM P[ERCE AGEt~Y ]MC. FAX N0. 13206933452 P. O1 acoRV INSURANCE BtND~R aA OATi~ 05/14/02 THIS BINDER ~ A TEMPORARY INSt1RANC! COHfRACT, 8U8UECT T'O 711E CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. PAOOUCen ----• • ' ----" ~ ~ ~; 320-693-6115 CO4P""Y ' 2717 3~0-693-3452 S1leatern_ National Mutual _ _-____ P1erCe Agency, IAC. O+-TF~-- ,-- TIME ---- ---.- -_ ---' GATE BATON- ~ Tt4E P.O. Box 418 %' A"' • ~-+'c"`~+ T,itch#ield HN 55355 05/06/02 I 12:01 ~ 'n+ 05/06/03 ~ nco+, David W. Pierce, CIC __ TI{IS ~INpER S ISSUED TO EXTEW COVERAGE IN 7H£ A80Vt NVJE3 COMPA.tiV coDE: .. -- "_ _ - - - - ~ sus coDE: PER c"xPIRUrG PoucY s- APPLICATION C~i16ETdIER ID: LATTED 1 DE3CRIPf10N OF OPEAATIOMSNEMIGLE$rPROPEATY pnc+udlnp lautbn) Latour Construction, Inc. 213A Co. Road 8 HW >vlaple Lake IdlQ 55358 O.waer of Railroad: aurliagton Northern t sate Fe BR; Track Location: City of Albertville, MN; Amount of Work: $13,020 CAVFRSGES LIMITS TYPE OF INSURANCE ~ COVERAGEFORKS _ - ~ DEDUCTI9LE ~ COINS ~ ! .. - - - - - ANOUN7 -.. PROPERTY CAVScB OF t-OSS .-.... -_ .- ... - .... -. _ . I I - ... , - 3ASIC I I BROAD ( ~ sPEC Ii ~' ' GENERAL Ua91UTY EACH OCCURP.c"NCE 5 2 , 000, 000 CGh+MEaC+AL GENERAL L`Aa:UY{ ~ ' FIRE OAMA3E (fury aw d,ej S .. .. .CLAIMS k1AL~E ~ ~~ OCCUR ~'. - U5D EY.P iAny onn persaN S X Tilt Protect 1V ~ PERSu^NAL 8 ACV 1,4JIJFY 5 ~ GE11EFLiL AUGRE3ATE - ~ 6, 000, 000 _- ~n`ETRODATEFOR!':AIMSA'IAOE: .PRODUCTS-CCMP;G?hGG :5 AUTO+,OBILE LIABIL+TY - COM61NED SIN6Lc' LIMIT 3 ANV AUTO yODILY ;AIIURY IPa parson} - - - " ALI- Owl.E~ AUTOS BODILY :DU JRV ;Ppr a.-Iacn+7 SG'~iEb.:.EO AUTOS iAOGEFIY DAMA3E S ~ - -. _ H:FiED AJT03 -, ~ `1EDICAI PA':~ME NTS MOH-ON/hED AUTG~ p5?SOM1AL INJURY PRCIT @ - 7NI:VOUPG3 A+OTOR15T - S AUTO PHYSICAL QALAGE GtCI'CT~BLE ~ AL_VE-MICLE.i - SCMECi~~LED `!-hICLES ----~ -~ -- nCTILtL CA3ii VAWE _-- -~ - - COLL13'ON. STATED Ah10UM1T - - -- ------""_- - OTHEFTHANCCL ~ OTHER GA.IAGE UABIUTY AU70 OMLY - EA ACCIDENT r.t~JY .4UT0 ' GT~-+EF THAN 4UT0 ONt,\- _... - - - EACM ACCT OcNT , . ._. -. AGu nE ~ii+T g EXC ESa UAa1JTY EA,'N OCCUPAEl:Cc - - ~ "- - - JGOP.ELLA FOfiM AGGREGATE "- CTh_P-HAP,CMBR=LLA rORSi RETRO DATE FC~.IAIMSIvACE: SEL-iN3CRED P_TENT~.CN $ LVC STATUTOP:~LfM:T~ LYORKER'S COMPENSAT`.ON E._ Ehl7H ACCIJEh"i 5 ANO .- . _- .- -. .. - ET.,PLOYER'SLIABILITY E.~'1~SASE-=A EIAPLO`/-.-."k "> E L DISE4,°,E - FCLICY Ll'd T 5 SPEC~AL F_55 5 OTHER TARE.`. COVERAGES ~ - " ESTIt1ATED TOTAL ~IEMIJM 3 NAME & ADDRESS ! r,ORTGAGEE ' nCOGIOwA~ ~hls,~at0 - ,t LOSS PAYEE LDA,i Staubach Global Services, Inc. Permit 50rviCAB Ju1THOf+IIEO REPRESENT6TNE 5650 N Riverside Dr., Ste 101 G~~~/~L/i! ~, Ft North TY 76137 David W. Pierce, GI arnan ~~s ryrss~ NOTE: IMPORTANT STATE INFORf1ATION ON REVERSE SIDE ~ACORD CORPORATION 1993 05-14-02 16:38 RECEIVED FROM:13206933452 P.01