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1940 Cliff Lake Rd - Cub Foods Certificate of InsuranceTHE 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 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD 'L INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDD/YYYY) POLICY EXPIRATION DATE (MMIDD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY MWZY58889 08/01/2010 08/01/2011 EACH OCCURRENCE $ 2 000,000 DAMAGE TO PREMISES(Ea o $ 100,000 CLAIMS MADE I X OCCUR MED EXP (Any one person) $ -0- X X GENERAL $1 000,000 SIR PERSONAL BADVINJURY $ 2,000,000 Erodes Each Occ Limit GENERAL AGGREGATE $ 4,000,000 AGGREGATE LIMIT APPLIES PER POLICY PRO LOC JECT X PRODUCTS - COMP/OP AGG $ 4,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ S WORKERS EMPLOYERS' ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER (Mandatory SPECIAL COMPENSATION AND LIABILITY Y / N WC STATU- OTH- TORY I IMITS FR E.L. EACH ACCIDENT $ EXCLUDED? N E.L. DISEASE - EA EMPLOYEE $ in NH) If yes, describe under PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSFLOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS CITY OF EAGAN IS ADDITIONAL INSURED FOR THE GENERAL LIABILITY POLICY AS REQUIRED BY WRITTEN CONTRACT AS RESPECTS THE SALE OF FIREWORKS AT CUB FOODS, 1940 CLIFF LAKE RD., EAGAN, MN. CITY OF EAGAN CITY CLERK 3830 PILOT KNOB ROAD EAGAN, MN 55122 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Of MBriRSil LE PIDC ENTATNE l.r Li _ V ^ \V Katey E. Jones ® Av CERTIFICATE OF LIABILITY INSURANCE M/DD /YYYY) 07 /30/ 07/30/2010 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION Marsh USA Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 333 South 7th Street, Suite 1600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Minneapolis, MN 55402 -2400 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Attn: MinneapolisCertRequest @marsh.com fax: 212 - 948 -0700 067800 - SUPER- GL -10 -11 INSURED SUPERVALU INC. ITS AFFILIATES AND SUBSIDIARIES P.O. BOX 990 MINNEAPOLIS, MN 55440 COVERAGES CERTIFICATE HOLDER ACORD 25 (2009/01) CHI - 002293711 -21 INSURERS AFFORDING COVERAGE INSURER A: Old Republic Insurance Co INSURER B: INSURER C: INSURER D: INSURER E: NAIC # 24147 CANCELLATION © 1998-2009 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. Acord 25 (2009/01)