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fes. <br /> ACORNMm <br /> =DATEYYYY)CERTIFICATE OF LIABILITY INSURANCE <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 have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer ri hts to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER LOCK FUN COMPANIES CONTACT NAME: <br /> 5100 Wayzata Blvd..Suite 510 PHONE FAX <br /> Minneapolis MN 55416MA1 E 0 __LAIC.Nal: ... <br /> 763-512-8600 ADDRESS: <br /> kcasuQ°lockton.COm INSURER[SAFFORDINGCOVERAGE gA1C <br /> -- <br /> INSURER A:The Charter Oak Fire Insurance Company 25615 <br /> INSURED MACQUEEN EQUIPMENT,LLC INSURERS:Travelers Property Casualty CompaTty of America. 25674 <br /> 1355447 DBA MACQUEEN EMERGENCY GROUP INSURER C:The Travelers IndemnitvCompany of Connecticut <br /> 1125 E.7TH STREET -- — --- x$682- <br /> ST. PAUL MN 55106 INSURER D:Travelers Casualty and Surety Company _ 19038 <br /> INSURER E: <br /> INSURER F -- <br /> COVERAGES CERTIFICATE NUMBER: 19332053 REVISION NUMBER: XXXXXXX <br /> THIS IS TO CERTIFY THAT 17HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVF FOR THE POLICY PFRIOD <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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR; --. 'AOOL SUBRi <br /> LTR TVPE OF INSURANCE POLICY NUMBER MMI IC YYYV7 POLICY X T mmyyyyi � — <br /> ,� X COMMERCIAL GENERAL LIABILITYy Y 630-867K8328 11/112022 1 23 HOCCURRENCE _ $ <br /> CLAIMS MADE X;OCCUR T=TdI&IiTEUi <br /> PREMISES Ea occurrence S 1,000.000 <br /> — MED EXP(Annone son) f 9,000 <br /> _PERSONAL a ADV IINJURY S I OOO._r_OOQ. <br /> GEN'L AGGREGATE p OT APPLIES PER- {GENERAL AGGREGATE S 2 000 000 <br /> ' <br /> POLICY JECT X_ t_<Tc PRODUCTS-COMPIOPAGG s 1 )000 <br /> X orHER TOTAL AGG: 58.000 000 _ <br /> C AUTOMOBILE LIABILITY Y ,' Y 810-7N364433 11/112022 11/11!2023 OM8INED SIN LI S <br /> .IEa accent) 1000 000 <br /> Fx_ <br /> ANVAUTO BODILYINJURY(Perparson) S XXXXXXX <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTO$ ED BODILY INJURY(Per acclden0 S XXXXXXx <br /> HIRED AUTOSNON-ONLYAUTOS ONLY AUTOS dNLY I ERTY DAMAGS XXXXXXX <br /> GKLL-Com/ dlli ion S XXXXXXX <br /> B X UMBRELLA LIAB X OCCUR Y Y11444 I VII2022 11/1/2023 EACH OCCURRENCE S 101000.0-0 _ <br /> -- <br /> EXCESS UAB_ CLAIMS-MgpE' AGGREGATE �� S_I.O 000,000,_,_, <br /> M707XRETENTIdrox 10,000 Vs XXXXXXX <br /> WORKERS COMPENSATION E LACH ACCIDENTS PER <br /> 1) ANO EMPLOYERS'UABIUTV Y Y 4504 11/1STATUTE/2022 11/1/23 X .- ER_ <br /> ANY PROPRIETORIPARTNERIEXECUTIVE EACH S ] OO(J QOO <br /> OFFICERIMEMBER EXCLUDED? <br /> (Mandatory in NH) <br /> 0 yes describe under E L OISE ASE-CA EMPLOYEEs 1,000,000 <br /> DESCRIPTION OF OPERATIONS bebw Et DISEASE-POLICY LIMIT > ) QOQ 000 <br /> DAMAGE <br /> C HIRED CAR PHYSICAL 810.7N364433 11/112022 1 11/1/2023 ACTUAL CASH VALUE <br /> r <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES IACORD 101,Additional Remarks sCnedule,may be attached it more space is required) <br /> '• SFF,ATTAC'HED '•• <br /> CERTIFICATE HOLDER CANCELLATION See Attachments <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENrATIV <br /> 19884015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />