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R. Digitally signed by Francine R. Francine . Il Villareal /IIIA rPAI Date: 2021.12.1412:57.42 FDATE1(0MM/DD1YYYY) 121/2021 �� CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. 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 endorsements . PRODUCER 651-464-3333 Landmark Insurance Services 232 Lake Street South CONTACT Dan Quam PHONE FAX (A/C, No, Ext): 651-464-3333 (A/c, No):651-464-7596 n RLSS: kalm@landmark-ins.com Forest Lake, MN 55025 Dan Quam INSURERS AFFORDING COVERAGE NAIC # INSURER A: Evanston Insurance Company INSURED Spineless Wonders LTD Kra igg Anderson 1216D Scandia Tr No Scandia, MN 55073-9427 INSURERB: Evanston Insurance Company INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ILTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 3AA519443 12/03/2021 12/03/2022 EACH OCCURRENCE $ 1,000,000 DAMAGEPREMISES REor ED currenCe $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY PRO- [::] LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY EOMBI deD SINGLE LIMIT $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ B UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EZXS3066303 12/03/2021 12/03/2022 EACH OCCURRENCE 2,000,000 X AGGREGATE 2,000,000 DED FT RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH- E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Additional insured per form MEGL 0009 (09 18) status is provided on General Liability on a primary & non-contributory basis per form CG 20 01 (04 13) attached. Excess Liability dec with schedule of Underlying coverage Comm general liability attached. SANTA-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 CivicCenterPlaza-4th floor AUTHORIZED REPRESENTATIVE ,. Risk Managzrrtent Division Santa Ana„ CA 92702 REVIEWED & APPROVED BY. m , ACORD 25 (2016/03) ©1988-2015 ACORD CO The ACORD name and logo are registered marks of ACORD I. Wsk Pjanagennent Analyst