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W 3 Ym � z 0 00r4O 0 � NF! rf < 1131 kiCi al CC i=4 2 +I rl1/4° r'a UI 2 N m i,tg o F CI'ri -I m . W 3 0cel;pz- WL J N a tu W U) 01 2 Z'�.OCC W cc nla < co) <0 8 I � %:- (( S1, . OF -31) T SoTA ' - „ . t1 E ?1 ' O ••ERTIFICAT � F TITLE ---. - . ,- ' .\ TOAVOTOR HICLE ,, ` L O! / THIS TITLE IS PRIMA FACIE PROOF OF OWNERSHIP \ V -{(A Er 1, { �, ' KEEP INA SAFE PLACE —ANY ALTERATION OR ERASURE VOIDS THIS TITLE N RWUT080037 /REQD UT IL 80 TRI 'Y VEHICLE IDENTIFICATION NUMBER_, ODOMETER MAKE YEAR TYPE C `.1l/ \P T, X 14200050 05 /23/80 . � TITLE NUMBER DATE ISSUED NEW OR USED IF NEW,DATE OF FIRST SALE FOR CENTRAL OFFICE USE ONLY- 4 ?.. [ i NO SECURITY INTERESTS OWNER J . CI TY OF OAK PARK HGTS �`� � ', 14168 57TH ST STILIWATER MN 55082 0 997 C76 00 Z I 7. ... FIRST SECURED PARTY'S INTEREST RELEASED BY: SECOND SECURED PARTY'S INTEREST RELEASED BY: AUTHORIZED V AUTHORIZED V -' SIGNATURE A SIGNATURE A 1 ASSIGNMENT BY SELLER(TRANSFEROR) . f- YOU ARE REQUIRED BY LAW TO DISCLOSE THE ACTUAL ODOMETER READING AT THE TIME OF TRANSFER. ANY FALSE STATEMENT MAY MAKE YOU LIABLE FOR CIVIL AND CRIMINAL PENALTIES PURSUANT TO THE FEDERAL MOTOR VEHICLE INFORMATION AND COST '' ' SAVINGS ACT AND MINNESOTA LAWS 1973 CHAPTER 264 AND 1977 CHAPTER 105.ODOMETER READING EXCLUSIONS LISTED ON THE REVERSE. I (WE)CERTIFY TO THE BEST OF MY KNOWLEDGE THAT THE ODOMETER READING IS_ AND REFLECTS THE ACTUAL MILEAGE/KILOMETER OF THE VEHICLE DESCRIBED HEREIN OR(CHECK IF APPLICABLE). F 1. O THE ODOMETER READING IS OVER 99,999. 2. 0 THE ODOMETER READING IS NOT ACTUAL. ' ,'4' I(WE) U ER CERTIFY THAT THIS VEHICLE IS EE FROM ALL SECURITY INTERESTS,WARRANT TITLE AND ASSIGN THE VEHICLE AND REGISTRATION TAX PAID TO •,. f` �. SELLER'S SIGNATURE(SI DATE PRINT BUYER'S NAME(S) 'e I • COMPLETE REVERSE SIDE APPLICATION FOR TITLE BY BUYER(TRANSFEREE) (PLEASE PRINT) rr ,' DATE(S)OF BIRTH PRINT BUYER'S FULL NAME(S)LAST,FIRST,AND MIDDLE 1. STREET ADDRESS CITY COUNTY STATE ZIP CODE ��' IS THIS VEHICLE SUBJECT TO SECURITY AGREEMENT(S)? NO 0 YES 0 ADDITIONAL 0 IF YES,COMPLETE SECTION BELOW FIRST SECURED PARTY(PRINT NAME) DATE OF SECURITY AGREEMENT y'' .j STREET ADDRESS CITY STATE ZIP CODE f pfz r Ik IF THERE IS AN ADDITIONAL NAME OF POLICY SECURITY AGREEMENT(S) INSURANCE NUMBER ...,., COMPLETE AND ATTACH DPS2017. COMPANY to be insured while opam erat operof ating legal public streets have bought this highways,landsubject I of myliens (our)shown declarations are truethis andvehicle correct�s and will continue 's X s BUYER'S SIGNATURE(S)ALL BUYERS SIGN. , -f I DETACH THIS PORTION . • , , DO NOT SEPARATE UNTIL SOLD ,`; MINNESOTA MOTOR VEHICLE REGISTRATION CARD RECORDED OWNER(S)RECORD OF SALE TITLE NUMBER 997076 00 , . NUMBER 7970766 OO NUMBER X 14200050 TITLE 76 '� PLATES 12/31/80 TAX 100 TAX BASE NUMBERX14200050 t EXPIRE }� RWUT080037 T /� ,•,y MAKE UT IL MODEL YEAR 8O TYPE TRL V.I.N. RWU t OR0037 -_h,; Y.I.N. RWUT080037 STICKER R s',,,,. NUMB . , •' a C I T Y OF 0 AK P ARK HGTS BUYER'S SIGNATURE(S) SALE DATE 14168 57TH ST W STILLWATER MN 55082 STREET ADDRESS ./ E I: P R CITU STATE al et 114 itil �21P CODE, L. ,' (Sl T, 4 1 �'it `t i,�`. , �` .4.-sr1'(A t y MI A,L � ,> ` t I, I 2' ` fAt �E 2TIFICATE F, T ITLEb ,t '' O�A I9T®'R VEHICLE :, �.� ! ' .,r l t'. 4 k.. _... a,R +u ,x.-fie s.� ' .r, ✓ r -, ' i '� �t ` THIS TITLE IS PRIMA FACIE PROOF OF OWNERSHIP_ �, ,S ;i � t KEEP INA SAFE PLACE ANY ALTERATION OR ERASURE VOIDS THIS TITLEz()4 -.-.:- --,---'.','.4'.:Q V,,,: \ RWL 8077007 ROE?'TG 77 TRI -VEHICLE IDENTIFICATION NUMBER MAKE YEAR TYPE r 4 G21400823 08/09177 ',1'..'''''f' TITLE NUMBER DATE ISSUED NEW OR USED IF NEW,DATE OF FIRST SALE FOR CENTRAL OFFICE USE ONLY- ��` ..t5 b C'Y: o I .XS k NO SECURITY INTERESTS OWNER r r CITY OF OAK PARK HIS _)/ STILL WATER MN 5.5082 • 0 997059 00 . .. Z FIRST SECURED PARTY'S INTEREST RELEASED BY: SECOND SECURED PARTY'S INTEREST RELEASED BY: i ^ d• AUTHORIZED V AUTHORIZED �/ t�y(l ,, SIGNATURE A SIGNATURE A h ASSIGNMENT BY RECORDED OWNER(S):I(WE),CERTIFY THIS VEHICLE IS FREE FROM ALL SECURITY INTERESTS,WARRANT TITLE,AND ASSIGN THE VEHICLE TO: "'� t PRINT BUYER'S NAME(S) OWNER'S SIGNATURE(S)ALL OWNERS MUST SIGN DATE OF SALE !''lq . x APPLICATION FOR TITLE BY BUYER(S) COMPLETE FRONT AND BACK PLEASE PRINT(DARK INK) . X41 '.:-,;:',7.,-,,, STREET ADDRESS CITY COUNTY ■ STATE ZIP CODE I.wIS THIS VEHICLE SUBJECT TO SECURITY AGREEMENT(S)? YES ❑ NO ❑ IF YES,COMPLETE SECTION BELOW FIRST SECURED PARTY(PRINT NAME) DATE OF SECURITY AGREEMENT ' ,.:1 x"`D' STREET ADDRESS CITY STATE ZIP CODE I( � y y' SECOND SECURED PARTY(PRINT NAME) DATE OF SECURITY AGREEMENT ��"' w STREET ADDRESS CITY STATE ZIP CODE ^ i, lIrl IF THERE IS AN ADDITIONAL NAME OF POLICY �� COMPLITY ETEAANRD ATtTACHSDPS2S17. COMPANY E NUMBER w d .,, BUYER SUBSCRIBED AND SWORN TO BEFORE ME: z I (we), certify I (we) am (are) of legal ikr iyW X age, have bought this vehicle subject }', to liens shown and no others, this ve- '' rNOTARY SIGNATURE DATE hicle is and will continue to be insured while operating upon the public streets 4 0 5. and highways,and all of my(our)dec- s,,„ r k.' Iarations are true and correct. \x, eA"a COUNTY DATE MY COMMISSION EXPIRES BUYER'S SIGNATURE(S)ALL BUYERS SIGN. ,, -Ai YB ps ' ^42:D -AC THISPORTION14<i: F � �� CC NOT SEPARATE UN I1 SJR Dh �,.:._, itl' MINNESOTA MOTOR VEHICLE REGISTRATION CARD RECORDED OWNER(S) RECORD OF SALE PLATE TITLE PLATE tm , NUMBER 997359 00 NUMBER G21400823 NUMBER 997359 =1Le IT f" PLATES 12131177 TAX 100 TAX NUM G21400823 a�', EXPIRE BASE NUMBER n (� /�{ `� .¢ MAKE POETT/+ MODEL YEAR 77 TYPETRL V.I.N. RW1807700i i V.I.N. T�,) ! l7 7 STICKER 1 I t+ ' ii R RWLB077007 NUMBER v C v L :-';i4-''-' D CI TY OF OAK PARK HTS BUYER'S SIGNATURE(S) SALE DATE D �� D STREET ADDRESS k;� E STTLLWATER MN 55082 � M�( R V (Si CITY STATE ZIP CODE `3 r rr ,:,. 1 `, Imo )i lg . , r alt ,n �' ¢ >,.r CO NO. POLICY PERIOD CL&TR POLICY NUMBER AND DESCRIPTION CHARGE PREMIUM CREDIT BALANCE 76 7/7/80-81 10 5 BA6094543-58540 Additional 109.00 1979 Roettinger Trailer added to business auto policy effective 7/7/80. Thank you, \o 7/7/81 PREMIUMS DUE AND PAYABLE ON EFFECTIVE DATE OF POLICY ` CHANGE IN DECLARATIONS ENDORSEMENT d #1 - (EnE'1048 This endorsement,effective on 7-7-80 at 12:01 A.M.standard time,forms a part of policy No. BA 6094543-58540 of the Home Indemnity Company issued to: City of Oak Park Heights Agency at Forest Lake Isurance Agency or Forest Lake, MN 009022-351 Authorized Re pres nt ve It is agreed that the policy is amended as indicated by the following items designated by an "X": NEW TOTAL.POLICY PREMIUM n The Insured's name and/or address as shown in ITEM ONE of the policy Declarations is changed as follows: $ El The limit(s) shown opposite the Coverage(s) in SCHEDULE A below, and for which an additional or return premium is indicated, replaces(replace) the limit(s) shown I I for the same Coverage(s) in ITEM TWO of the policy Declarations. n The Coverage(s)indicated by a return premium in SCHEDULE A below is(are)hereby terminated. El The Coverage(s) indicated in SCHEDULE A below for which an additional premium charge is shown is (are) added to the policy and such Coverage(s) applies (apply)to the autos indicated by the Covered Auto Designation symbol(s) from Declarations ITEM THREE shown in the "COVERED AUTOS" column in SCHEDULE A. The auto(s) described in SCHEDULE C below are hereby included under the policy Coverage(s) indicated in SCHEDULE A below by the additional premium charge I I shown opposite the applicable Coverage(s). ri The auto(s)described in SCHEDULE B below are hereby eliminated from coverage under the policy Coverage(s) indicated in SCHEDULE A by a return premium. n The Coverage(s)indicated by a return premium in SCHEDULE A below is(are)hereby terminated for Covered Auto(s)No.(s) 9-30-80 LM P/R 100% SCHEDULE A COVERED AUTOS (Entry of one or more of the LIMIT PREMIUM symbols from ITEM THREE THE MOST WE WILL PAY FOR ANY ONE COVERAGES shows which autos are covered autos) ACCIDENT OR LOSS Additional Return LIABILITY INSURANCE $ $ 59.00 $ PERSONAL INJURY PROTECTION(P.I.P.) SEPARATELY STATED IN EACH P.I.P. ENDORSEMENT MINUS (or equivalent No-fault coverage) $ Deductible $ 3.00 $ ADDED P.I.P.(or equivalent added No-fault coo.) SEPARATELY STATED IN EACH ADDED P.I.P. ENDORSEMENT $ $ PROPERTY PROTECTION INSURANCE(P.P.I.) SEPARATELY STATED IN THE P.P.I. ENDORSEMENT MINUS (Michigan only) $ Deductible FOR EACH ACCIDENT $ $ AUTO MEDICAL PAYMENTS INSURANCE $ $ $ UNINSURED MOTORISTS INSURANCE $ $ $ Q COMPREHENSIVE COVERAGE ACTUAL $ Deductible FOR EACH COVERED AUTO FOR ALL $ $ m� OR COST OF LOSS EXCEPT FIRE OR LIGHTNING 21 .00 o¢ REPAIR, $25 Deductible FOR EACH COVERED AUTO FOR LOSS $. $ —J cc SPECIFIED PERILS COVERAGE WHICHEVER � =IS LESS CAUSED BY MISCHIEF OR VANDALISM � z COLLISION COVERAGE MINUS $ Deductible FOR EACH COVERED AUTO $26.00 $ = D_ TOWING AND LABOR iNCalifotiala $25 for each disablement of a private passenger auto $ $ SCHEDULE B TOTAL ADDITIONAL OR RETURN PREMIUM 109.00 $ covered DESCRIPTION PURCHASED TERRITORY: Town&State Where the Covered Auto " Year Model;Trade Name; Body Type Actual NEW(N) No. Serial Number(S);Vehicle Identification Number(VIN) Original Cost New Cost& USED(U) Auto will be principally garaged SCHEDULE C Add effective 7-7-80 Covered DESCRIPTION PURCHASED TERRITORY: Town&State Where the Covered Auto Year Model;Trade Name; Body Type Actual NEW(N) No. Serial Number(S);Vehicle Identification Number(VIN) Original Cost New Cost& USED(LI) Auto will be principally garaged 5 '79 Roettinger Welding single axle 1 ,225, _ ,T-006 Oak Park Heights, A trakLer RW VT 080037 , CLASSIFICATION Covered Radius of Business use Size GVW,GCW Primary Secondary EXCEPT FOR Towing all physical damage loss is payable to you and the loss Auto Operation s=service or Vehicle Age Rating Rating Code payee named below as interests may appear at the time of the loss No. r=retail Group (In Miles) c=comm'I Seating Capacity Factor Factor 5 50 2 .25 ' 68199 - COVERAGES—PREMIUMS, LIMITS AND DEDUCTIBLES (Absence of a deductible o limit entry in any column below means that the limit or deductible entry in the corresponding ITEM TWO column in the Declarations of the Policy applies instead) ADDED PROP.PROT. UNINSURED SPECIFIED TOWING& LIABILITY ' P.I.P. P.I.P. (Mich.only) AUTO. MED. PAY. MOTORISTS COMPREHENSIVE PERILS COLLISION LABOR Covered . Limit° ' Limit" Limit** Limit** Limit Limit Limit $25 per Auto minus' Limit° minus minus Limit** minus (InPre- Pre- (In Pre- (In Pre- Pre- Disable- No. Premium deductible deductible deductible deductible Premium Thou- mium mium Thou- mium Thou- mium ment mium shown Premium shown shown Premium shown sands) below below sands) sands) below _ below Premium 5 500 59 3 . 21 250 26 Total Add'I Premium 59 \\\\ 3 \\\\\ \\\\ \\\\\ 21 26 7-81 *Limit stated in each applicable P.I.P.,Added P.I.P.or P.P.I.Endorsement. **Limit stated in ITEM TWO of the Policy Declarations. UNIFORM PRINTING , SUPPLY DIV.