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Home My WebLink AboutPARKLAND (U.S.) HOLDING CORP. - INSURANCE CERTIFICATE�� • DATE(MM/DDIYYYY) A� a CERTIFICATE OF LIABILITY INSURANCE 0�/37l202a THIS CERTI�ICA7E IS ISSUED AS A MAT7ER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTI�ICATE HOLOER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVEI.Y AMEND, EXTEND Oli ALTER THE COVERAGE AFFORDED BY THE ?OLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITU7E A CONTRACT BEFWEEN THE ISSUING INSURER(S), AUTHORtZED REPRESEhFTATIVE OR PRODUCER, AND THE CERTIFICATE HOI.DER. IMPORTANT: If the certificate holdar is an ADDI710NAL INSURED, the policy(ies) must have ADDITIONAL INSUAED provisions or be endorsed. It SUBROGATION IS WAIVED, subject to tha terms and Conditions oi the policy, certain policies may require an endorsement. A statement on this certificete does not confar rights to the certificete holder in lieu of such endorsement(s). PRODUCER CONTACT AOI1 Risk Services Central, Inc. N�� Mi nnedp0l i 5 MN offi ce fa�C. No. Ext): �866) 283-7122 aC No ;(800) 363-0105 Sb00 west 83rd Street e-ewt 8200 Tower, Suite 1100 nOOREss: Minnedppli5 MN 55437 USA INSURER(S) AFFORDING COVERAGE NAIC K INSURED Parkland <u.s.) Holding Corp. Po sox 1842 100 NE 27ih St Minot ND 56702 USA INSURERA: ACE Amencan Insurance CORI iHsuRFRa: Zurich American Ins Co INSURERC: ZUI'lCh insurance Company L iNSurteR�: American Zurich Ins Co INSURER E: INSURER F: REVISION NUMBEI�: THIS IS TO CER7IFY 7HAT 7HE PpLICIES 4F INSIiRANCE L.ISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLfCY PERIOD � INpICATED. N4TWITHSTANDING ANY REQUIREMENF, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEN7 WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICfES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAfD CLAlMS. Limfls shown are as �equested LTR TYPE OF INSURANCE INSU YND POLICY NVMB£R MM/00lYYYY MM/DDIY7Y LIMITS X CQMMERCIAL GENERAL LIABtLITY G�� EACH OCCURRENCE S% , SOO, OOO CLAIMS-AAADE aOCCUR PREMISES Eaoccurcence g30�,000 X Sudden 8 Atcidental P011ulion InCluded MED EXP (Any Ona per5on) SS , 000 PERSONAL&pDVINJURY S%,SOO,OOO � GEN'LAGGREGATE LIMITAPPLIES PER� GENERAIAGGREGATE S7 � SOO, OOO � X POLICY � �E a � LOC PRQDUCTS - COMP�OP AGG E7 , SOO, OOO � O7HEFi: o ti A AUTQMOBILE LIA8ILRY Y Y N2512419a OG/Ol/2023 06/O1/2024 COMBINED SINGLE LIMIT � E i nt SS,000,000 ANY AUTO 80DILY iNJURY ( Per person) � X � OWNED SCHEDULEO BOQILYlWURY(Poraccidenl) N AUTOS ONLY AUTOS HIREOAUTOS NON�OWIJED PROP�R7VDAMAGE � ON�r AUTOS ONLY Pe� aaident U i d � UMBqELLAL3AB X OCCUR Y Y CSINT2 � 7f> Ol 2023 06 O1 2024 EACHOCCURRENCE 5,000,00� V X EICCESSLIAB CLAIMS•MAOE SIR dpplie5 p@r pOliCy tfr 5& condi ions AGGREGATE SS,OOO,OOQ DEO X RETENTION D WORKERS COMPENSATION AND WC 1 2 X PER STATUTE OTH- EMPLOYERS' LIA8ILITY V 1 N AOS ER ANYPROPRIETOR PARTNER E%Fc'��_TIVE E.L.EACHACCIDENT SZ�OOO�OOO B OFFICE.W'MF.MBERE%GLUDEO� � N�A wc665797700 02/01,1z�24 dZ/�Lf20Z$ (Mandetory In NFQ y�I E L DISEASE•EA EMPIOYEE E 1, OOU, OOU II Y85. d85C�be under bESCRtPTION OF OPERATIONS betow E.. DISEASE•POUCYLIMIT S1, 000, OOO - � � OESCRIPTION OF OPERATION3 � LOCATIONS! YEF;ICLES (ACORD 101, AddNional Remarks Schedule, mey be atteched II more spece is required) City of Fort Collins is included as additional insured wiih respect to General Liability, Auxomobile �iability, and Extess �� iability policies. General �iabi3ity, Automobile Liability and Excess Liability policies, evidenced herein is �rimary and Non-Contributory to other insw•ance availabie io an additional Insured, but only in atcordance with the pol�cy's provisions. y� Cross liab�lity/Severability of Interests Language, Contractual Liabiiity and coverage for independent contractors are included � under the General Liability policies. � �s-� CERTIFICATE HOLDER ,� � City of Fori �ollin5 � VO Box 580 Fort CO11in5 CO 80522 USA ACORD 25 (2416/03) CANCELLATION SHOULD ANY OF THE ABOVE OESCRfBEO POLICIES BE CANCELLEO BEFORE TME EXPIRATION pATE THEREOF, NOTICE WILL BE DEIIYERED IN ACCQRDANCE WI�H THE POLICY PROVISIONS. ALITHORIZED REPRESENTATIVE �� / / / i / . � m1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and lago a�e registered marks of ACORD 22667 40142 0 � v c d � d � 0 T