HomeMy WebLinkAboutSCHRADER OIL - INSURANCE CERTIFICATEACORD,�
PRODUCER
FEDERATED MUTUAL INSURANCE COMPANY
5701 W. Talavi Boulevard
Glendale, AZ 85306
Phone: 1-888-333-4949
Home Office: Owatonna, MN 55060
INSURED
SCHRADER OIL CO
PO BOX 495
FORT COLLINS CO 85022
DATE (MMIDD[YY)
04/0210(02/07
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANY FEDERATED MUTUAL INSURANCE COMPANY OR
A FEDERATED SERVICE INSURANCE COMPANY
COMPANY
B
COMPANY
C
COMPANY
D
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.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMIDDIYY)
POLICY EXPIRATION
DATE IMMIDDtYY)
LIMITS
A
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1K OCCUR
OWNER'S & CONTRACTOR'S PROT
9802184
06/30/07
06/30/08
GENERAL AGGREGATE
8 2,000,000
X
PRODUCTS - COMP/OP AGG
$ 2000,000
PERSONAL & ADV INJURY
8 1 000 000
EACH OCCURRENCE
8 1,000,000
FIRE DAMAGE IAny one tire)
$ 100,000
AUTOMOBILE
LIABILITY
X
ANY AUTO
ALL OWNED AUTOS
A
SCHEDULED AUTOS
X
HIRED AUTOS
X
NON -OWNED AUTOS
GARAGE LIABILITY
I ANY AUTO
9802184
06/30/07 I 06/30/08
MED EXP (Any one person)
$
COMBINED SINGLE LIMIT
S 1,000,000
BODILY INJURY
$
(Per person)
BODILY INJURY
$
(Per accident)
PROPERTY DAMAGE
8
AUTO ONLY - EA ACCIDENT
$
9
ARM
7ESMsS`1R`1LuATFD
OTHER THAN UMBRELLA FORM
9802185
06/30/07
06/30/08
EACH OCCURRENCE
8 4 OOO
AGGREGATE
s 4,000,000
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR/ INCL
PARTNERS/EXECUTIVE
OFFICERS ARE; EXCL
OTHER
WC STATU- OTH
TORY LI ITS ER
EL EACH ACCIDENT
S
EL DISEASE -POLICY LIMIT
5
EL DISEASE - EA EMPLOYEE 1
S
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESISPECIAL ITEMS
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522
65 I SHOULD ANY OF THE ABOVE DESCRIBED POUCHES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMP ITS AGENTS OR REPRESENTATIVES.
I AUTHORIZED REPRESENTATIVF/,7 / // , 4p //
Cert Acct: 314-627-1 65
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522