HomeMy WebLinkAboutSCHRADER OIL - INSURANCE CERTIFICATE (2)ACORD�
PRODUCER
[INSURED
FEDERATED MUTUAL INSURANCE COMPANY
5701 W. Talavi Boulevard
Glendale, AZ 85306
Phone: 1-888-333-4949
Home Office: Owatonna, MN 55060
SCHRADER OIL CO
PO BOX 495
FORT COLLINS CO 85022
DATE(MM/DDIYV)
04/02/07
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(MMIDDIYYI
POLICY EXPIRATION
DATE(MMIDDIYY)
LIMITS
A
GENERAL
UABILTY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X❑ OCCUR
OWNER'S & CONTRACTOR'S PACT
9802184
06/30/07
06/30/08
GENERAL AGGREGATE
$ 2,000,000
X
PRODUCTS - COMP/OP AGG
$ 2,000,000
PERSONAL & ADV INJURY
$ 1,000,000
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Any one fire)
$ 100,000
MED EXP (Any one person)
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
9802184
06/30/07
06/30/08
COMBINED SINGLE LIMIT
$ 1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN AUTO ONLY:
EACH ACCIDENT
$
AGGREGATE
$
A
EXCESS LIABILITY
X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
9802185
06/30/07
06/30/08
EACH OCCURRENCE
$ 4,000,000
AGGREGATE
s 4,000,000
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR/ INCL
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL
WC STATU- OTH
T DRYLIMITS ER
EL EACH ACCIDENT
$
EL DISEASE - POLICY LIMIT
$
EL DISEASE - EA EMPLOYEE
_
$
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESISPECIAL ITEMS
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522
65 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 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.
Cert Acct: 314-627-1 65
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522