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Home My WebLink AboutFIRST NATIONAL OF NEBRASKA - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANa..E 0DATE (MMID 1/04/08DNYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Harry A. Koch Co. P.O. Box 45279 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Omaha, NE 68145-0279 402 861-7000 INSURERS AFFORDING COVERAGE NAIC # INSURED First National of Nebraska, Inc Attention, Patrick Mahoney 1620 Dodge St Stop lode 1155 Omaha, NE 68197-1155 INSURERA St Paul Mercury Insurance Co INSURER B NSURER C INSURER D INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED 13ELOW 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY FS06305114 01/18/08 01/18/09 EACH OCCURRENCE $1000000 CRFMISESOIEa OCC r $1 000 000 X COMMERCIAL GENERAL LIABILITY ] CLAIMS MADE Fx-1 OCCUR MED EXP (Any one person) $5 000 PERSONAL B ADV INJURY $1000000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $1000000 POLICY n PRO- JECT n I.00 A AUTO MOBILE LIABILITY ANY AUTO FS06305114 01/18/08 01/18/09 COMBINED SINGLE LIMIT ('_a accdent) $1 000,000 r X BODILY INJURY (Der person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Peracadent) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ _ GA RA GE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ $ (DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE LL EACH ACCIDENT $ I_ L DISEASE - EA EMPLOYEE $ OFFICERIMEMBFR EXCLUDED? _ - , Ityes descrne under SPECIAL PFOVISIONS below L L DISEASE - POLICY LIMIT $ OTHER -7 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE. BANKING SERVICES AGREEMENT THE CITY OF FT COLLINS, ITS OFFICERS, AGENTS 8r EMPLOYEES ARE AIDDL INSURED FOR GL BUT ONLY AS RESPECTS LIABILITY ARISING OUT OF PERFORMANCE OF WORK UNDER THIS AGREEMENT FIRST NATIONAL OF COLORADO, INC IS A NAMED INSURED UNDER THE POLICY (CITY OF FORT COLLINS IPO BOX 580 (FORT COLLINS, CO 80522 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 'i0_ DAYS WRITTEN Z TO THE CERTIFICATE HOLDER N 4MED TO THE LEFT, BUT FAILURE TO DO SO SHALL iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVE AI:UKU ZO \ZUUTIUS) 1 of 2 #M16125 POHLD @ ACORD CORPORATION 1988 TWO] ail lO]:AEXUA If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) 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 endorsement(s) DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon ACORD 25-S (2001108) 2 of 2 #M16125 ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE (MMID 01/04/08DNYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Harry A Koch Co ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE [IDES NOT AMEND, EXTEND OR P O. Box 45279 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Omaha, NE 68145-0279 402 861-7000 INSURERS AFFORDING COVER/\GE NAIC # INSURED INSURER A St Paul Mercury Insurance Co First National of Nebraska, Inc. INSURER B Federal Insurance Company Attention: Patrick Mahoney INSURER 1620 Dodge St Stop Code 1155 INSURER D Omaha, NE 68197-1155 INSURER E COVERAGES 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR NSR TYPE OF INSURANCE POLICY NUMBER DALICY TE IMM%DD/YYE POLICY DATE MM OD/YVON LIMITS A GENERAL LIABILITY FS06305114 01/18/08 01/18/09 EACH OCCURRENCE $1 OOOOOO X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED Ea occurrence) $1 OOO OOO CLAIMS MADE F OCCUR .2REMISES NIED EXP (Any one person) $5 000 PERSONAL &ADV INJURY $1 OOO OOO GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $1000000 POLICY n PRCT O n I.00 JE A AUTOINOBILE LIABILITY ANYAUrO FS06305114 01/18/08 01/18/09 COMBINED SINGLE LIMIT (Ea accident) $1,000 OOO , X EODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Der accident) $ HIRED AUTOS VON -OWNED AUTOS X PROPERTY DAMAGE (Der accident) $ _ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ A NV AUTO $ AUTO ONLY AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE AGGREGATE $ $ DEDLCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND 71701763 01/18/08 01/18/09 ;( WCSTATU orH- EMPLOYERS' LIABILITY ANY PROPFIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $500,000 E L DISEASE - EA EMPLOYEE $500,000 OFFICER/I.IEMSER EXCLUDED?_ - _ -, If yes descrne under SPECIAL PFOVISIONS below E L DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS The City of F t. Collins, its officeis, agents & employees are named as additional insured for general liability but only insofar as loss or damage was the result of negligence of First National Bank (Ft. Collins) First National Bank (Ft. Collins) is a named insured under the policies. City of Ft. Collins Director of Purchasing & Risk Management 110 BOX 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVE X/ ACORO Z5 (Z0e1108) 1 of 2 #M16126 POHLD 0 ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) 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 endorsement(s) DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon ACORD 25-S (200110a) 2 02 #M16126