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HomeMy WebLinkAbout109447 INDEPENDENT SALT COMPANY - INSURANCE CERTIFICATE (4)ACORDN CERTIFICATE OF LIABILITY INSURANCE 08/06/2004 08/06/2004 PRODUCER (800) 563-1871 FAX (785)825-5098 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Insurors &Investors, Inc. RECENEI) HOLDER. 217 S. Santa THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. 0. Box 1213 u�,��i � �;ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. =� Salina, KS 67402-1213 MppW INSURERS AFFORDING COVERAGE NAIC # INSURED Independent Salt Compan INSURERA: Chubb Group of Insurance Co. 20346 P. 0. Box 36 INSURERS: Liberty Mutual Kanopolis, KS 67454 INSURERC: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINI 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. NSR II TO DD' NOR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE fMMIDDNYI POLICY EXPIRATION DATE (MM/DDNY) 09/16/2004 LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE F OCCUR 37110044 09/16/2003 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 1,000,00 MED EXP (Any one person) $ 5 , 00 PERSONAL & ADV INJURY $ 1 , 000 , 00 GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,00( A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTOS HIREDAUTOS NON -OWNED AUTOS 78389735 09/16/2003 09/16/2004 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY -FA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $ 10,00 79764048 09/16/2003 09/16/2004 EACH OCCURRENCE $ 5 , 000 , 00 AGGREGATE $ S,000,000 $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER WC734S336671013 09/16/2003 09/16/2004 X WCSTATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,00 E.L. DISEASE -POLICY LIMIT I $ 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins ATTN: Purchasing Division P 0 Box 580 Fort Collins, CO 80522-0580 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR RFPRFSFNTATWPQ .+ wram.+ L0 jcwuvo) ©ACORD CORPORATION 1988