HomeMy WebLinkAboutINDEPENDENT SALT COMPANY - INSURANCE CERTIFICATE (5)DATE
ACORD CERTIFICATE OF LIABILITY INSURANCE 1 09/19/2 0 (MMIDDNYYY'
PRODUCER (800) 563-1871 FAX (78S)825-5098 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Sunflower Insurance Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
217 S. Santa Fe ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 1213
Salina, KS 67402-1213 INSURERS AFFORDING COVERAGE NAIC #
INSURED Independent Salt Company INSURERA: Federal Insurance Company 126291
P. 0. Box 36
Kanopolis, KS 67454
INSURERS: Assigned Risk WC
INSURER C:
INSURER D:
INSURER E:
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.
INSR
ADD'L
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMIDDIM
POLICY EXPIRATION
DATE (MMIDONYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fj] OCCUR
37110044
09/16/200S
09/16/2006
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
$ 1,000,000
MED EXP (Any one Person)
$ S,00(
PERSONAL & ADV INJURY
$ 1,000,00(
GENERAL AGGREGATE
$ 2,000,00(
GEML AGGREGATE LIMIT APPLIES PER:
X POLICY PROECT LOC
J
PRODUCTS - COMP/OP AGG
$ 2,000,00(
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
78389735
09/16/2005
09/16/2006
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY- EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGO
$
$
A
EXCESSIUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ 10, 00
79764048
09/16/200S
09/16/2006
EACH OCCURRENCE
$ S,000,00
AGGREGATE
$ S,000,000
$
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTNE
OFFICER/MEMBER EXCLUDED?
If yea describe under
SPECIAL PROVISIONS below
BINDER
09/16/2005
09/16/2006
X WC STATU- OTH-
E.L. EACH ACCIDENT
$ 1,000.000
E.L. DISEASE - EA EMPLOYE
B 1 000 , 0Q
E.L. DISEASE -POLICY LIMIT
I $ 1,000,00
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
city of Fort Collins, CO is named as an additional insured with respect to the General Liability
overage for Independent Salt Company, but only with respect to Independent Salt's product.
nCeTIQIf.w TC I ^l f1G= P ALIPQI I AVI^U
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
City of Fort Collins
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
ATTN : Purchasing Division
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
PO Box S80
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE /j w
Fort Collins, CO 80522-0580
Brenda Smith SFLAMI �fjVCJfwsq`11rR� �[rpJ(nJti�GI,
ACORD 26 (2001/08) FAX: (970)221-6707 ®ACORD CORPORATION 1988