HomeMy WebLinkAboutINDEPENDANT SALT COMPANY - INSURANCE CERTIFICATEDATE(69M\DD\�
AC"411 )a CERTIFICATE OF INSURANCE' ;
- - - - -
10-13-08
PRODUCER
SUNFLOWER INSURANCE GRP
PO BOX 1213
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.
217 S SANTE FE
SAUNA KS 67402
COMPANIES AFFORDING COVERAGE
CO -- -
MPANY
747GF
A THE TRAVELERS INDEMNITY COMPANY
INSURED
_
COMPANY
INDEPENDENT SALT COMPANY
B
P 0 BOX 36
KANOPOLIS KS 67454
COMPANY
C
COMPANY
D
COVERAGES
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,
LTA
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM\DD\YV)
POLICY EXPIRATION
DATE (MM\00\VY)
LIMITS
GENERAL
LIABILITY
GENERAL AGGREGATE
$
PRODUCTS-COMP/OP AGG.
S
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR.
PERSONAL & AOV. INJURY
$
EACH OCCURRENCE
$
OWNER'S & CONTRACTOR'S PROT.
FIRE DAMAGE (Any one fire)
S
MED. EXPENSE (Any one person)
$
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE
LIMIT
S
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per Person)
$
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per Accident)
S
PROPERTY DAMAGE
S
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
S
ANY AUTO
OTHER THAN AUTO ONLY:
EACH ACCIDENT
$ W
_
AGGREGATE
$
EXCESS LIABILITY
EACH OCCURRENCE
$
UMBRELLA FORM
AGGREGATE
$
OTHER THAN UMBRELLA FORM
A
WORKER'S COMPENSATION AND
EMPLOYER'S LIABILITY
(GKUB-0839C97-7-08)
09-16-08
09-16-09
STATUTORY LIMITS
N/A
EACH ACCIDENT
$ j non
THE PROPRIETOPo
PARTNERS/EXECUTIVE X INCL
DISEASE -POLICY LIMIT
$
OFFICERS ARE: EXCL
OTHER
DISEASE -EACH EMPLOYEE $ 1 00 0
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS
THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE.
CERTIFICATE H OLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
CITY OF FORT COLLINS
ATTN: PURCHASING DIVISION
PO BOX 580
FORT COLLINS CO 80522-0580
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 COMPANY, ITS AGENTS OR REPRESENTATIVES.
AGGgD xs.s {/53)
AUTHORIZED REPRESENTATIVE
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