HomeMy WebLinkAbout109447 INDEPENDENT SALT COMPANY - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE 7%zz%2o o'
PRODUCER (800)563-1871 FAX: (785)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
2090 S. Ohio ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 1213
INSURED INSURERA Federal Insurance Company20281
Independent Salt Company INSURER B:
KCI, Inc' INSURER C:
PO Box 36 INSURER 0:
Kanopolis KS 67454 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.
INSR ADD'L TE
POLICY EFFECTIVE POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYY DATE MM/DD/YY LIMITS
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ❑XOCCUR
37110044
9 / 16/2009
9/16/2010
EACH RREN^E
$ 1,000,000
DAMAGE TO RENTED
P e
$ 1,000, 000
MEDEXP An one arson
$ 5,000
PERSONAL$ADVI RY
$ 1,000,00C
N R
$ 2,000,000
GEWL AGGREGATE LIMIT APPLIES PER
X POLICY PET LOC
D A
$ 2,000,000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
78389735
9/16/2009
9/16/2010
CO BINS 0
Ea amident) LE OMI T
$ 1,000,000
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANV AUTO
AUTO ONLY -E4 ACCIDENT
$
OTHER THAN EA AGG
AUTO ONLY: AGG
$
$
A
EXCESSNMBRELLA LIABILITY
X OCCUR �CI-MMSMADE
DEDUCTIBLE
X RE NTION 30 000
79764048
9/16/2009
9/16/20
$ 5,000,000
E
.5,000,000
;E.L.
$
WORKERS COMPENSATION AND
EMPLOYERS' UABIUTY
ANY PROPRIETOWPARTNEWEXECUTIVE
OFFICERIMEMBER EXCLUDED?
Hyeedescdbeender
SPECIAL PROVISIONS below
ATU- OTW
E.L.CCIDENT
$
E-EA EMPLOYE
$
E.L. DISEASE -POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Fort Collins, CO is named as an additional insured with respect to the General Liability coverage for
Independent Salt Company, but only with respect to Independent Salt's product.
(970)221-6707
City of Fort Collins
ATTN: Purchasing Division
PO Box 580
Fort Collins, CO 80522-0580
ACORD 25 (2001108)
IMcn*A ,n,no,
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
AUTHORIZE SmitREPRESENTATIVE
Brenda Smith/D/DWALKLKE
® ACORD CORPORATION 1988
Paro1MJ
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.
INS025 (0108).08a Page 2 of 2