Loading...
HomeMy WebLinkAbout480452 THE MOSAIC COMPANY - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/29/2010 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER Aon Risk Services Central, Inc. Chicago IL office CONTACT NAME: PHONE (866) 283-7122 FAX (847) 953-5390 (A/C. No. Ext): (A/C. No.): E-MAIL AME S: 200 East Randolph Chicago IL 60601 USA PRODUCER 570000035052 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: National Union Fire Ins Co of Pittsburgh 19445 The Mosaic Company and its Subsidaries and Affiliates INSURER B: New Hampshire Ins Co 23841 INSURER C: Attn: Terry Van Vuren Atria Corporate Center, Ste E490 3033 Campus Drive Plymouth MN 55441 USA INSURER D: INSURER E: INSURER F: GLJVtKAGf•S GtK111-IGAit NLIMIStK_ b/UU4l lbUYlS REVISION NLJM6ERe 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. Limits shown are as requests LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD MM/DD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR GI_4=08 EACH OCCURRENCE $3,000,000' DAMAGE PREMISES Ea occurrence MED EXP (Any one person) PERSONAL &ADV INJURY $3,000,000 GENERAL AGGREGATE $6,000,000 GEWL AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGG $3,000,000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS - CA397-67-20 1230 2010 10 22 2011 COMBINED SINGLE LIMIT (Ea accident) $3,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DEDUCTIBLE RETENTION B B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? F9 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A wCO26149828 All other States SIR applies per policy terns wc026149832 TX 12/30/2010 & conditions 12/30/201010/22/2011 10/22/2011 X I WC STATU- oTH- To LIMITSER E.L. EACH ACCIDENT $3,000,000 E.L. DISEASE -EA EMPLOYEE $3,000,000 E.L. DISEASE -POLICY LIMIT $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins CO AUTHORIZED REPRESENTATIVE 4316 W. La Porte Ave. Fort Collins CO DE 80521 USA ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD Attachment to ACO" Certificate for The Mosaic Company and its Subsidaries The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain -all terms, conditions, coverages or exclusions contained in the policy. INSURED The Mosaic Company and and Affiliates Attn: Terry van vuren Atria Corporate Center, 3033 Campus Drive Plymouth MN 55441 USA its Subsidaries Ste E490 INSURER INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER/ POLICY DESCRIPTION POLICY EFF (MM/DD/YYYV) POLICY EXP (MM/DD/YYYY) LIMITS WORKERS COMPENSATION B N/A wc026149829 CA SIR applies per policy terms 2/30/2010 & Condit 10/22/2011 ons B N/A WCO26149830 FL SIR applies per policy terms 12/30/2010 & condit 10/22/2011 ons B N/A wc026149833 NM, WA, & WI SIR applies per policy terms 2/30/2010 & condit 10/22/2011 ons B N/A wc026149831 MN 2/30/2010 10/22/2011 Certificate No: 570041150215 MOSIC The Mosaic Company Tel 763-577-2700 Atria Corporate Center, Suite E490 Fax 763-577-828-8286 �. 3033 Campus Drive Plymouth, MN 55441 www.mosaicco.com December 29, 2010 To Whom It May Concern: The Mosaic Company intends to acquire Lucier Chemical Industries (LCI) effective December 30, 2010. The attached certificate is intended to replace the certificate you have on file for LCI. It references Mosaic's insurance coverage that now applies. Should this acquisition not be effective December 30, 2010, the information this certificate presents is null and void. If you have any questions please contact Betty Kendall -Jones at (800) 578-7891. Thank you.