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HomeMy WebLinkAboutFIRST NATIONAL BANK OF NEBRASKA INC - INSURANCE CERTIFICATE1 ®
AcoRo, CERTIFICATE OF LIABILITY INSURANCE-
DATE (MM/DD/YYYY)
1 17 2011
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-,,Af the'certifidate'holder is an ADDITIONAL INSURED, the policy(les) 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 onfer rights to the_ •.
"..-.certificafe` holder in,lieu..ofsuch_endorsement s :. _ _. _.... _
PRODUCER""' _ ` I
The Harry A . Koch Co
- —'
NAME::
PHONe ; ;` FAX
C No
- - '_ -
P.Oj. BOX 45279 i i
Omaha -NE 68145-=0279-....._
E-MAIL. .•., ::.': •C'.`"'.'.:!'1.; o::�
ADDRESS:
INSURERS AFFORDING COVERAGE " '
NAIC #
_
INSURER A:Federal Insurance Company
20281
INSURED
INSURER B
INSURERC:
First National Of Nebraska, Inc.
INSURERD:
Attention: Patrick Mahoney
1620 Dodge St Stop Code 1155
Omaha NE 6 8197 -1155
INSURER E :
'1
INSURER F
COVERAGES CERTIFICATE NUMBER: 1857774591 REVISION NUMBER:
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.
INSR
LTR
TYPE OF INSURANCE
ADDLISUBR
INSR
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
GENERAL LIABILITY
35757477
1/18/2011
/18/2012
EACH OCCURRENCE
$1,000,000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
PREMISES Ea occurrence)
$1, 000, 000
MED EXP (Any one person)
$10, 000 `
CLAIMS -MADE a OCCUR
_
PERSONAL &ADV INJURY
$1, 000, 000"
`
;_
_
_ - ",
- ;',;� •';
GENERAL AGGREGATE
$2, 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS -COMP/OP,`AGG
$included
$
..... POLICY.,. ,..,,, . PRO-... -.._-. ,.LoC . . .. ...........
. ..
. .. _ ......... _ _...._ :_
•
B `'
`AUTONIOBILELIABIL'ITY
X ANY.AUTO
73560467 "
1/18/2011
...-.;
/18/2012
_
Ea accident
$1, 000, 000
'BODILYINJURY(Perper son)
ALL OWNED SCHEDULED .,....._
' 'AUTOS.. *. ... AUTOS^ -...-., = ,
- NON -OWNED
X. HIRED AUTOS . X ; AUTOS
.
,^} ; •
..............
- .
-
--
-BODILY INJURY (Peraceident)
$ ' _
ROPERTYt DAMAGE
$
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
HCLAIMS-MADE
AGGREGATE
$
EXCESS LIAR
DED I I RETENTION $
$
WORKERS COMPENSATION
I WC STATU- OTH-
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
N / A
E.L. EACH ACCIDENT -
$
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE - POLICY LIMIT
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
RE: BANKING SERVICES AGREEMENT THE_CITY OF FT COLLINS, ITS OFFICERS, AGENTS & EMPLOYEES ARE
ADDL INSURED FOR GL BUT ONLY AS RESPECTS LIABILITY ARISING OUT OF PERFORMANCE OF WORK UNDER
THIS AGREEMENT FIRST NATIONAL OF COLORADO, INC IS A NAMED INSURED UNDER THE POLICY
r PPTIFICATF H(11 n;:p CANCELLATION
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
n 19RR_21110 ACORD CORPORATINN- All riahts reserved
ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD