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109447 INDEPENDENT SALT COMPANY - INSURANCE CERTIFICATE (3)
City of Fort Collins SunflowerInsurance 1 15/09/2011 16:46 ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (M MID1'Y ) 9/15/2011 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: If the certificate holder is an ADDI710NAL 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 confer rights to the certificate holder in lieu of such endorsement(s►. PRODUCER Sunflower Insurance Group, Inc. CONTACT Brenda Smith NAME: PHCON Na i (800)563-1871 FAX, No: (785)e26 -509e 2090 S. Ohio ADDRESS:bsmith@sunflowerinsurance.com P.O. BOX 1213 PRODUCER 00000749 INSURERS) AFFORDING COVERAGE NAICI Salina KS 67402-1213 INSURED INSURER A Federal Insurance Company 0281 INSURER B : Independent Salt Company INSURERC: KCI, Inc. INSURER D: INSURER E: PO Box 36 INSURER F: Kanopolis KS 67454 rnVLO aGLC rFTPTI FI rl1TF NI IM RF R• I l -1 % RFVISInN NI IMIRFR• 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF MIODNYYY POLICY EXP MMIDD�VV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 1,000,000 X COMMERCIAL GENERAL LIABILITY A CLAIMS -MADE $OCCUR 37110044 /16/2011 /16/2012 Mm EXP(Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOP ASS $ 2,000,000 X POLICY PROT OC $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS 8389735 /16/2011 /16/2012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) 8 X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ X NON -OWNED AUTOS PIPBasic$ Uninsured motorist Bl-sing!e $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS MADE AGGREGATE $ 5,000,000 DEDUCTIBLE I $ A X RETENTION $ 0 9764048 /16/2011 /16/2012 1$ WORKERS COMPENSATION AND EMPLOYERS UABILRY YIN WC STATU- OTH- T RY LIMITSR EL. EACH ACCIDENT $ ANY PROPRIETOR/PARTNEWEXECUTIVE OFRCERRJEMBER EXCLUDED? NIA EL DISEASE - EA EMPLOYE $ (Mandatory in NH) Mes describe under SCRIPTIONN OF OPERATIONS below EL. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONSI VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) 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 SaltIs product. (970)221-6707 City of Fort Collins ATTN: Purchasing Division PO Box 580 Fort Collins, CO 80522-0580 VMI\VLLLli I IVI\ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUrHOPoZELi REPRESENTATIVE Smith/DNALKE ip aj,/v� v ©1988-2009ACORD CORPORATION. All rights reserved- INS025 (200909) the ACURD name and logo are registered marks of ACORD