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Home My WebLink AboutFIRST NATIONAL BANK - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE DATE(MWDMYYYY) 1/16/2013 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 CONTACT NAME: The Harry A. Koch Co. P.O. Box 45279 Omaha NE 68145-0279 a/oC"N FAX Ed :402-861-7000 ac Na :402-861-7111 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A:Federal Insurance Company 0281 INSURED INSURER B:Great Northern Insurance Company 0303 INSURER C: First National of Nebraska, Inc. Attention: Patrick Mahoney 1601 Dodge St Stop Code 3081 Omaha NE 68197-1155 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1375137279 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 ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF MWDDIVVVV POLICY EXP MWI)MYVVV LIMITS A GENERAL LIABILITY 35757477 1/18/2013 1/18/2014 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE ToRENTED Ea accuu.nce $1000000 CLAIMSMADEOCCUR -PREMISES MED EXP(Any one person) $10000 PERSONAL 8 ADV INJURY $1000000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $1000000 X POLICY PRO- IFCTLOC $ B LIABILITY 73560467 1/18/2013 1/18/2014 COMBINED SINGLE LIMII Ea aceidenl 1,000,000 BODILY INJURY (Per person) $ ANV AUTO POMOBILE ALL OWNED SCHEDULED AUTOS AUTOSNON-OWNED BODILY INJURY(Per acedent) $ PROPERTY DAMAGEHIREDAUTOS Per acedent $ X AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ I $ A WORKERS COMPENSATION ANDEMPLOVERS'LIABILITV YIN 71701763 1/18/2013 1/18/2014 X WC STATU- OTH- TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E IFEACHACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? ❑ NIA E L DISEASE - EA EMPLOYEE $500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICYLIMfr $500,000 DESCRIPTION OF OPERATIONS I 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 and employees are named as additional insured for general liability and auto liability as required by written contract executed prior to a loss, but only insofar as loss or damage was the result of negligence of First National Bank, a division of First National Bank of Omaha. First National Bank, a division of First National Bank of Omaha is a named insured under the policies. City of Fort Collins Attn James B. O'Neill 215 N Mason Ft Collins CO 80524 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 1988-2010 ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD