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Home My WebLink About118873 FIRST NATIONAL BANK - INSURANCE CERTIFICATEA4C1l CERTIFICATE OF LIABILITY INSURANCE 111 DATE (mmloonrn) 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 INSURE R(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 certificateholderin lieu of such endorsements . PRODUCER CONTACT NAME: PHONE 4 2- 1 7 FAXNo :4 2- 61-7111 The Harry A. -Koch Co. "- P.O. BOX 45279 Omaha NE 68145-0279 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC 0 INSURER A:Federal Insurance Company 20281 INSURED INSURER B: ( Northern Insurance Com n 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: 419206144 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 ADDL INSR SUBR WV POLICY NUMBER POLICY EFF MMIOOIYYYY POLICY EXP MM.AI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IOCCUR 5757477 1/18/2013 /18/2014 EACH OCCURRENCE $1000000 DAMAGE TO RENTED PREMISES Be ocommorce $1000000 MED EXP (Any one person) $10000 PERSONAL B ADV INJURY S1000000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY PRO- FQT LOC PRODUCTS - COMPIOP AGO $1000000 S B AUTOMOBILE LIABILITY.. ANY AUTO OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 73560467 1/18I2013 /18/2014 -- Ea accdenl 1,000,000.E BODILY INJURY(Perperson) IALL H BODILY INJURY(Par accident) $ PROPERTY DAMAGE Peracndent $ - UMBRELIA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED' (Mandatorym NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 1701763 1/18/2013 /18/2014 X WC STATU- OTH- TORY LIMES ER E.L. EACH ACCIDENT $500,000 E.L. DISEASEEAEMPLOYE $500,000 E L DISEASE - POLICY LIMIT $500 000 DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Ft. Collins, its officers, agents & employees are named as additional insured for general liability as required by written contract 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. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ft. Collins; Director of Purchasing & Risk ACCORDANCE WITH THE POLICY PROVISIONS. Management PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 "� G CT:CbLL nTTQ�I a aiQ�l:11�1: L\ � f�l d �•\ I �'i rl TLi93SS.IrS � ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD