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480452 MOSAIC COD NUTRITION LLC - INSURANCE CERTIFICATE
CERTIFICATE OF LIABILITY INSURANCE ll/G4/2013 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 Aon Risk services Central, Inc. Chicago IL Office 200 East Randolph Chicago IL 60601 USA CONTACT NAME: lac NNo. - (866) 283-7122 (FAIC AX No.): (800) 363-0105 E-MAIL ADDRESS: INSURER($) AFFORDING COVERAGE NAIC # INSURED INSURER A. Old Republic Insurance company 24147 Mosaic Crop Nutrition. LLC: The Mosaic A C� B: go Company, its Subsidiaries & Affiliates`o Attn: Mike Bishop, Director Risk Mgmt. URER C: [INSURER URER D: Atria Corporate Center, Ste E490 3033 Campus Drive URER E: Plymouth MN 55441 USA URER F: COVFRAC%FB CFRTIFICATF NIIMRFR• 570n51R7A2RA 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE INSR WND POLICY NUMBER DD/YYYY) tMWDDfYYYYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR MNZY 4 EACH OCCURRENCE $3,000,000 PREMISES Ea occurrence Excluded MED EXP (Any one person) EXCI uded PERSONAL &ADV INJURY $3,000,000 GENERAL AGGREGATE $6,000,000 GENL AGGREGATE LIMIT APPLIES % POLICY PRO- 1 PER: LOC PRODUCTS - COMaIOP AGG $3,000,000 A AUTOMOBILE LIABILITY % ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS MWTB 3007 1 22 1 1 014 COMBINED SINGLE LIMB Ea id nt E3,000,000 BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED RETENTION A WORKERS COMPENSATION AND EMPLOYERS LIABILT' ANY PROPRIETOR PARTNER I EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If describe anger DESCRIPTION OF OPERATIONS below NIA MWc 30073200 10/22/2013 10/22/2014 X ORV UTTATMn`OTH. 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 I LOCATIONS I 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 JQL ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 30 October2013 To Whom It May Concern, Please find enclosed a replacement certificate of insurance for The Mosaic Company and Its Subsidiaries and Affiliates. The certificate issued previously contained errors with regard to the General Liability and Auto Liability coverage. A Self Insured Retention (SIR) does not apply under either policy and therefore the reference to this has beon removed from the Policy Number section on the certificate. We regret any inconvenience this may have caused and should you have questions please do not hesitate to contact me. Thank you, ,isa Sullivan Account Executive Aon Risk Solutions 312 381 4248 lisa.sullivan@aon.com cc: Dan Buhr, Insurance Analyst, The Mosaic Company Kathy Hallway, Risk Management Assistant, The Mosaic Company Betty Kendall Jones, Bids & Contracts Manager, Mosaic Crop Nutrition, LLC Aon Risk Solutions 200 E Randolph Street Chicago, IL 60W1 t+1.312.381.a2481 aon.com Aon Risk Services, central I Illinois Division