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Home My WebLink About118790 TEAM PETROLEUM A LIMITIED LIABILITY COMPANY - INSURANCE CERTIFICATEACOROe Ill CERTIFICATE OF LIABILITY INSURANCE DATE (MMMD/YYYY) 01/13/2014 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 endorsements . PRODUCER CONTACT CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 PHONE A/c No Ext : 888-333-4949 FAX A/c No): 507-446-4664 pDDNESS: CLIENTCONTACTCENTERaFEDINS.COM OWATONNA, MN 55060 INSURERS AFFORDING COVERAGE NAIC N INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 313-963-1 INSURER B: TEAM PETROLEUM A LIMITED LIABILITY COMPANY PO BOX INSURER C: INSURER D: FORT COLLINS,LI CO 80522 o a INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 2 REVISION NUMBER: 0 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. ILTR TYPE OF INSURANCE SR BURRDDIYYY Y& POLICY NUMBER MPOIUCY EFF POLICY EXP LIMITS A GENERAL X LIABILITY COMMERCIALGENERALLIABILITY CLAMS -MADE Fx-1 OCCUR N N 9052691 01/10/2014 01/10/2015 EACH OCCURRENCE $1,000,000 DAMAGE S(Ed occurni O RENTEDPREMISE $1001000 MED EXP (My one Person) EXCLUDED PERSONALS ADV INJURY $1,OOD,ODO GENERAL AGGREGATE $2,000,000 GEN'L -X]POLICY AGGREGATE LIMIT APPUES JEC PER: LOC PRODUCTS - COMPIOP AGO $2,ODO,000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS N N 9052691 01/10/2014 01/10/2015 COMBINED SINGLE LIMIT $1 000 000 "OILY INJURY (Par person) BODILY INJURY (Per accident) PROPERTY DAMAGE r cc A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAMS -MADE N N 9065929 01/10/2014 01/10/2015 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED I I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY /N ANY PROPRIETORMARTNERIEXECUTIVE OFRCERIMEMBER EXCLUDED? (Mandatary in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A WC STATU- TORY UNITS OTH- ER E.L EACH ACCIDENT E.L DISEASE - EA EMPLOYEE E.L DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Amid, ACORD 101, Additional Remand Schedule, if mom vow Is reeulredl CERTIFICATE HOLDER CANCELLATION 313-963-1 20 CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO BOX 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FORT COLLINS, CO 80522-0580 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD