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127942 XCEL ENERGY INC - INSURANCE CERTIFICATE
A✓ o® CERTIFICATE OF LIABILITY INSURANCE CAT/04 /aoDD/13 1z/ 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 1-612-333-3323 Hays Companies CONTACTNAME: Randy Dauaiale Or Davin DeBuhr PHONE FAX (A/6 No. Ea 612-333-3323 No: 612-373-7270 E-MAIL ADDRESS: ddebuhr0hi /companies. coat 80 South 8th Street Suite 700 Minneapolis, MN 55402 INSURE 8 AFFORDING COVERAGE NAIC0 INSURERA: OLD REPUBLIC INS CO 24247 INSURED B 2� 1 u^1 Xcel Energy, Inc. INSURER e: ORGY INSURANCE SERVICES Northern State Power Company; Public Service Company of CO INSURER C: INSURER D; and Southwestern Public Service Co. 414 Nicollet Mall 4th Floor Minneapolis, MN 55401 INSURERS: INSURER F: COVERAGES CERTIFICATE NUMBER: 37173021 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 L rypE OF INSURANCE ADDL U POLICY NUMBER POLICY EFF M/DD POLICY EXP fmmloDryyyyl umrra A GENERAL LIABILITY X MWZY59347 11/01/1 11/01/14 EACH OCCURRENCE $ 3,000,000 X COMMERCIAL GENERALLIABILITY CLAIMS -MADE Fz� OCCUR PREMISES - YRENTEDEa $3,000,000 NED EXP(Any one parson) S 10,000 Y 2MM SIR - SEE BELOW PERSONAL 8 ADV INJURY $ 3,000,000 GENERAL AGGREGATE $ 20,000,000 GENII AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $3,000,000 POLICY PRO- LOC X JFCT $ A AUTOMOBILE LIABILITY MNTB COMBINED SINGLE LIMIT 5,000,000 INJURY (Par parson) S ANY AUTO ALL OWNED SCHEAUTODULED JURY(Pw acldelt) $ X CAMAGE al $ NON -OWNED HIRED AUTOS X AUTOS E UMBRELU LUB OCCUR EACH OCCURRENCE $ H AGGREGATE $ EXCESSLIAB CLAIMS•MADE DED I I RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILT' YININ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N/A UNC11728802 11/01/1 11/01/14 X we STATU- OTH- T EL. EACH ACCIDENT S 2,000,000 EL DISEASE -EA EMPLOYE $ 2,000,000 (Mandatory In NH) If yyeea. descdhe under DESCRIPTION OF OPERATIONS helow E.L. DISEASE -POLICY LIMIT $2,000,000 e OL Self -Insured Retention P081325 11 Tol/1 11 01 14 BIR 21000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attack ADDING 101, Additional Remarks Schedule. It more space Is required) Certificate holder is additional insured as respects general liability policy where required by written contract. Al9l`1.a13al L'\LLgC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. k management North Mason AUTHORIZED REPRESENTATIVE BOX 580 �Py t Collins,liCO 80522-0580 USA © 1988-2010 ACORD CORPORATION. All rights reserved ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD ddebuhr