HomeMy WebLinkAbout480452 THE MOSAIC COMPANY - INSURANCE CERTIFICATE (3)-1 •
CERTIFICATE OF LIABILITY INSURANCE
DATE(NINVE 'YV)
alT)2ora
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 pollcy(ies) must be endorsed. H 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
ADO Risk Services Central, Inc.
Chicago IL office
CONTACT
NAME:
HONE (g66) 2g3-]122 FAX (900) 363-0105
(Aa.Ra.Ea: Ac. No.:
200 East Randolph
Chicago IL 60601 USA
EMAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAICR
INSURED
INSURERA Old Republic insurance Company
24147
Mosaic Global Sales. LLQ The Mosaic
Company, its Subsidiaries & Affiliates
Attn: Mike Bishop, Director Risk Mgmt.
INSURER a:
INSURER C:
Atria Corporate Center, Ste E490
3033 Campus Drive
INSURER D:
INSURER E:
Plymouth MN 55441 USA
INSURER F:
COVERAGES CERTIFICATE NUMBER: 570055615252 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
LTR
TYPE OF INSURANCE
INSC
WD
POLICY NUMBER
MNyi�o
lJMR3
A
X
I COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X❑OCLDR
MWZY302499
EACH OCCURRENCE
$3,000,000
PREMISE$ Ea ma.)Excluded
MEDEXP(Anyonepmson)
Excluded
PERSONAL E ADV INJURY
S3,000,000
GENL AGGREGATE LIMIT APPLIES PER:
X POLICY ❑PRO ❑LOC
ECT
OTHER:
GENERAL AGGREGATE
$6,000,000
PRODUCTS - COMPIOP AGO
$3,000,000
A
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS NON1)WNED
AUTOS
MWTB 302501
10/22/201410/22/2015
COMBINED SINGLE LIMB
Ea mxnJ,M)
f3, 000,000
BODILY INJURY( Per person)
BODILY INJURY (Far accident)
PROPERTYDAMAGE
For..dent
UMBRELLA LIM
EXCESS LAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
AGGREGATE
DED
RETENTION
A
WORKERS
EMPLOYERCOMPEENSA ION AND YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFIOEWMEMBER EXCLUDED? N
(Mandsto. In NH)
I ym desadbe under
DESCRIPTION OF OPERATIONS bebw
NIA
wc30250000
10/22 201410
22/2015
ER
X I STATUTE OTH
E.L. EACH ACCIDENT
$3,000,000
E.L. DISEASE-EAEMPLOYEE
S3,000,000
E.L. DISEASE -POLICY LIMB
$3,000,005
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addifiwal Remarks Schedukr, mey 6v atM1cMd It more space Is regWmd)
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE PATH THE
POLICY PROVISIONS.
City Of Fort Collins CO
4316 W. La Porte Ave.
AUTHOR® REPRESENTATIVE
Fort Collins CO DE 80521 USA
aJL,KW V/t.61tYN CiHfJGali! c./fJCI
9)1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD -