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HomeMy WebLinkAboutFIRST NATIONAL OF NEBRASKA INC - INSURANCE CERTIFICATE (6)I ACORO® CERTIFICATE OF LIABILITY INSURANCE DAM(MMIDDIYYYY) 1/15/2015 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 CERTIFICATEpOF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED - REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. - - - -- - — ,,! IMPORTANT:-Iflthe certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to - - I'the term s-aInd,conditions.of the: policy,. certain policies may require an endorsement. A'statement on this certificate does not confer -rights -to the__ certificate.holder-M9ieu of.such'endorsemerl I - - - -- r"L' _ ." PRODUCER... .... .... _. CONTACT NAME: The Harry A..Koch Co._ --- P.O.Box45279 Omaha NE 68145-0279 PHONE - - - - Fn c NP : - 1 .. __. E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC e INSURER A:Fed Pal Insurance Company 20281 INSURED INSURER B. ��Q(thef0 ln5ufanCe COmDBD20303 INSURERC: First National of Nebraska, Inc. Attention: Patrick Mahoney 1601 Dodge St Stop Code 3272 Omaha NE 68197-3272 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 968619136 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 SUER POLICY NUMBER POLICY EFF MMIDDNYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY 35757477 1/18/2015 /1812016 EACH OCCURRENCE $1000000 XDAMAGE COMMERCIAL GENERAL LIABILITY TO RENTED PREMISES Ea occurrence $1000000 CLAIMS-MADEIT] OCCUR MED EXP(Any one person) $10000 PERSONAL& ADV INJURY $1000000 q, GENERAL AGGREGATE E2000000 GEN L AGGREGATE X . POLICY LIMIT APPLIES PER: II- LOC PRO PRODUCTS-COMP/OP AGO -31000000 _ 1, IGv•, t ,. .,. ... _ _ BI a ?. AUTOMOBILE X. LIABILITY; .8,. `, ANY AUTO. f.... '� ... _ 73560467' - - _ +. ._. .._ '. _ .... 1/18/2015. r .�.-. �' ".'�: /18/2016 UU Ea am -dent 1000000 BODILY INJU RY(Per. person) E-.. BODILY INJURY (Per accident) E -"" ""'• •, AOWNED... SCHEDULED AUTOS AUTOS, . - X Perracciden DAMAGE , E •• . NONLOM HIRED AUTOS X AUTOS ED ..___ ._ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE S AGGREGATE E EXCESS LIAB CLAIMS -MADE DED RETENTIONS E A WORKERS COMPENSATION 71701763 1/18/2015 /18/2016 X WCSTATU- DTH- AND EMPLOYERS' LIABILITY Y I N E.L. EACH ACCIDENT $500.000 ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ "IA E. L. DISEASE -EA EMPLOYE E500,000 In NH) (MIf yandatory OE Ss.debe under CP.IPTION OF OPFRATIONSbolmv EL.DISEASE - POLICY LIMIT $500.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it 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. ' City of Ft. Collins; Director of Purchasing & Risk Management PO Box 580 Fort Collins CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD I