HomeMy WebLinkAbout467921 3M COMPANY - INSURANCE CERTIFICATE (2)AFRO® CERTIFICATE OF LIABILITY INSURANCE page 1 of 1
02/`24/2015
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 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
Willis of Minnesota, Inc.
C/o 26 Century Blvd.
P. O. Box 305191
Nashville, IN 37230-5191
CONTACT
NAM :
PHONE FAX
A/ N XT: 877-945-7378 A/C No: 888-467-2378
E-MAIL
ADDRE CEZt1flCateB@W11118.COID
INSURER(S)AFFORDING NG COVERAGE
NAIC 11
INSURERA. Old Republic Insurance Company
24147-001
INSURED
3M Company
INSURERS:
INSURERC:
3M Insurance Department
Bldg 224-5S-29
St. Paul, MN 55144
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 22792342 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 JJJL
TYPE OF INSURANCE
DDL
SUB
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
OCCUR
MWZY 301339
3/1/2014
3/1/2017
EACH OCCURRENCE
$ 5,000,000
ppMRTQpoccueCLAIMS-MADEX
rnce)
$ 1,000,000
MED EXP (Any one person)
$
PERSONAL B ADV INJURY
$ 51000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOG
OTHER:
GENERAL AGGREGATE
$ 5,000,000
PRODUCTS.COMP/OPAGG
$ 5,000,000
$
jL
AUTOMOBILE LIABILITY
X ANYAUTO
ALLOWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS AUTOS WNED
MWTB 300812
3/l/2014
3/1/2017
COMBINED SINGLE LIMIT
(Ea accident
$ 2,000,000
BODILY INJURV(Per person)
$
BODILY INJURY(Per accident)
$
Per accident A
$
$
UMBRELLA LIAR
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACHOCCURRENCE
$
AGGREGATE
$
DEC) RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVEO
IMEMBER OFFICEREXCLUDED?
[Mantlatory,in NH)
[Manunder
DESCRIPTION OF OPERATIONS below
N/A
MWC304139 00
3/1/2015
3/1/2016
X I SPTFAFTUTE
E.L. EACH ACCIDENT
.$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
$ 2,000,000
E.L. DISEASE -POLICY LIMIT
Is 2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additonal Remarks Schedule, may be ahached if more space is required)
City of Fort Collins
215 N Mason Street, 2nd Floor
PO Box 580
Fort Collins, CO 80522
Co11 e46416R5 Tn1 e1921204 Carte
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
.2 92449. (C) 1 PlAA-1017114 ACnRn
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ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD