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HomeMy WebLinkAboutFIRST NATIONAL OF NEBRASKA INC - INSURANCE CERTIFICATE (7)oR CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1 /15/2019 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 have ADDITIONAL INSURED provisions or 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 NAME: The Harry A. Koch Co. PHONE - - - Fax P.O. Box 45279 ,I: 402-861-7000 IA/C, No): 402-861-7111 Omaha NE 68145-0279 A DRESS: INSURER A: Federal Insurance Company 20281 INSURED INSURER B : Great Northern Insurance Company 20303 First National of Nebraska, Inc. Attn: Risk & Insurance Dept INSURERC: Travelers Indemnity Co. 25658 1620 Dodge St., Mail Stop 1151 INSURERD: _ Omaha NE 68197 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER:712396083 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 OF INSURANCE ADDL�SUBRTYPE INSD WVD POLICY NUMBER MM/DDIYPOLICY EYYY MMIFF LDD� LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR Y 35757477 1/18/2019 1/18/2020 EACH OCCURRENCE $1000000 DAMAGE TO RENTED PREMISES Ea occurrence $1000000 MED EXP (Any oneperson) $10000 PERSONAL &ADV INJURY $1000000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT LOC OTHER: GENERAL AGGREGATE $ 2000000 PRODUCTS - COMP/OP AGG $ Included $ e AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-0WNED AUTOS ONLY AUTOS ONLY 73560467 1/18/2019 1/18/2020 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB HCLAIMS-MADE OCCUR EACHOCCURRENCE $ AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, desa be under DESCRIPTION OF OPERATIONS below N/A UB3K852764 1/18/2019 1/18/2020 X STATUTE ERH E.L. EACH ACCIDENT $ 500,000 _ E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if 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. I1:8:[N11111e1:1:7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ft. Collins', Director of Purchasing & Risk ACCORDANCE WITH THE POLICY PROVISIONS. Management PO Box 580 AUTHO ED REPRESENTATIVE Fort Collins CO 80522 f�� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD