Loading...
HomeMy WebLinkAboutRHINEHART OIL CO LLC - INSURANCE CERTIFICATEPARKUSA-01 CTHELEN ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/1'YYY)6/11/2019 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 CONTACT NAME: Billings Office PHONE 406 238-1900 (AIC 406 245-9887 PayneWest Insurance, Inc. (A/c, No, Ext): ( ) (Alc, No):( ) P.O. Box 30638 E-MAILDS: Billings, MT 59107-0638 1Mm1DC01¢1 AornonWr- rnvcraer-F NAIrA INSURED INSURER A : Zurich American In8Ura PARKLAND (US) AQUISITION CORPORATION DBA Rhinehart INSURERC: Oil Co., LLC P.O. Box 1842 INSURER D Minot, ND 58702 INSU'ER E: INSURER F : r f%%10DAr_CQ rI=DTICI1-AT9= IUIIIUIRI=D• RFVl-gIOKI NIIMRFR- 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 LTRCOMMERCIAL TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ $ PREMI ESO RENTED n MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO ❑ JECT LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO OWNED L SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY EO aBCNeDISINGLE LIMIT $ BODILY INJURY Perperson) BODILY INJURY Per accident PROPERTY DAMAGE Per accident $ UMBRELLA LAB EXCESS LAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y IFEXCLUDED? datory in NH) ( an� If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC796464004 7/1/2019 7/1/2020 X PER OTH- TAT T ER E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYE 1,000,000 $ E.L. DISEASE - POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) WC796464004 Blanket Waiver of Subrogation form WC000313 Stop Gap Coverage Included under policy number WC796464004 in North Dakota and Wyoming: $1,000,000 each accident / $1,000,000 each employee / $1,000,000 policy limit. Policy WC796464004 includes States of South Dakota, Minnesota, Kansas, Texas, Colorado, Utah and New Mexico, and Arizona Excluded Officers: Bruce Hest, Mike McMillan, Bob Espy Irk:[•: City of Fort Collins 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD