HomeMy WebLinkAbout467921 3M COMPANY - INSURANCE CERTIFICATE (3)A� �® CERTIFICATE OF LIABILITY INSURANCE page 1 of. 1
02/1 /2 16
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
theterms 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
Willis of Minnesota, Inc.
c/o 26 Century Blvd.
P. 0. Box 305191
Nashville, TN 37230-5191
PHONE 877-945-7378 FAx 888-467-2378
E-MAILCert].f].Cat EB@Wi 11iB. COIIl
ADDBESS
INSURER(S)AFFORDING COVERAGE
NAIC If
INSURERA: Old Republic Insurance Company
24147-001
INSURED
3M Company
INSURER B:
INSURERC:
3M Insurance Department
Bldg 224-SS-29
- St. Paul, MN 55144
INSURERD:
INSURER E:
INSURER F:
I
COVERAGES CERTIFICATE NUMBER: 241159Ro RFVISION NIIIMRPR-
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
TYPE OF INSURANCE
WDDL
iNgn
SUB
N POLICYNUMBER
IIMWZY
POLICY EFF
POLICY EXPLTR
LIMITS
A
X
COMM ERCIALGENERAL LIABILITY
CLAIMS -MADE X OCCUR
301339
3/1/2014
3/l/2017
EACHOCCURRENCE
$ 5,000,000
DpgqMMGGEE7QeAENTED
a occurence)
$ 1,000,000
MED EXP (Any one person)
$
PERSONAL B ADV INJURY
$ 5,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY �E T LOC
OTHER:
GENERAL AGGREGATE
$ 51000,000
PRODUCTS - COMP/OP AGG
$ 5,000,000
$
p
AUTOMOBILE LIABILITY
X ANYAUTO
AUTOS OS S SCHEDULED
AUBODILY
HIREDAUTOSHANUOTNOOWNED
AUTOS
MWTB 300812
3/1/2014
3/1/2017
COMBINED SINGLE LIMIT
(Ea accident)
$ 2,000,000
BODILY INJURY(Per person)
$
INJURY(Per accident)
$
PROPERTYDAMA E
(Peraccident)
$
UMBRELLA LIAR
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACHOCCURRENCE
$
AGGREGATE
$
DED RETENTION$
$
p
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVEFN—].N/A
OFFICER/MEMBER EXCLUDED?
f EMandatory in NH)
yes, describe under
DE SCRIPTION OF OPERATIONS below
MWC306927 00
3/l/2016
3/1/2017
X
E.I„EACH ACCIDENT
$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
$ 2,000,000
E.L. DISEASE -POLICY LIMIT
$ 2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additonel Remarks Schedule, may be attached if more space is required)
Lay.u1A Lml■ y. Pl M a Hd
City of Fort Collins
215 N Mason Street, 2nd Floor
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 (2014/01)
Coll:4852941 TD1:2032177 Cert:
5980 01988-V014ACORDCORPORATION_ Allrinhtcracaruad
The ACORD name and logo are registered marks of ACORD