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351548 US BANKCORP - INSURANCE CERTIFICATE
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 07/18/2017 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 1-612-333-3323 CONTACT Dawn Heinemann NAME: Hays Companies PHONE FAX A/C No E, 612-333-3323 A/C No. 612-373-7270 80 South 8th Street Suite 700 Minneapolis, MN 55402 EMAIL scorn dheinemann@ha anies.com ADDRESS: Y P INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: OLD REPUBLIC INS CO 24147 INSURED U.S. Bancorp and its Subsidiaries 200 South 6th Street EP-MN-L20I Minneapolis, MN 55402 INSURER B : INSURER C INSURERD: INSURERE: INSURER F: CnVFRAGFS CFRTIFICATF NIIMRFR• 50384620 RFVISInN 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MWDDNYY POLICY EXP MM/DD/YYY LIMITS A X COMMERCIAL GENERAL LIABILITY X MWZY310877 08/01/17 08/01/18 EACH OCCURRENCE $ 5,000,000 CLAIMS -MADE I -XI OCCUR PREM SESOEa occurrence) $ 1,000,000 MED EXP (Any oneperson) $ N/A PERSONAL & ADV INJURY $ 5,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 RO- X PRO ❑ POLICY D LOC PRODUCTS - COMP/OPAGG $ 6,000,000 $ OTHER: A AUTOMOBILE LIABILITY X DMTB310875 08/01/17 08/01/18 COMBINED SINGLE LIMIT Ea accident $ 5,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE E. RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N/A MWC31087400 08/01/17 08/01/18 PER X STATUTE I I EERH E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 If es, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is additional insured as respects general and automobile liability policies where required by writte contract. UtH I IFIUA I L HULULH UANULLLA I IUN CON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Gerry S. Paul 215 N. Mason Street, 2nd Floor AUTHORIZED REPRESENTATIVE Fort Collins, CO 80524 USA © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ddebuhr �nooncon