F&B COL.tif AC'4° t ' LI ' DATE (MMIDD,YYY1�
1 4/11/2013
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 NAME: e e
SilverStone Group PHONE Fax
Arc No Ext :402.964.5575 c No :402.557.6325
11516 Miracle Hills Drive
E-MAIL
Omaha NE 68154 ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC *
INSURERA:Cincinnati Insurance Co. 10677
INSURED F &BCO -1 INSURER B : C!nCinnati I nSUranCe CO
F & B Constructors, Inc. INSURER C:
4344 S. 87th Street
Omaha NE 68127 INSURERD:
INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER: 2044748287 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.
l �TR TYPE OF INSURANCE INSR WVD POLICY NUMBER MIDDY E FF POLICY LIMITS j
B GENERAL LIABILITY PP0887656 /112012 /1/2013 EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED
X COMMERCIAL GENERAL LIABILITY
PREMISES Ea occurrence $500,000
CLAIMS -MADE li-I OCCUR MED EXP (Any one person) $10,000
PERSONAL& ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
POLICY PRO- $
CT LOC
• AUTOMOBILE LIABILITY CPA0887656 /1/2012 511t2013 Ea accident $1,000
X ANY AUTO BODILY IN URY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY1Peraccident) $
AUTOS AUTOS P $
N ROPERTY DAMAGE
AUTOS Peraccident N
HIRED AUTOS AUTOS
• X UMBRELLA LIAB OCCUR CPP0887656 /1/2012 /1/2013 EACH OCCURRENCE $4,000,000
EXCESS LIAB CLAIMS -MADE AGGREGATE $4,000,
DED X RETENTION $10, 000 $
WORKERS COMPENSATION A102108040 /1/2012 /1/2013 X WCSTATU- OTH-
AND EMPLOYERS' LIABILITY Y / N TOR LIMrrS ER
ANY
OFFICER/MEMBER EXCLUDED? PROPRIETOR/PARTNER/EXECUTIVE FN NIA E.L. EACH ACCIDENT $1,000,000
(Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $1,000,000
If es. describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $1,000,000
B Equipment Floater PP0887656 11/2012 /1/2013 Hired/Leased $150,000
I
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DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
I
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CERTIFICATE HOLDER CANCELLATION
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
O
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