Sterling COL.tif I
ACOR®® CERTIFICATE OF LIABILITY INSURANCE F DATE
4/23/2015 DlrrvY)
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: To Request A Certificate
Cottingham & Butler
800 Main St. ac PHONE 888 -785 -4677 FAX N 563 - 587 -5990
Dubuque IA 52001 E-MAIL . NSTDCertificates @cottinghambutler.com
INSURERS AFFORDING COVERAGE NAIC #
INSURERA:Acuity A Mutual Insurance Co. 14184
INSURED STETRAO INSURER B :
Sterling Transportation Services Inc INSURERC:
PO Box 79
Blair NE 68008 INSURER D:
INSURER E:
INSURER F :
COVERAGES CERTIFICATE NUMBER: 1446487593 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICY NUMBER MM /DD/YYYY MMIDD/YYYY
• X COMMERCIAL GENERAL LIABILITY L28983 10/12/2014 10/12/2015 EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED
CLAIMS -MADE X OCCUR PREMISES Ea occurrence $100,000
MED EXP (Any one person) $5,000
i
PERSONAL &ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
X POLICY ❑ JECT E LOC PRODUCTS - COMP/OP AGG $2,000,000
OTHER: $
10/12/2014 10/12/2015 Mel ED SINGLE LIMIT $
• AUTOMOBILE LIABILITY L28983 Ea accident 1,000,000
X ANY AUTO BODILY INJURY (Per person) $
A LL O WNED SCHEDULED BODILY INJURY (Per accident) $
NON -OWNED PROPERTY DAMAGE
X HIRED AUTOS X AUTOS Per accident $
• UMBRELLA LIAB X J OCCUR L28983 10/12/2014 10/12/2015 EACH OCCURRENCE $5,000,000
EXCESS LIAB CLAIMS -MADE AGGREGATE $5,000,000
DED RETENTION $ $
• WORKERS COMPENSATION L28983 10/12/2014 10/12/2015 X STATUTE EER
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR /PARTNER/EXECUTIVE ❑ NIA E.L. EACH ACCIDENT $100,000
OFFICER /MEMBER EXCLUDED?
(Mandatory in NH) E.L. DISEASE - EA EMPLOYE $100,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $500,000
A Cargo L28983 10/12/2014 10/12/2015 Limit $50,000
DED $500
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The certificate holder is an additional "insured" on the Auto Liability policy subject to the terms & conditions of the policy.
CE RTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City Of Blair ACCORDANCE WITH THE POLICY PROVISIONS.
218 S 16th Street
Blair NE 68008 AUTHORIZED REPRESENTATIVE
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