HomeMy WebLinkAboutBUSCO, INC. DBA ARROW STAGE LINES - INSURANCE CERTIFICATE.�� Buscirvc-o�
ACG7R�' CERTIFiCATE OF LIABILITY tNSURANCE DATE�MMIDDJYYYY)
`�� 1/12/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPpN THE CERTIFICATE HOLDER. THIS
CERTIFIGATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLfCIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTfTUTE A CON'iRACT BETWEEN THE ISSl71NG INSURER(S}, AUTHORIZED
REPRESENTATIVE OR PRODUC�R, AND THE CER7IFICATE HOLDER.
IMPORiANT: If the ce�tificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION 1S WAIVED, subject to the terms and conditions of the policy, ceRain policies may require an endorsement. A statement on
this ce�tificate does not confer rights to the certificate holder in lieu of such endorsement{s1.
PRODUCER
American Highways Ins. Agency
3250 Interstate Drive
Richfield, OH 44286
INSURED
Busco, Inc. dba Arrow Stage Lines
4220 South 52nd St.
Omaha, NE 68117
COVERAGE$ CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT 7HE POLIC�ES OF INSURANC� LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY i2EQUIREMEN7. 7ERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN !S SUBJECT TO ALL THE TERMS
EXCLUSIONS AND CONDITIONS OF SUCH POLICiES LIMITS SHOWN MAY HAVE BEEN REDUCEO BY PAID CLAIMS.
INSR AODI(SUBR�., POLICY EFf POLICY EXP
LTR TYPEOFfNSURANCE I��,�p,,,��� POi1CYNUMBER �.(��ipQ,�YY� llAMlDpm•yY� LIMITS
A �( COMMERCIAL GENERAL LIABILITY
I II I CfAIMS MADE X O�:CUR
�
GEN'L AGGREGATE LIM1T APPUES PER
X POLICY P��T LOC
X XPP1119490-21 ti�nosa srusoss
A AUTOMOBILE LIABILITY
� X � ANY AUTO
1 OWNED SCHEDULED
.. AUTOS ONLY AUTOS
µ X, AU �� ONLY X-. A�TOS ONL�
A I UMBRELLA LIAB X OCCUR
)( �EXCESS LfAB ! CWM$-A�
I DEO � � RETBNTION S
x XPP1119490-21
XEX1119490-20
...... �.e. �... �.... �....,.�.. . Y f N
ANY PROPRIETORlPARTNERIEXECUTIVE
Q_FFICERfMEbSBER E:(CLUDED? N 1 A
�Mandalary in NH)
2/1l2024 21112025
2l1/2b24 2/1/2025
EAGH OCCURRENCE , $
DAMAGE TO RENTED
. P!?�MI$�S.(E8 OGGu!�@�GBi . $
MED_EXP {Any one person � S
PERSONAL 8 AOV INJURY $
GEN[RALAGGREGATE S
PROpUCTS - COMP/OP AGG S
S
COMBINED SiNGLE LIMIT
1E3.�G.LQC�1; . $
BODILYINJURYiPerper50n $
BODILY INJURY � Per accident; �$
PROPERN OAMAGE
�Peraccid^nti , $
iCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Addltlonal Ramarka Schedule, may be aHached if more apace fs requlred)
�sical Damage Deductibles:
,000 per charter bus (> 29 PAX} - Comprehensive, Collision
100 per van, limo, school, transit - Comprehensive, 510,000 Collision
i00 per pplservice for ComprehensivelCollision
and Abuse S1,aoa,000 each clalmlSl,OOO,UOU aggregate
ATTACHED ACORD 101
City of Fart Collins
PO Box 580
Fort Collins, CO 80522
Suc°,No.exs:_(S00) 935-2442 �u ,No�{33d) 659-8912
A ORt�$�ahia.highwayservice@natl.com
INStJRER(SJ AFFORDING COVERAGE HAIC A
�HsuReR a: National Interstate Insu�ance Company �2620
SHOULD ANY OF THE ABOVE DESCRIBED POEICIES BE CANCELLEO BEFORE
TH� EXPlRATION DATE THEREpF, NOTICE WILL BE DELIVERED IN
ACCORDATlCE WITH THE POLICY PROVISION9.
AUTHORILED REPRESENTATIVE
��
ACORD 25 (201fi103) Q 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACQRD
���
A�RO
AGENCY
merican Highways Ins. Agency
POLICY NUMBER
EE PAGE 1
caRa�a
EE PAGE 7
AGENCY CUSTOMER ID: BUSCINC-0')
I.00 #:
ADDITIONAL REMARKS SCHEDULE
� NAMEOINSURED
Busco, Inc. dba Arrow Stage Lines
4220 South 52nd St.
"Omaha, NE 68117
1 N�ic cooe �
�SEE P � f EFFBCTIVE DATE:
ADDITIONAI. REMAftKS
THIS ADDITIONAL f2EMARKS FORM IS A SCHEbULE 70 ACORD FpRM,
FORM NUMSER: ACORD 25 FORM TITLE: Ceriiticate of Liability Insurance
Description of OperationslLocationsNehicles:
City of Fort Collins, its officers, agents and employees are additional insured on the auto liability and general liability policies
pursuant to the terms and conditions of the policy.
� The company will mail the ce�tificate holder written notice of cancellation. If possible, the notice will be mailed at least 30 days,
� except for cancellation of non-payment of premium, which wilt be mailed according to the policy provisions, prior to the effective
date of the cancellation. Any provision that is in conflict with a statute or rule is hereby amended to conform to that statute or rule.
ACORD 101 (2008101)
C�) 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
NCVAXM
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