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HomeMy WebLinkAboutBusco, Inc. dba Arrow Stage Lines - Insurance Certificate 2024-2025 BUSCINC-01 NCVAXM A`nRC CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1/12/2024 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 ( CONTACT American Highways Ins.Agency PHONE 3250 Interstate Drive (A/c,No,EXt):(800)935-2442 1 (AAixC No):(330)659-8912 Richfield,OH 44286 E-MAIL ahia.highwayservice@natl.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:National HInterstate Insurance Corn an 32620 INSURED INSURER B Busco,Inc.dba Arrow Stage Lines L SURER C: 4220 South 52nd St. INSURER D Omaha,NE 68117 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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. IN SR ADDLISUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IN SD WVD I POLICY NUMBER MM DD Y I FOLIC YY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 5,000,000 CLAIMS-MADE X OCCUR X XPP1119490-21 2/1/2024 2/1/2025 DAMAGE TO RENTED 250,000 PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 5,000,000 GGE�N'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5,000,000 11C I POLICY�JECT � LOC PRODUCTS-COMP/OP AGG $ 5,000,000 I . OTHER: A '' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5,000,000 X ANY AUTO Ea accident $ _ X XPP1119490-21 2/1/2024 2/1/2025 BODILY INJURY Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED PROPERTY DAMAGE AUTOS ONLY 1 AUUTOS ONLYY Per accident $ I A UMBRELLA LIAR X OCCUR $ EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE XEX1119490-20 2/1/2024 2/1/2025 AGGREGATE $ DED RETENTION$ AL/GL WORKERS COMPENSATION AND EMPLOYERS'LIABILITY PER OTH- I ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N I SLATUTE I ER OFFICERAIENIBE R EXCLUDED' NIA E.L.EACH ACCIDENT $ (Mandatory in NH If yes,describe under E.L.DISEASE-EA EMPLOYE $ i DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES ( Additional bACORD 101 i Physical Damage Deductibles ona)Remarks Schedule,may be attached if more spaces required) $20,000 per charter bus(>29 PAX)-Comprehensive,Collision $5,000 per van,limo,school,transit-Comprehensive,$10,000 Collision $2,500 per pp/service for Comprehensive/Collision Sexual and Abuse$1,000,000 each claim/$1,000,000 aggregate SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins,CO 80522 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: BUSCINC-01 NCVAXM LOC#: ACORO �.� ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY ; NAMED INSURED merican Highways Ins. Agency Busco,Inc.dba Arrow Stage Lines 4220 South 52nd St. POLICY NUMBER .Omaha,NE 68117 EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 iSEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/LocationsfVehicles: 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 certificate 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 will 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 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC�- BUSCINC-01 NCVDMS �f CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLD RO 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 CONTACT American Highways Ins.Agency PHONE 3250 Interstate Drive (A/C,No,Ext):(800)935-2442 =FAX Richfield,OH 44286 E-MAIL (A/C,N.Y(M)659-8912 ADORE :ahia.highwayservice@nat.com INSURERS AFFORDING COVERAGE NAIC# — JINSURER NSURER A.National Interstate Insurance Com an 3262Q INSURED NSURER B: Busco,Inc.dba Arrow Stage Lines NSURER C: 4220 South 52nd St. Omaha,NE 68117 NSURERD: E: NSURER F COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADDL SUBR1 D POLICY NUMBER POLICY EFF POLICY EXP X A , COMMERCIAL GENERAL LIABILITY M/DD Yyl IMM/DD/YYYY),' LIMITS CLAIMS-MADE X OCCUR EACH OCCURRENCE $ 5,000,000 ❑ X XPP1119490-22 2/1/2025 2/1/2026 DAMAGE TO ocureEN nce $ 250,000 MED EXP An one arson $ 10,000 GEN'LAGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ 5,000,5,000,000 000 X POLICY❑PRo LOC GENERAL AGGREGATE $ OTHER: PRODUCTS-COMP/OP AGG $ 510001000 A AUTOMOBILE LIABILITY $ COMBINED SINGLE LIMIT 510001000 X ANY AUTO a a ident $ OWNED SCHEDULED X XPP1119490-22 2/1/2025 2/1/2026 BODILY INJURY Per rson $ AUTOS ONLY AUTOS X HIRED X NON-AWNED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ A UMBRELLA LIAB X OCCUR $ X EXCESS LIAR EACH OCCURRENCE $ 6,000,000 CLAIMS-MADE XEX1119490-21 2/1/2025 2/1/2026 DED RETENTION$ AGGREGATE $ L WORKERS COMPENSATION AUG $ AND EMPLOYERS'LIABILITY TH- ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N PER TAT TE ER R OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.EACH ACCIDENT $ If yes,describe under — -- E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Physical Damage Deductibles: $20,000 per charter bus(>29 PAX)-Comprehensive,Collision $5,000 per van,limo,school,transit-Comprehensive,$10,000 Collision $2,500 per pp/service for Comprehensive/Collision Sexual and Abuse$1,000,000 each claim/$1,000,000 aggregate SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOU;EXPIRATION THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCOITH THE POLICY PROVISIONS. Fort Collins,CO 80522 AUTHORIZENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 13USCINC-01 -- - NCVDMS ACORO" LOC#: ------ ---- ---------- ------ --- ADDITIONAL REMARKS SCHEDULE AGENCY Page 1 of 1 merican Highways Ins.Agency NAMED INSURED - - BUSCO,Inc.dba Arrow Stage Lines POLICY NUMBER -- — - --- -- — _4220 South 52nd St. EE PAGE 1 Omaha,NE 68117 CARRIER EE PAGE 1 NAIC CODE ADDITIONAL REMARKS SEE P 1 EFFECTIVE DATE:SEE PAGE 1 FFORM DITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, UMBER: ACORD 25FORM TITLE: Certificate of Liability Insurance tion of Operations/Locations/Vehicles: 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. except for The company will mail the certificate holder written notice of cancellation. If possible, the notice will be mailed at least 30 days, l be date of the cancel at on. Any provision nt of that isnin conflictch with la statute eorr rule is'ng to the policy hereby amended to conform provisions, prior at the effective onform to that statute or rule. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD