HomeMy WebLinkAbout105396 TRAFFIC MASTERS - INSURANCE CERTIFICATE (2)ACORD,. CERTIFICATE
OF LIABILITY INSURANCE
YY)
05/21
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER O
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER ANational Fire & Marine Insurance CO.
Traffic Masters, Inc.
INSURER Illinois Union
1304 Duff Drive #14
INSURER C Pinnacol Assurance
Ft. Collins, CO 80524
NsuRERo: Travelers Insurance Company
INSURER E:
rn%1F:PAf]FS
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
DATEYMM DD/YYE
EXPIRATION
P DATE MM/DD/Y )
LIMITS
A
GENERAL LIABILITY
72LPS002004
08/03/06
05/03/07
EACH OCCURRENCE
$1000000
X COMMERCIAL GENERAL LIABILITY
CANCELLED
PREM SES Ea occurrence)$100
000
CLAIMS MADE I X i OCCUR
MED EXP (Any one person)
$5 000
PERSONAL & ADV INJURY
$1 00O 000
GENERAL AGGREGATE
$2 000 000
GEML AGGREGATE LIMIT APPLIES PER.
PRODUCTS - COMP/OP AGG
s2,0001000
POLICY M PRO-
JECT LOC
D
AUTOMOBILE
LIABILITY
ANY AUTO
BA6547C34106SEL
07/14/06
07/14/07
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY. AGG
B
EXCESS/UMBRELLA LIABILITY
N01907311
08/03/06
05/03/07
EACH OCCURRENCE
$1000000
X1 OCCUR CLAIMS MADE
CANCELLED
AGGREGATE
$1 000 000
$
DEDUCTIBLE
$
X RETENTION $ 10000
1
C
C
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY
ANY PROPRIETORlPARTNERlEXECUTIVE
4058170
4058176
06/01/07
06/01106
06/01/08
06i01/07
X WC STATU- OTH-
T RY LIMITS R
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES ( EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
City of Ft. Collins is listed as Additional Insured where their interest
may appear.
City of Fort Collins
ATTN: Purchasing
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -In_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENT T.
F-t ocn4 1. 'r G.r� J e,.o dl.l
AGUIRU 25 (2UU11U5) 1 of 2 #M381494 KLB O ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
AGUKU Zh-S (ZUU9(U8) 2 of 2 #M381494