HomeMy WebLinkAbout105396 TRAFFIC MASTERS - INSURANCE CERTIFICATE (3)Flood & Peterson Ins 5/30/2007 9:33 PAGE 001/003 Fax Server
Flood and Peterson Insurance, Inc.
FAX TRANSMITTAL SHEET
ATTN: FROM:
John Stevens
COMPANY:
DATE:
Kelly Bishop
City of Fort Collins 5/30/2007 9:32:52 AM
FAX NUMBER: SENDER FAX NUMBER:
2216707 970-266-8715
# OF PAGES INC. COVER: SENDER PHONE NUMBER:
3 970-266-7121
NOTESICOMMENTS:
The contents of this message sent from Flood & Peterson Insurance, Inc. is confidential, possibly privileged,
and intended only for its addressee. If you have received this message in error, you must not disclose, copy,
circulate, or in any other way use or rely on the information contained in this message. If you have received
this message in error, please contact Flood & Peterson Insurance, Inc. by phone at 970-356-0123.
Flood & Peterson Ins 5/30/2007 9:33
PAGE 002/003 Fax Server
r-Hanre• 27MIR
TDAUA
ACORDt. CERTIFICATE OF LIABILITY
INSURANCE
DATE(MMIDDIYYYY)
05130/07
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
P O Box 270370
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIL #
INSURED
Traffic Masters, Inc.
1304 Duff Drive #14
R. Collins, CO 80524
INSURER A National Fire & Marine Insurance Co.
INSURER B: Pinnacol Assurance
INSURER G Travelers Insurance Company
INSURER D:
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
MY 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 PAD CLAMS.
NOR
LTR
N:PVL
NSRE
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECr1VE
0&15107
POLICY EXPIRATION
LIMBS
A
GENERALLIABILIrY
72LPS002004
08/03/07
EACHOCCURRENCE
$1000000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
DAMAGE TO RENTED
MED EXP one pa
$100 O00
$5 000
PERSONAL$ADV INJURY
$1 000 000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS -COMPIOP AGO
$2000000
POLICY PR6 LOC
Ci
AUTOMOBILE
LIABILITY
ANY AUTO
BA6547C34107EL
07/14/07
07/14/08
COMBINED SINGLE LIMIT
(Eaadda/)
$1,000,000
BODILY INJURY
(Pa person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
1XXX
HIREDAUTOS
NON -OWNED AUTOS
BODILY INJURY$
(Paaadderl)
PROPERTYDAMAGE
(Pa aeddat)
$
GARAGE LIABILITY
ALTO ONLY -EAACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTOONLY: AGG
MBRELLA LIABILITY
CUR CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
RDEDUCT113LE
$
S
RETENTION $
B
WORKERS COMPENSATION AND
EMPER
4058170
06/01/07
06/01/08
X WCSTATU- DTH-
E.L. EACH ACCIDENT
$500 000
ANYLOYERS'LUABILITY
ANY PROPRIETORI
OFFICERIMEMBnd EXCLUDEDT
EXCLUDED?
Ir ea tleaelbe ands
E.L. DISEASE -EA EMPLOYEE
$500000
E.L. DISEASE- POLICY LIMB I
$5OO OOO
E IAL PROVISIONS h.1.
OTHER
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
City of Ft. Collins is listed as Additional Insured where their Interest
may appear.
Faxed to John Stevens 970-221-6707
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 AWL 30_ DAYSWRITTEN
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 AGE NTS OR
REPRESENTATIVE
^��^� �-^ ••��I T OT t rFS itl15Z(1/M38Z518 KLB 0 ACORD CORPORATION 1988
Flood & Peterson Ins 5/30/2007 9:33 PAGE 003/003 Fax Server
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy('ies) must be endorsed. A statement
on this certiricate does not confer rights to the certificate holder in lieu of such endorsemert(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 insuraos), 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.
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