HomeMy WebLinkAbout110520 TRAFFIC SIGNAL CONTROLS - INSURANCE CERTIFICATE01/10,12008 03:25
3037762940
AMERICAN FAMILY INS
PAGE 02/02
Insumd's Name and Address
Traffic: Signal Controls 1
255 Weaver Park Rd
Longmont, CO 80504
CERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company p
American Family Mutual Insurance Company If selection box is not checked
6000 American Pky Madison, Wlawriam 53783-0001
AgenPs Name, Address, and Phone Number (Aqt /Die( )
Gary L Johnson (303) 776-9870
023 Main St.
Longmont, CO 80501 (071/311)
This certificate Is Issued as a matter of Information only and confam 110 rights upon the Certificate Holder.
This certificate does not amond, extend or alter the coverage afforded by the policies listed below.
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TM1Ie Is to cartly mat ponces ofueurenPe rehdbelowhere beenieeuedto the Imu,edmmned abovela Me pohoypedod Mashed, nohenWteneop ao'Y nngU sit., r.Rmi or conditla ormy wroncl adher
do urnerit W1th rodpayfowhM eua de OMIA maybe towed m may peEem, tha udunnn!¢ aeordad by the boli di sabod haran is wblxl tool the Iamb. ardudaw. wed cknedona of aion poldog
TVPE OF INSURANCE
POLICY NUMBER
POLICY DATE
LIMITS OF LIABILITY
—
1FFVc` W �IRATION
Homaotanore/
eoay Myry ens Pmp.yy n,m.s.
Mobllshomeownars Liability I
Each Ocdwnnca $ ,000
Boaownars Liability
eotay frllury and Property Damage
E.aocwmena. $ ,ow
Peraonai Umbrella Liability
godly aqury and Prgwrry Danaga
Each Ocvoence $ ,000
Farm Lamb, a Persona Labuib,
Farm/Ranch Liability
Each ounerance $ 000
Ferro Employers ueMRy
Uen o0amalwe $ 000
Workers Compensation and
Each wAMt $ ,0o0
Employers Liability?
ois.aaa Egra Empioycc $ ,000
Daee9e Pole Lora $ 1000
General Liability
a.nvy Aggmgate $ 2,000 o00
Products. Coro hnod mdmaA $ 000
® Commercial General
Paraetpl sw sour u $ 1.000 QM
LJabilaY(OCWranos)
❑
05 X48565.02.00
06/24/2007
06/24/2008
EadlOaurrence $ 1,000 000
❑
0 ib Premlee9 flamed W YW $ 100,000
MedcM eMperes Wry One mfDCM) $ 5 OW
Busineeeormars Liability
Earn o''"11°1CeiY $ ,000
Apprepeaa't1' $ 1000
Liquor Liability
common Own Worst $ 1000
Aptirs IhNt $ 1000
Automobile Liability
6odlly lop" - Eat, P. $ 1000
❑ Any Auto
❑ All Owned Autos
e.dny lot, - Ead'Aeddem $ ,000
❑ Sclheduled Autos
PrWany Damage $ O00
❑ Hired Auto
❑ Nonowned Autos
❑
Rudy tyury and Pmpww carnage conhMsd $ 1000
Excess Liability
❑ Commercial Blanket Excess)
Each OcdeemearAggregat. $ 000
Other (Miscellaneous, Coverages)
DESCRIPTIONOFOPEMTiDNs/L AT10Na/VEHieLEa/q I NS ISPEO LITFIAS tTla.ldrv,dPa or DaMen shown as anund ❑Hose ❑w.e not
.Iota d to he nerered ee employees under eM policy
y
h 1' Pmdteta-CanyaUa 000a aggresots is egos b sea
eendrenee ferht and is included In poky aggragata.
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_-'"_ - �-;.L`::-�,?:?: �INCEi`L3�7JOF�i :t•'>.-'2,...ti.3 ,'"`
•`CITY OF FORT COLLINS
LJ Should any of the above described pollCles be oancelled before the
expiration dale thereof, the 0mpany will endeavor to mad'( days)
PURCHASING DIVISION
wnttm robed n to the Cedieste Holder named, bud failure to mail such
PO BOX 580
nonce shall impose no obligation or Itabiluty of arty kind upon the
•f0
FT COLLINS, C0I80522
a ny, its agents or reprasantaWas_ days unless different
n at of tleye siTown.
IM Thls certifies coverage, on the date of issue only The above
described bourses are aubleet to cancellation inconformity with their
terms and Dy the laws al the to of I e.
PA lis"�$�pE
A IZED E NTATIVE
01/10/2008
LI-201 Ed. 5100 Cerhfirate Holder e Stook No 0658a Rev 7M2