HomeMy WebLinkAbout110520 TRAFFIC SIGNAL CONTROLS - INSURANCE CERTIFICATE (2)01/10/2008 03:25 13037762940 AMERICAN FAMILY INS PAGE 02/02
CERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company it selection box Is not checked
WW American Pky Madison, Wisconsin 53783-0001
Insured'a Name and Address Agent's Name, Address, and Poona Number (WDlst )
Traffic Signal Controls I Gary L. Johnson (303) 776-9070
255 Weaver Park Rd 023 Main St.
Longmont, CO 80504 Longmont, CO 80501 (071/311)
This certificate Is Issued as a matter of Information only and confare no rights upon the Cedrfieate tltplder-
This certificate does not Amend, extend or altar the coverage afforded by the policies fisted below.
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Tine Is to ce.wy tilm poldee ofineurenoe Feted below hers been Nwed to me inewednamed ebore Ira tlu policypaAad mradated, noMinnendnp my mq..m^er0. term air conddan o1 aril' mmmm a char
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TYPE OF INSURANCE
POLICY NUMBER
POLICY DATE
LIMITS OF LIABILIRY
EFFSCTNE E%PIIiAT1ON
[Mo. sec. Yr
Homeowners/
Bodily mpq end Pmpvey Dao•ege
Mobilahomaownars Liability
each Oaca.mrca $ ,DOD
Boatowners Liability
safer Injury are Properly Damage
E'ohccur.mnde $ ,DDD
Pereomel Umbrelld Liability
ao6r Inner and Pmpay Ddmapa
cam occummos $ 1000
laalu
eerso.,ai ny Farm
FarmfRaneh Liability
0camen $ 000
Each Lcuwerhee
Farm Empe yere t-AbAey
Edcn Occvrmnce $ 000
Workers Compensation and
sue,
sow Aaadmt S 1000
Employers Liability t
oacase -EoM empbyee S 1000
Debase - Policy Lora $ 1000
General Liability
General $ 2 000 DOD
Pmdvca -co Iamd uwra m $ 000
® Commercial General
Llabifrtv (occurrence)
05-X46565-02-00
06/24/2007
D6/24/2008
P°rsow and nw° ' $ 1.000 ggg
Each Oceuaence $ 1,000 000
Darape to Prem[aes Honed to Yap $ 100000
medce Eapmae VM ono I'arson) $ 5.000
BVsitte99oamflra LlabOhy
Eecuocaemncett $ ,000
Aggnegab'tt $ 1000
Liquor Liability
cownai Caaea Von $ 1000
Atemgam Uma If ,000
Automobile Liability
eoey«Nry-Each Farsan $ ,000
Q Any Auto
❑ All Owned Autos
eoeq In"- Each Accident S ,000
Property Damage S ggg
❑ Sc haduled Autos
L3 Hired Auto
LJ Nont»vned Autos
awry Ins" and Pmpe.y Orange COmbnad S ,000
Excase Liability
CJ Commercial Blanket Excess
Even oaarebnaalayyrepem S 1000
Other (Miscellane sue Coverages)
DESCRIPTION OF OPERATIONS I LOCKnONa/ VEHICLESIH IOTIWS I SP12CIALff Ns t me.ndm"l Of panrera ahova, a a waned ❑cave 0W. nw
elected to be cevaatl As emplgeee under this policy
t t Prod«n Canpalad Op..M .c aggregate te equal b earn
aoa. ranca Gant and is Inchood In pouq aggregate
;:cEq�7 ICpyi p ' A lull D7iE_SS?"•,,,,+ t; ti ' •z
PLJ < :: LN E r ){71A-1 F-. • =. • <7
• CITY OF FORT COLLINS
CITY OF FOR
Should any of me above described riciae be cancelled before the
expiration date thereof, the company will endeavor to mail'( days)
DIVISION
cannon nonce to the Cerafteste Holder named, but failure to mail such
PO BOX 580
noticeshallImpose obligation or hablrity of any itind upon the
•10
FT CO 80522
tsno
or representatives days unless different
number of days
COLLINS,
shown
® This candies coverageon the date of Issue only The above
described policies are subject to cancellation in conformity with their
!eons and Dy the laws of the is of I e.
P4
.
A ZED NTATIVE
01/10/2008
17
LI-201 Ed 5/00 Certificate Holder O Stock No 0615118 Rev 7/02