HomeMy WebLinkAbout470559 J & A TRAFFIC PRODUCTS - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE
04/08/20 )
PRODUCER (913) 649-7800
THE GERHER INSURANCE GROUP
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5200 W. 94th TERRACE
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
SUITE 110
`PRAIRIE VILLAGE KS 66207-
INSURERS AFFORDING COVERAGE
NAIC #
INSURED ..
INSURER A: Hart ford Casualt >Ins. Co.--
INSURER B: Hartford Underwirters ,Iris-'-
�J & A TRAFFIC "PRODUCTS
INSURERC:
627 NW. VALLEY._RIDGE,,.... _...__
INSURER D.
INSURER E:
GRAIN VALLEY MO 64029-
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.
INSR
LTR
ADD'L
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MM/DD/YY)
POLICY EXPIRATION
DATE(MM/DD/YY)
LIMITS
GENERAL LIABILITY
37SBAAK7590
09/24/2010
09/24/2011
EACH OCCURRENCE
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
PREMISES Ea o¢urrence
a 300,000
A
CLAIMS MADE FRI OCCUR
MED EXP (my oneperson)
$ 10,000
F ERSONAL E ADV INJURY
0 1,000,000
GENERALAGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s 2,000,000
X POLICY JE� I LOC
AUTOMOBILE
LIABILITY
ANY AUTO
09/24/2010
09/24/2011
COMBINED SINGLE LIMIT
(Ea accident))
6 1,000,000
BODILY INJURY
(Per Person) -
5 >
ALL OWNED AUTOS
SCHEDULED AUTOS - _ ...
_'
. -
X
BODILY INJURY.
(Per accident)
,A
L
HIRED AUTOS
NON -OWNED AUTOS
"." �
I''�^-!'"'"
'-
X
PROPERTY DAMAGE
'(Per accident)
....
'.'.�•.. �`
I -I-
GARAGELIABILITY "'
F
`1 '.
AUTO ONLY-EAACMDENT
$ - -' - -
OTHER THAN EA ACC
$ '
ANY AUTO _ _ _
_
$
-
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR F-ICI-AIMS MADE
AGGREGATE
$
a
5
DEDUCTIBLE
-
5
RETENTION $
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
37WECKD7371
10/28/2010
10/28/2011
X TORYLIMITS T
ER
E.L. EACH ACCIDENT
$ 100,000
E.I. DMEASC-EAEMPLOYEE:
100,000
OFFICEFUMEFABFR EXCLUDED?
-
/
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT Is
500,000
OTHER
DESCRIPTION OF OPER nONSILOCAMONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Fort Collins is an Additional Insuredwhererequired by written contract.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Purchasing Dept. EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
City of Fort Collins FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
215 N. Mason INSURER, ITS AGENTS OR REPRE ENTATIVES.
2nd Floor AUUQRLZED REPRESENrATIV
Fort Collins CO 80524- LjQ4
ACORD 25 (2001/08) TJ ACORD CORPORATION 1988
{p
V6 INS025 (=8).o5 ELECTRONIC LASER FORMS, INC. - 800)327-0545 Page 1 of 2
ACORD CERTIFICATE OF LIABILITY INSURANCE
04/08/20 )
PRODUCER (913) 649-7800
THE GERHER INSURANCE GROUP
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5200 W. 94th TERRACE
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
SUITE 110
`PRAIRIE VILLAGE KS 66207-
INSURERS AFFORDING COVERAGE
NAIC #
INSURED ..
INSURER A: Hart ford Casualt >Ins. Co.--
INSURER B: Hartford Underwirters ,Iris-'-
�J & A TRAFFIC "PRODUCTS
INSURERC:
627 NW. VALLEY._RIDGE,,.... _...__
INSURER D.
INSURER E:
GRAIN VALLEY MO 64029-
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.
INSR
LTR
ADD'L
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MM/DD/YY)
POLICY EXPIRATION
DATE(MM/DD/YY)
LIMITS
GENERAL LIABILITY
37SBAAK7590
09/24/2010
09/24/2011
EACH OCCURRENCE
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
PREMISES Ea o¢urrence
a 300,000
A
CLAIMS MADE FRI OCCUR
MED EXP (my oneperson)
$ 10,000
F ERSONAL E ADV INJURY
0 1,000,000
GENERALAGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s 2,000,000
X POLICY JE� I LOC
AUTOMOBILE
LIABILITY
ANY AUTO
09/24/2010
09/24/2011
COMBINED SINGLE LIMIT
(Ea accident))
6 1,000,000
BODILY INJURY
(Per Person) -
5 >
ALL OWNED AUTOS
SCHEDULED AUTOS - _ ...
_'
. -
X
BODILY INJURY.
(Per accident)
,A
L
HIRED AUTOS
NON -OWNED AUTOS
"." �
I''�^-!'"'"
'-
X
PROPERTY DAMAGE
'(Per accident)
....
'.'.�•.. �`
I -I-
GARAGELIABILITY "'
F
`1 '.
AUTO ONLY-EAACMDENT
$ - -' - -
OTHER THAN EA ACC
$ '
ANY AUTO _ _ _
_
$
-
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR F-ICI-AIMS MADE
AGGREGATE
$
a
5
DEDUCTIBLE
-
5
RETENTION $
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
37WECKD7371
10/28/2010
10/28/2011
X TORYLIMITS T
ER
E.L. EACH ACCIDENT
$ 100,000
E.I. DMEASC-EAEMPLOYEE:
100,000
OFFICEFUMEFABFR EXCLUDED?
-
/
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT Is
500,000
OTHER
DESCRIPTION OF OPER nONSILOCAMONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Fort Collins is an Additional Insuredwhererequired by written contract.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Purchasing Dept. EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
City of Fort Collins FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
215 N. Mason INSURER, ITS AGENTS OR REPRE ENTATIVES.
2nd Floor AUUQRLZED REPRESENrATIV
Fort Collins CO 80524- LjQ4
ACORD 25 (2001/08) TJ ACORD CORPORATION 1988
{p
V6 INS025 (=8).o5 ELECTRONIC LASER FORMS, INC. - 800)327-0545 Page 1 of 2
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.
ACORD 25 (2001/08)
*, INS025 pioe)A5 Page 2 of
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.
ACORD 25 (2001/08)
*, INS025 pioe)A5 Page 2 of