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Home My WebLink AboutECONOLITE - INSURANCE CERTIFICATEACORQM CERTIFICATE OF LIABILITY INSURANCE °�Y' 04/29/0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Armstrong/Robitaille Bus&lnsSv 680 Lan 5dorf Drive #100 g ONLY AND CONFERS NO RIGHTS HOLDER. THIS CERTIFICATE DOES ALTER THE COVERAGE AFFORDED UPON THE CERTIFICATE NOT AMEND, EXTEND OR BY THE POLICIES BELOW. PO Box 34009 Fullerton, CA 92834-9409 INSURED - — ___ - Econolite Control Products, Inc. California Chassis, Inc 3360 E. La Palma Avenue Anaheim, CA 92806 COVERAGES INSURERS AFFORDING COVERAGE INSURER A: Federal Ins. Co/Chubb INSURER B: INSURER C: INSURER D: INSURER E: 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. --- ---- NSR POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY DATE MMA)DIYY LIMITS A GENERAL LIABILITY 35818716 04/27/04 04/27/05 EACH OCCURRENCE $1 000 000 _ X COMMERCIALGENERALLIABILITY FIREDAMAGE(Anyonetire) $1,000,000 CLAIMS MADE X J OCCUR MED EXP (Any one person) $10,000 PERSONAL& ADV INJURY GENERAL AGGREGATE $1,000,000 — —{I $2�OQ0�0 _ I PRODUCTS -COMP/OP AGG GEN'L AGGREGATE LIM ITAPPLIES PER: $1,000,000 POLICY X PE : X LOG A AUTOMOBILE LIABILITY ANY AUTO 73215072 04/27/04 04/27/05 COMBINED SINGLE LIMIT (Ea accident) $1,1)�0,000 X ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ BODILY INJURY X HIREDAUTOS X NON -OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ $ ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE _ $ $ $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC U- RHt $ E.L. EACH ACCIDENT IEA E.L.DSEASE EMPLO€ ONEE $ $Li E.L. DISEASE -POLICY LIMIT OTHER DESCRIPTION OF OPERATIONSrLOCATIONS)VEHVCLESMXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The City of Fort Collins, its officers, agents are named as Additional Insured, as respects general liability,as required by written contract per form 17023080-0401 attached. City of Fort Collins, CO Attn: Mr. James B. O'Neil, III P.O. Box 580 Fort Collins, CO 80522 SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30__ DAYSWRITTEN NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUT FAILURE TO DOSOSHALL IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURE R,ITS AGENTS OR rta.vnu"a % flat) I OT-1 iFM-LSIVZV LLU u N.wnu �.unrunw I%Vr+ I VIM 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 25S (7/9T -) . F n 1C cFIUBB Who Is An Insured Employees (continued) Policy Number: NHN211682 General Liability Policy Period: 04/27/04 to 04/27/05 • your employees, as insureds, with respect to such damages caused by cardio- pulmonary resuscitation or first aid services administered by such employee. B. property damage to any property owned, occupied or used by you or by any of your directors, managers, members, officers or partners (whether or not an employee) or by any of your employees. This limitation does not apply to property damage to premises while rented to you or temporarily occupied by you with permission of the owner. '-'• ,...:: rAt ,e: .... .:�:r t :.. F:: s..2.. i L .. 'r:< <i.. ...a. acts. ...... .. ..„.,:�3....<.. Volunteers Persons who are volunteer workers for you are insureds; but they are insureds only for acts within the scope of their activities for you and at your direction. YC Real Estate Managers Persons (other than your employees) or organizations acting as your real estate managers are Insureds; but they are insureds only with respect to their duties as your real estate managers. . .: ,jai , ,: .. .. .,....r .. ,,... ., ... ..,.:.: ., v. ..-..:.'. .. .::- Permissive Users Of With respect to mobile equipment registered in your name under a motor vehicle registration law: Mobile Equipment A. persons driving such equipment on a public road with your permission are Imureds; and B. persons or organizations responsible for the conduct of such persons described in subparagraph A. above are insureds; but they are insureds only with respect to the operation of the equipment and only if no other insurance of any kind is available to them However, no person or organization is an insured with respect to: bodily Injury ro any co -employee of the person driving the equipment; or property damage to any property owned or occupied by or loaned or rented to you, or in your charge or the charge of the employer of any person who is an insured under this provision. Vendors Persons or organizations who are vendnrs of your products are iasuredr; but they are issareds only with respect to their liability for damages for bdddy injury or property damage resulting from the distribution or sale of your products in the regular course of their business and only if this Insurance applies to the products -completed operations hazard. However, no such person or organization is an Insured with respect to any: • assumption of liability by them in a contract or agreement, This limitation does not apply to the liability for damages for bodily injury or property damage that such vendor would have in the absence of such contract or agreement; representation or warranty unauthorized by you; • physical or chemical change in your products made intentionally by the vendor; • repackaging, unless unpacked solely for the purpose of inspection, demonstration or testing, or the substitution of parts under instruction from the manufacturer and then repacked in the original container, LieWpytnnwwwr Farm 17-02.3080(Rev.4-01) t:ortbaet Page7cf32 Who s An Insured Vendors failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to (continued) make or normally undertakes to make in the usual course of business in connection with the distribution or sale of your products; demonstration, installation, servicing or repair operations, except such operations performed at the vcndofs premises in connection with the sale of your products; or of your products which, after distribution or sale by you, have been labeled or relabeled or used as a container, ingredient or pan of any other thing or substance by or for the vendor. Further, no person or organization from whom you have acquired your products, or any container, ingredient or part entering into, accompanying or curtaining your products, is an iastred under this provision. :.. w'.:.... ">;,.i..i=. K.xk Lessors Of Equipment Persons or organizations from whom you lease equipment are insureds; but they are insureds only with respect to the maintenance or use by you of such equipment and only if you are contractually obligated to provide them with such insurance as is afforded by this contract. However, no such person or organization is an Insured with respect to any: damages arising out of their sole negligence; or occurrence that occurs, or offense that is conunided, after the equipment lease ends. >f ... Lessors Of Premises Persons of organizations from whom you lease premises are insureds; but they are insureds only with respect to the ownership, maintenance or use of that particular part of such premises leased to you and only if you are contractually obligated to provide them with such insurance as is afforded by this contract. However, no such person or organization is an insured with respect to any; damages arising out of their sole negligence; occurrence that occurs, or offense that is committed, after you cease to be a tenant in the premises; or structural alteration, new construction or demolition operations performed by or on behalf of them. 7":x •f >z f.:.::> .z,. ;�L J:i ....,b !.:< .;!. .ti>.4'M :$vZ. ,H £< £3.,i.,y:"'8a i�.?.: :>.ez y. ,. do>:5.<� .-.-.. :!:.:Ya$..3a.'. X;;'?.. 3t. t _vr`<.4.l. -•„ Subsidiary Or Newly If there is no other insurance available, the following organizations will qualify as named iusaeds; Acquired Or Forted a subsidiary organization of the first named insured shown in the Declarations of which, at Onganizagons the beginning of the policy period and at the time of loss, such first named Insured controls, either directly or indirectly, more than fifty (50) percent of the interests entitled to vote generally in the election of the governing body of such organization; or a subsidiary organization of the fir named lu oured shown in the Declarations that such first oamcd insured acquires or forms during the policy period, if at the time of loss such first named insured controls, either directly or indirectly, time than fifty (50) percent of the interests entitled to vote generally in the election of the governing body of such organization. Lklb ty tnamanca Farm r7-07.30do (Rev. "t) Gbnrreef 1`996 8 of 32 ACORQM CERTIFICATE OF LIABILITY INSURANCE oaz9/ 4D""' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Armstrong/Robitaille Bus&InsSv ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 680 Langsdorf Drive #100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 34009 Fullerton, CA 92834-9409 INSURED Econolite Control Products, Inc. California Chassis, Inc 3360 E. La Palma Avenue i Anaheim, CA 92806 AGES INSURERS AFFORDING COVERAGE INSURER A: Federal Ins. Co/Chubb INSURER B: INSURER C: INSURER D: INSURER E: 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. DATE MMIDDlYY DATE MM/DDlYY LTR TYPE OF INSURANCE PODCY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY 35818716 04/27/04 04/27/05 EACH OCCURRENCE $1 OOO,OOO F�DAMAGE (Any onefire) $1,000,000 X COMMERCIAL GENERAL LIABILn Y MED EXP (Any one person) CLAIMS MADE 1XI OCCUR $10,000 PERSONAL&ADV INJURY $11000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS -COMP/OP AGG GE_N'L AGGREGATE LIM IT APPLIES PER: $1,000,000 POLICY X JECT X Lix-- A AUTOMOBILE LIABILITY '73215072 ANY AUTO 04/27104 04/27/05 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 r EXCESS LIABILITY EACH OCCURRENCE $ _— AGGREGATE $ OCCUR u CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- ITOR_V LIMI7 - _. ,_ER_ EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONS(VEHICLEStEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE:City of Fort Collins video Project The City of Fort Collins, it's officers, agents and employees are named as Additional Insured, as respects to General Liability, as required by written contract per form 17023080-0401 attached. City of Fort Collins,CO Director of Purchasing & Risk Management P.O. Box 580 Fort Collins, CO 80522 SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYSWRITTEN NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR ACORD 25-S (7/97)1 Of 2 #M237929 LLO 0 ACORD CORPORATION 19M 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. ACORD25-S(7/97)2 of 2 #M237929 1CGeneral Liability cHuas Who Is An Insured Policy Number: NHN211682 Policy Period: 04/27/04 to 04/27/05 Employees your employees, us inarreds, with respect to such damages caused by cardio- (continued) pulmonary restiacitation or first aid services administered by such employee. B. property damage to any property owned, occupied or used by you or by any of your directors, managers, members, a0mrs or partners (whether or not an employee) or by any of your employees. This limitation does not apply to property damage to premises while rented to you or temporarily occupied by you with permission of the owner. Volunteers Persons who are volunteer workers for you are insureds: but they are htsareds only for acts within the scope of their activities for you and at your direction. . •: •�:; .Y i2 .si... {i'.. ... ,)). ,g.n.: ..n ..Y..". y{F. S-:s.. ..e ..... S:':`i >! fEs'..:y Real Estate Managers Persons (other than your employees) or organizations actingasyour real estate managers are fosireds; but they are iasareds only with respect to their duties as your real estate m nagers. .... ,,..., s .° .... ... .... ... Permissive Users Of With respect to mobile equipment registered in your name under a motor vehicle registration law: Mobile Equipment A. persons driving such equipment on a public road with your permission are insureds; and B. persons or organizations responsible for the conduct of such persons described in subparagraph A. above are insnredr, but they are insureds only with respect to the operation of the equipment and only if no other insurance of any kind is available to thent. However, no person or organization is an insured with respect to: bodily Injury to any co -employee of the person driving the equipment; or property damage to any property owned or occupied by or loaned or rented to you, or in Your charge or the charge of the employer of any person who is an insured tinder this provision. -.r, ......„ ..: s, , ...:.Mr 4 .,.,:.r-::, , .V. t" ), %,'- . >.,.es. ..v�.A•as.x '. x,,.,a s3ia7.a. <, x. S a..r E < J Vendors Persons or organizations who are vendors of your products are htsuredr. but they are insureds only with respect to their liability for damages for badly Injury or property dansage resulting from the distribution or We of your products in the regular course of their business and only if this Insurance applies to the products -completed operations b utard. However, no such person or organization is an Insured with respect to any: • assumption of liability by them in a contract or agreement, This limitation does not apply to the liability for damages for bodily injury or property damage that such vendor would have in the absence of such contract or agreement; • representation or warranty unauthorized by you; • physical or chemical change in your products made intentionally by the vendor; • repackaging, unless unpacked solely for the purpose of inspection, demonstration or testing, or the substitution of parts under instruction from the manufacturer and then repacked in the original container, tieblsytnstvancs Form r 7-02 _3090 (Rev. 4-01) Comma Page 7 of 32 Who rs An insure Vendors failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to (continued) make or normally undertakes to make in the usual course of business in connection with the distribution or sale of your products; demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of your products; or of your products which, after distribution or sale by you, have been labeled or relabeled or used as a container, ingredient or part of any other thing or substance by or for the vendor. Further, no person or organization from whom you have acquired your products, or any container, ingredient or pan entering into, accompanying or containing your products, is an insured under this provision. Lessors Of Equipment Persons or organizations from whom you lease equipment are insureds; but they are insureds only with reaped to the maintenance or use by you of such equipment and only if you are contractually obligated to provide them with such insurance as is afforded by this contract. However, no such person or organization is an insured with respect to any: damages arising out of their sole negligence; or occurrence that occurs. or offense that is committed after the equipment lease ends_ :S.r?fx,` Lessors Of Premises Persons or organizations from whom you lease premises are insureds; but they are insureds only with respect to the ownership, maintenance or use of that particular part of such premises leased to you and only if you are contractually obligated to provide them with such insurance as is afforded by this contract. However, no such person or organization is an insured with respect to any: damages arising out of their sole negligence; occurrence that occurs, or offense that is commined, after you cease to be a tenant in the premises; or structural alteration, new construction or demolition operations performed by or on behalf of them. £sz$'":L .o..:.. 1!1:. ..:.:,<-x.--!:'..Vgni4.k:x'.<T,Y,.rs'R z.. :3 (P . p .:..h'i.i:ii e.n ..><,.fi 2?v--.:. dr: ♦-:.�..ni.;t . 1.: ?k 0. .>Y<« ,. •.:: ':: Subsidiary Or Newly If there is no other insurance available, the following organizations will qualify as named insureds: Acquired Or Formed a subsidiary organization of the first named insured shown in the Declarations of which, at Organizations the beginning of the policy period and at the time of loss, such first named Insured controls, either directly or indirectly, more than fifty (50) percent of the interests entitled to vote generally in the election of the governing body of such organization; or a subsidiary organization of the first named Insured shown in the Declarations that such first named insured acquires or forms during the policy period, if at the time of loss such first named insured controls, either directly or indirectly, more than fifty (50) percent of the Interests entitled to vote generally in the election of the governing body of such organization. S.. .a. .: ,:,;< ,. ,. .:an.:R .:;.::.;, sees: :sett ::. .. .;.:x,: A:.+L� .. t:aEi; ..:.:,.-'. f: ,: �e„, s ,,.a'. ;.;».2 :.-e'.x., .�.:. •p RE ,s. _...,,x. ix < ,:sees Llsb* Insurance Form y7-a•3aeo (Ray. 4-0t) Cannel Page 8 of 32