The URL can be used to link to this page

Home My WebLink About119979 QUALITY TRAFFIC CONTROL - INSURANCE CERTIFICATE (22)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID P DATE (MM/DD/YYYY) UALI-6 OS 11 O5 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agency -PC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1614 Oakridge Drive, Unit A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80525 Phone:970-229-9304 Fax:970-229-1398 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Mountain States Insurance Grp INSURER B: uality Traffic Control, Inc. Ike ODester INSURER C: 216 RaCquette Drive #$ Fort Collins CO 80524 INSURER D: INSURER E: COVERAGES 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. LTR NS TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE MMIDD/W DCY EXPIRATION ATE MMIDDlYY LIMITS A GENERAL LIABILITY X COMMERCIALGENERALLIABILITY CLAIMS MADE FK OCCUR CGL009571402 07/27/05 07/27/06 EACH OCCURRENCE s 500 , OOO PREMISES (Ea occurence) $100,000 MED EXP (Any one person) $ 10 , 000 PERSONAL &ADV INJURY $500,000 GENERAL AGGREGATE $ 1 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PROECT LOC J PRODUCTS - COMP/OP AGG $1,000, 000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY OCCUR El CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? It yes, describe under SPECIAL PROVISIONS below TORY LIMITS I I ER E.L_EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDEO BY ENDORSEMENT / SPECIAL PROVISIONS All Locations / Traffic Control Operations CERTIFICATE HOLDER CANCELLATION FTCOLLP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Fort Collins Purchasing Division 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 AGENTS OR P.O. Box 580 REPRESENTATIVES. AU RIZ REPRES CAJ�^�+/ Fort Collins CO 80522 AGUKU 25 (200110B) C ACORD CORPORATION 1988 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 (2001/03) R ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID P DATE IMWDDNYYY) 11 UALI-6 08 11 05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agency-FC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1614 Oakridge Drive, Unit A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80525 Phone:970-229-9304 Fax:970-229-1398 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Nountain states Insurance Grp INSURER B: TualitKy Traffic Control, Inc. Dke 0 ester 216 R8Cgu9tte Drive #5 Fort Collins CO 80524 INSURER C: INSURER D: INSURER E: COVERAGES 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. IN3K LTR ROU INSIR TYPE OF INSURANCE POLICY NUMBER POLICY DATE MDD/YY EFFECTIVE M/ POLICY EXPIRATION DATE MM/DD/YY LIMITS A 1-1 GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X❑ OCCUR CGL009571402 07/27/05 07/27/06 EACH OCCURRENCE $500000 PREMISES(Eeoccur�ence) $100,000 MED EXP (Any one person) S 10,000 PERSONAL &ADV INJURY $500,000 GENERAL AGGREGATE $1 0001000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO POLICY PRO LOC PRODUCTS - COMP/OP AGO $ 1,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANYAUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ S $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? if yes, describe under SPECIAL PROVISIONS below TWL; LIMITS ER E.L. EACH ACCIDENT E E.L. DISEASE - EA EMPLOYEEI S E.L. DISEASE - POLICY LIMIT I $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS All Locations / Traffic Control Operations CERTIFICATE HOLDER CANCELLATION CITYOF3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN City Of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn: Purchasing Division 215 North Mason Street, 2nd F1 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR PO BOX 580 REPRESENTATIVES. AU ¢ REPRE 0 Fort Collins, CO 80522 ACORD 25 (2001/08) C ACORD CORPORATION 1988 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. 25