HomeMy WebLinkAbout105396 TRAFFIC MASTERS - INSURANCE CERTIFICATE (7)ACORD- CERTIFICATE OF LIABILITY INSURANCE 05/18/06DN"'")
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood 8r Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Employers Mutual Casualty Company
Traffic Masters, Inc. INSURERB: Pinnacol Assurance
1304 Duff Drive #14 INSURER C:
Ft. 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
NSR
TYPE OF INSURANCE
POLICY NUMBER
ICY
PDA E IMWDDIYYE
POLICY
DATE MMIDD/YY N
LIMITS
A
GENERALUABILITY
3X39058
05/30/06
07/14/06
EACH OCCURRENCE
$1 000 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 51OCCUR
DAMAGE TO RENED
PREMISE (E.
$1 OO OOO
MED EXP (Any one person)
$5 000
PERSONAL 8 ADV INJURY
$1 O0O OOO
GENERAL AGGREGATE
s2 OOO OOO
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
s2000000
POLICY JET LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
3X39058
05/30/06
07/14/06
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)
s
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESS/UMBRELLA LIABILITY
3X39058
05/30/06
07/14/06
EACH OCCURRENCE
$1 000 000
X I OCCUR CLAIMS MADE
_
AGGREGATE
$1 OOO 000
$
$
DEDUCTIBLE
$
X RETENTION $ 10000
B
WORKERS COMPENSATION AND
4058170
06/01/06
06/01/07
X wesrATu- ER
LIMI
EMPLOYERS' UABIUTY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
s500 000
E.L. DISEASE - EA EMPLOYEE
s500,000
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
City of Ft. Collins is listed as Additional Insured where their interest
may appear.
City of Fort Collins
ATTN: Purchasing
PO Box 580
Fort Collins, CO 80522
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 'In DAYS WRITTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
AUTHORIZED REPRESENT nnTIVE
F 6,,ek 'r /'.trtcl s o.%1 ,riot ✓e A.*J C.A , TAj e .
AGUIZD 25 (ZUUI/UB) 1 of 2 #M347222 KLB 9 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 25S (2001/08) 2 of 2 #M347222