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Home My WebLink About119979 QUALITY TRAFFIC CONTROL - INSURANCE CERTIFICATE (6)ACORD CERTIFICATE OF LIABILITY INSURANCE OPID BA DATE IMMIDD YYYI T, P, 07 OB OB PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LEN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A'. Mountain States Insurance Grp INSURER B: PinnB.001 Assurance Quality Traffic Control, Inc. ------ --- _ _------ — Mlke Obester INSURER C: For RaollinsO Drive 05 #5 INSURER D: Fort Collins CO 80524 ---- -- ----- — -- INBURERE: 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. INSA LTR DD'L NSft __— OF POLICY NUMBER POLICY EFFECTIVE -TYPE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE s500,000 A X COMMERCIAL GENERAL LIABILITY CPP 009571406 07/27/08 07/27/09 _ PREMISESGETURENTErence) 5100,000 CLAIMS MADE .X IOCCUR MED EXP(An, one person) $10,000 PERSONAL&ADV INJURY S500,000 GENERM-AGGREGATE $1,000,000 _ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $1,000,000 POLICY PRO- ECT OC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIREDAUTOS BODILY -- NONOWNED AUTOS (Per accitlentd.rt) p $ PROPERTY DAMAGE $ (Per as dent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHERTHAN EA ACC $ ANY AUTO _ S AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ S DEDUCTIBLE RETENTION S $ WORKERS COMPENSATION AND TH TORV LIMITS ATU ER vv�3087822 R EMPANY 04/01/08 04/01/09 E.L.EACHACCIDENT $100000 PRERSLIABILITV ANY PROPRIETORIPXCLUD /EXECUTIVE E.L. DISEASE - EA EMPLOYEE _. _ $ 100000 OFFICER/MEMBER EXCLUDED? II yes, aesviue__- EL. DISEASE -POLICY LIMIT - $Ij00000 SPECIALPROVISIONSbeIpW OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS All Locations / Traffic Control Operations V c.�IIrIVHIG IIVI-V G1� VHIYIiCLLH1IV IY 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 Fl IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR PO BOX 580 REPRESENTATIVES. Fort Collins, CO 80522 AUT @4l,?fdRESEV1AnTIVE' ni.,. n.I 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 CERTIFICATE OF LIABILITY INSURANCE OR ID BA DATE(MMIDB/YYYY) UALI-6 07 O8 OB PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAIC# INSURI ED -E -- --"___ .___..._...__.._-. PN13URER 8: pualityY Traffic Control, Inc. URERc: Bike Obester 216 Racquette Drive #5 URER DFort Collins CO 80524--- 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 POLICY EFFECTIVE PATE MMIDDIYV POLICTEXPIRATION DATE MMIDO/VY ............. LIMITS GENERAL LIABILITY EACH OCCURRENCE $500,000 A X COMMERCIALGENERALLIABILITY CPP 009571406 07/27/08 07/27/09 ED PREMISES (Ea ouurence) _ $100,000 CLAIMS MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY $500,000 GENERAL AGGREGATE $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1,000,000 POLICY PROECT- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accitlenQ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY $ — HIREDAUTOS NONOWNED AUTOS Peraccident) PROPERTY DAMAGE $ (Per aooid.nt) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC $ ANY AUTO AUTO ONLY: A G G S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND TORY LIMITS ER X EMPLOYERS' LIABILITY 3087822 04/01/08 04/01/09 E.L. EACH ACCIDENT --- - -- $100000 ANY PROPRIRIPARXECUTIVE E. L. DISEABE - EA EMPLOYE $ SOOOOO OFFICER/MEMB EXCLUDED? YES, describe under E.L. DISEASE -POLICY LIMIT $500000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS All Locations / Traffic Control Operations UtK I I1 1GA I t HULUtK GANGELLATION City of Fort Collins Purchasing Division P.O. Box 580 Fort Collins CO 80522 FTCOLLP I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOf DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 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 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.