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HomeMy WebLinkAboutFIRST STUDENT INC - INSURANCE CERTIFICATE (4)1 '0 CERTIFICATE OF LIABILITY INSURANCE DATE (MM DD/Y 12/16/1201YY1� 12/16/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER 1-212-994-7100 CONTACT NAME: Arthur J. Gallagher Risk Management Services, Inc. PHONE 212-994-7100 FAX 212-994-7047 N A/C No E-MAIL ADDRESS: 444 Madison Avenue 20th Floor PRODUCER CUSTOMER ID Ill: New York, NY 10022 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: INSURANCE CO OF THE STATE OF PA 19429 INSURER B: NATIONAL UNION FIRE INS CO OF PITTS 19445 FIRST STUDENT INC INSURERC: NEW HAMPSHIRE INS CO 23841 600 Vine St INSURER D: Ste 1400 CINCINNATI, OH 45202 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 18735381 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUER POLICPOLICY NUMBER MM/ DY EFF MMIDPOLICY EXP D LIMITS A GENERAL LIABILITY GL1737923 (10MM AGG) 12/31/1 12/31/11 EACH OCCURRENCE $ 5,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR DAMAGE To RENED PREMISES Ea occurrence) $ 5,000,000 MED EXP (Any one person) $ 50,000 PERSONAL & ADV INJURY $ 5,000,000 GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 5,000,000 POLICY PRO-JECT X LOC $ B B B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS CA5273862 (MA) CAS273864 2738 CAVA)) (((VA 12/31/1 12/31/1 12/31/1 12/31/11 12/31/11 12/31/11 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ X NON -OWNED AUTOS UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DEDUCTIBLE $ $ RETENTION $ C C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN (MandatoryOFFICER/MEMBER EXCLUDED7 (Mandatory in NH) NIA 1178527(FL) 6 1232492(TX 1178583(AOS) 117853l(IL,NY),1232493(W 12/31/1 12/31/1 ) 12/31/1 12/31/11 12/31/11 12/31/11 X WCSTATU- OR A E.L. EACH ACCIDENT $ 5,000,000 E.L. DISEASE - EA EMPLOYEE $ 5,000,000 C If yes, describe under DESCRIPTION OF OPERATIONS below 117 85 30(MA), 1178529 ( ) 12/31/1 12/31/11 E.L. DISEASE - POLICY LIMIT $ 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Location # 5955 - NFRMPO, the cities of Greeley, Loveland, and Johnstown and the Counties of Larimer and Weld are shown as additional insureds solely with respect to the General and Auto liability as evidence herein as required by written contract with respect to work performed by the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NFRMPO Transit Service THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Jame B. O'Neill 215 North Mason Street - 2nd. Flr Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE USA IcF— tanstep ACORD 25 (2009/09) 18735381 ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD �� �® CERTIFICATE OF LIABILITY INSURANCE 12/l6/220/ 0 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER 1-212-994-7100 CONTACT - NAME: Arthur J. Gallagher Risk Management Services, Inc. PHONN E 212-994-7100 a Ne;212-994-7047 E-MAIL ADDRESS: 444 Madison Avenue 20th Floor PRODUCER New York, NY 10022 CUSTOMER ID INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: INSURANCE CO OF THE STATE OF PA 19429. INSURER B: NATIONAL UNION FIRE INS CO OF PITTS 19445 FIRST STUDENT INC INSURERC: NEW HAMPSHIRE INS CO 23841 600 Vine St INSURERD: Ste 1400 CINCINNATI, OR 45202 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 18735816 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR EXP POLICY NUMBER MM DDY EFF MM DO LIMITS A GENERAL LIABILITY GL1737923 (10MM AGG) 12/31/1 12/31/11 EACH OCCURRENCE $ 5,000,000 % COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 5,000,000 MED EXP (Any one person) $ 50,000 PERSONAL BADVINJURY $ 5,000,000 GENERAL AGGREGATE $ 10,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 5,000,000 POLICY JFCT PRO X LOC $ B B B AUTOMOBILE X LIABILITY ANY AUTO CA5273862 (MA) CA5273859 (AOS) CA5273864 (VA) 12/31/1 12/31/1 12/31/1 12/31/11 12/31/11 12/31/11 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ X NON -OWNED AUTOS UMBRELLA LIAB FOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ C C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A 1178527(FL) 6 1232492(TX 1178583(AOS) 1178531(IL,NY),1232493(W 12/31/1 12/31/1 )12/31/1 12/31/11 12/31/11 12/31/11 X WcsTATU- OETH- Ylll!TS1R E.L. EACH ACCIDENT $ 5,000,000 E.L. DISEASE - EA rMPLOYEd $5,000,000 IfiC Dyes deTIONunder DESCRIPTION OF OPERATIONS below 117 85 30(MA), 1178529( ) 12/31/1 12/31/11 E.L. DISEASE -POLICY LIMIT $ 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) NFRMPO, the cities of Greeley, Loveland, and Johnstown and the Counties of Larimer and Weld are shown as additional insureds solely with respect to the General and Auto liability coverages as evidenced herein as required by written contract with respect to work performed by the named insured. VAI7 V CLLA 11%JN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NFRMPO Transit Service THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Jame B. O'Neill 215 North Mason Street - 2nd. Flr AUTHORIZED REPRESENTATIVE Fort Collins, CO 80524 USA�— tanstep © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 18735816