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Home My WebLink About119979 QUALITY TRAFFIC CONTROL - INSURANCE CERTIFICATE (16)OP ID: BA ACORO" CERTIFICATE OF LIABILITY INSURANCE DATYYYY) 03122 D3122/11 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 endorsements . PRODUCER 970-635-9400 PFS Insurance Group -JT 970-635-9401 4848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 - TLC -Special Accounts CONTACT PNONE - - FAX - -- A/C No Ex[ : AIC No E-MAIL ADDRESS: PRODUCER _ CUSTOMER ID N: gUALI'6 - INSURER 3 AFFORDING COVERAGE NAIC P INSURED quality Traffic Control, Inc. Mike Obester 216 Racquette Drive #5 Fort Collins, CO 80524 INSURERA:Mountain States Insurance - INSURER B: Pinnacol Insurance 41190 INSURERC: INSURER D: INSURER E INSURER F nnVFRAr:FB CFRTIFICATF NIIMRFR- 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 ADD POLICY NUMBER DI'CyYYYY MMID MMIDDYEYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 500,000 A X COMMERCIAL GENERAL LIABILITY CPP009571408 07/27/10 07/27/11 PREMISES Ea occurrence) $ 100,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE OCCUR PERSONAL B ADV INJURY $ - 500,000 GENERAL AGGREGATE $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: — PRODUCTS - COMP/OP AGO $ 1,000,000 -- SJECT -- POLICY PRO- LOD - AUTOMOBILE LIABILITY - -. _ COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ANYAUTO BODILY INJURY (Per accident) $ ALL OWNED AUTOS PROPERTY DAMAGE (Per acciden) $ SCHEDULED AUTOS HIRED AUTOS $ NON -OWNED AUTOS E UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION WC AT STU- 'OTH-AND B EMPLOYERS' LIABILITY ANY PROPRIETOR,PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 4130969 04/01/11 04101/12 E.L. EACH ACCIDENT a 100,000 $ E.L. DISEASE - EA EMPLOYEE 100,000 E.L. DISEASE -POLICY LIMIT 1 E 500,000 If yes, descriTION OF OPERATIONS below be under DESCRIP DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 1D1, AddIlonal Remarks Schedule, It mom space Is required) All Locations / Traffic Control Operations CITYFOR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 300 LaPorte Ave Fort Collins, CO 80522 AUTHORIZED REPRESENTATNE bra n 19RR-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD OP ID: BA CERTIFICATE OF LIABILITY INSURANCE DAT03/22DYrrr) F 03/22/11 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 endorsements). PRODUCER - 970-635-9400 PFS Insurance Groupr JT _. _ - ... 4848 Thompson PkSte 200 970-635-9401 wy, Johnstown, CO 80534 TLC -Special Accounts CONTACT NAME: PNONE FAX A/c No Ext:INCNo E-MAIL PRODUCER CUSTOMER ,,:QUALI-6 INSURERS AFFORDING COVERAGE NAIC# INSURED Quality Traffic Control, Inc. INSURER A: Mountain States Insurance Mike Obester 216 Racquette Drive #5 Fort Collins, COB0524 INSURER B: PInnacol Insurance 41190 INSURER : INSURER D INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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 SUBS POLICY NUMBER POLICY EFF MMIDD YYYY POLICY EXP MM IDDYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE O OCCUR CPP 009571408 07/27/10 0712711, EACH OCCURRENCE $ 500,000 DAMAGE TO RENTED100,000 PREMISES Ea occurrence E MED EXP (Any one person) $ 10,000 PERSONAL BAOV INJURY $ 500,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC IFCT PRODUCTS - COMP/OP AGO $ 1,000,000 $ AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea BcG4ent) $ BODILY INJURY (Per person) $ BODILY INJURY (Per account) $ PROPERTY DAMAGE (Per amdent) $ $ $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY r/ ANY OFFICERIMEIMBEREXCTNERIE ECUTNE ON (Mandatory In NH) If yes. descrioe under DESCRIPTION OF OPERATIONS below N/A 4130969 04/01111 04/01/12 WC STATU- OTH- - E.L. EACH ACCIDENT $ 100,000 EL DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space is required) All Locations 1 Traffic Control Operations CITYOF3 City of Fort Collins Attn: Purchasing Division 215 North Mason Street, 2nd FI PO Box 580 Fort Collins„ CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE A 01988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD