HomeMy WebLinkAbout110520 TRAFFIC SIGNAL CONTROLS INC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE
05-10-2011
THIS CERTIFICATEIS 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 SUBROGATIONIS 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
CON A
NAME:
HARTFORD FIRE INSURANCE COMPANY
PHONENo, Eztl: PAX
(A/C, No):
250760 P: O - F: O —E-MAIL
PO BOX 33015
ADDRESS:
PRODUCER
SAN ANTONIO TX 78265
CUSTOMER ID#:
INSURER(S)AFFORDING COVERAGE
NAIC#
INSURED
INSURER A: Multiple Companies
INSURER B
TRAFFIC SIGNAL CONTROLS, INC.
255 WEAVER PARK RD. STE 100
INSURER C:
LONGMONT CO 80501
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.
TR
TYPE OF INSURANCE
INSfl
WVDICY
POLICY NUMBER
(MM/DD/YYYY)
EXP
IMMLDD/VYYV)
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
-I CLAIMS -MADE U OCCUR
EACH OCCURRENCE $
PREMISES (Ea occurrence) I $
VIED EXP (Any one person) I $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER:
_ POLICY U JECT U LOC
PRODUCTS - COMP/OP AGG
$
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
E. accident)
I $
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
S
UMBRELLA LIAB U OCCUR
EXCESS LIAB CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBL
RETIE TIONE $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? U
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
76 WEG RQ1437
07/01/2011
07/01/2012
X WC STATU- OTH-
TORY LIMITS ER
E.L. EACH ACCIDENT
$ 100, 000
E.L. DISEASE EA EMPLOYE
$ 100,000
E.L. DISEASE -POLICY LIMIT
I S 500, 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101. Additional Remarks Schedule, it more space is required)
Those usual to the Insured's Operations.
CERTIFICATEHOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
City of Fort Collins
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZE REPRESENTATIVE
215 N MASON ST FL 2
FORT COLLINS, CO 80524
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