HomeMy WebLinkAbout122004 SHAMROCK YELLOW CAB (DIAL-A-RIDE) - INSURANCE CERTIFICATEA� v® CERTIFICATE OF LIABILITY INSURANCE
�1r2011 ""Y'
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: N the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. N 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
Marsh USN Inc
TWO LOGAN SQUARE
COWACT
NAME
NE
A�iC, No FAX Mal:
EaIAIL
ADDRESS:
PHILADELPHIA, PA 19103-2797
INSU 11AFFORDING COVERAGE
NAICO
INSURER A: Old Republic Insurance Co
24147
390631-VT-01W-11-12 zoA— Ck
INSURED
""'Colorado Cab Company, LLC,
INSURER B:
dba Fort CXdlim Yellow Cab
INSURER c
INSURER D:
76M Fast 41sl AVmue
Denver, CO 80126
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: CLE-003729882-01 REVISION NUMBER:1
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
LTRJIM
TYPE OF INSURANCE
POLICY NUMBER
POLICY
ID EFF
MPOLICYDYY
Users
A
GENERAL LIABILITY
MWZY59146
071012011
071012012
EACH OCCURRENCE
S 500,WO
X COMMERCIALGENERAL LIABILITY
PREMISES Eaoov..
It 100,000
CLAIMS -MADE OCCUR
HIED EXP(My ore Panne(
$
PERSONAL A ADV INJURY
S 500'000
GENERAL AGGREGATE
f 500,000
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMPIOPAGG
S 500,000
X POLICY PRO' LOC
I
f
A
AUTOMOBILE
LIABILITY
MINTB 21267
07/012011
07101/2012
COMBINED SINGLE UNIT
Ea acidwd
$ 500,000
X
BODILY INJURY (Par person)
f
A
ANY AUTO
MWZX2%84
071012011
07ID12012
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per artiderV)
$
PROPERTY DAMAGE
nP.ecuiderd
f
NO"MED
HIREDAUTOS AUTOS
S
UMBRELLA UAS
EACH OCCURRENCE
S
AGGREGATE
$
EXCESS UAB
4MOCCUR
CLAIMSADE
DED RETENTIONS
S
A
YJORMERSCOMPENSATION
MWC11700100
07/012011
07/012012
X I V.0 STATU- OTH-
AND EMPLOYERS' WIBILITY YIN
ANY PROPRIETOR/PARTNEMEXECUTIVE�
OFRCERA.IEMBER EXCLUDED'!
(Mandatary In NH)
NIA
E.L. EACH ACCIDENT
f 100,000
E.L. DISEASE -EA EMPLOYEE
$ 500,000
H yes, dasai0a under
DESCRIPTION OF OPERATIONS W.ELDISEASE
-POLICY LIMIT
S 100,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Add0 1 Remarks S Ule, N more pace Is f"wrad)
Dal A Ride Service Contrad
The City of Fort Collins, Its officers, agents, and employees are included as a0itimal insured (except Workers' Compensation) where required by written contract
City of Fort Collins
Aftn: James ONal
215 Mason Street, 2nd Floor
Fort Collins, CO MM
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORED REPRESENTATIVE
of Marsh USA Inc.
Masashi Mukhertee _P'Lauaol.: ,J4A A,-a.,4a
01988-2010 ACORD CORPORATION. All rights I
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD