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HomeMy WebLinkAboutFIRST STUDENT INC - INSURANCE CERTIFICATE (5)P5N.U.,n2 `� oM CERTIFICATE OF LIABILITY INSURANCE O12/20IDDI11 1a/ao/aou 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 Arthur J. Gallagher Risk Management services, Inc. NAME: ____ ___ __ PHONE FAX 312 994-7100 212-994-7047 jAIC,No,Eat):,_-- �IAIC, No)_ _ E-MAIL — 250 Park Avenue 3rd Floor ADDRESS: New York, NY 10177 __ INSURERIS) AFFORDING COVERAGE NAIC II INSURER A: INSURANCE CO OF THE STATE OF PA 19429 INSURED INSURER B: NATIONAL UNION PIRG INS CO OF PITTS �— —HA 19445 FIRST STUDENT INC ------ ------ — INSURER C: NORW HAMPSHIAE INS CO IN - 33841 600 Vine St INSURER D: Ste 1400 CINCINNATI, OR 45202 INSURER —_ INSURER F: CVVt"Ll C1,KI11FICAlt NUMHER' e4bnUJb3 RFVIXION NIIMRFR. "U HIS ISTOGERI IFY THAT IHE POLICIES OF -INSURANCE LIS TEU'bELOW HAVE BEEN ISSUED 10'THE INSURED NAMED ABOVE -FOR 1HE POLICY FERIOD— 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. ILm TYPE OF INSURANCE iNSRIISVDI POLICY NUMBER I MMIODFFIYYTMOLIC Y LIMITS A GENERAL LIABILITY GL1737923 (10$at AGG) 12/31/1112/31/12 X COMMERCIAL GENERAL LIABILITY rV JCLAIMS MADE( - I OCCUR _EACHOCCURRENCE __$5,000,000 DAMAGE TO RENTED PREMISES(Eao4urrence)_ MEDEXP(AnymePerron) 5 000, 000 Is $50,000 $ 5,000,000 PERSONAL 4 ADV INJURY _ _--_ _ GENERAL AGGREGATE �10, 000, 000 GENT AGGREGATE POLICY LIMIT APPLIES PER �� PEcT RO LOG PRODUCTS-COMPIOP AGG $5, 00 0-0— B B B AUTOMOBILE % -- JL LIABILITY ANY AUTO ALLOS r— SCHEDULED AUTOS AUTOS HIRED AUTOS I X NON OWNED AUTOS ICA5273859 (ADS) CA5273862 (MA) G527386d (VA) / 12/31/11 12/31/12 l 13 /31/11 12/31/12 COMBINED SINGLE LIMIT (Eaaccigem)__---n)$—_ BODILY INJURY (Per person) —--------- I 5,000, ODO — $ BODILY INJURY (Per accident) ------ $ _ PROPERTY DAMAGE (Per aceialson) $ $---- - �_ UMBRELLA LIAO CLAIMS EACH 4 EXCESS L MADE I AGGR GA ERRENCE _I DEC RETENTI -- —.__ — Is C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORiPARTNEIVEXECUTIVE OFFICER?AEMBER EXCLUDED? N� NIA 1178530(NA), 1178529(CA) '178527(FL) , 1232492(TX) I 12/31/11 12/31/12 12/31/11 12/31/17 X WC STATU- OTBI _�TORYLIMITS _I_ER_I EL EACH ACCIDENT jS 5,000,000 —j— EL OISEAGE -EMPLOYEE$ 5,000,000 C C (Nvaonmbrym Ni OSCPoPTIO OF OP[MTIONsoelgw 1178531(IL, NY),1232493(WI 1178583 (ADS),44216117 (MN) 112/31/11 12/31/12 12/31/13 12/31/12I E.L. DISEASE -POLICYLIMITS5,000, _ 000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anach ACORD 101, Additional Remaha Schedule, If more space Is required) NFRNPO, 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. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Transit Sli lee .. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. : Jame B. O'Neill North Mason Street - 2nd. Flr AUTHORVED REPRESENTATNE Collins, CO 80524 I Q _eP�-��-_ I USA ©1988-2010 ACORD rici r.cerwod ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD muttuny 24550353 ''CC)R o" CERTIFICATE OF LIABILITY INSURANCE D1ATE 2/20/201Y) 12 (MMIDO1 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 Arthur J. Gallagher Risk Mang aemenc Services, Inc. NAME:------ __ PHONE 212-994-7100 FAX - (AIC,NO,E.U: I(VC, No)_ 712994-7047 250 Park Avenue --- EMAIL 3rd Floor ADDRESS:_ - New York, NY 10177 — INSURERS).MFORDING COVERAGE NAIC9 INSURER A: INSURANCE CO OF THE STATE OF PA 19429 INSURED INSURERS: NATIONAL. UNION FIRE INS CO OF PITTS -- 19445 FIRST STUDENT INC INSURERC: NEW nAtCPSHIRE INS CO 23841 INSURER D: 600 Vine BE Ste 1400 CINCINNATI, OR 45202 INSURER E: INSURER F COVERAGES CFRTIFICATF NLIMRFR• 24547699 Octaclnu unuoco. 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� TYPE OF INSURANCE �AODV SUBR' POLICY EFF POUCYEXP LTR 1 POLICY XUMBER NNIDDIYYYY MMIDDfIY Y�r LIMITS A GENERAL LIABILITY GL1737923 (10 M AGO) 12/31/11 12/31/12 EACHOCCURRENCE I S 5, 000, 000 % COMMERCIAL GENERAL LIABILITY CLAIMS MADE IJ OCCUR _ DAMAGETO RENTED PREMISES(Ea o¢urrmce)_ y MED EXP IAn one perwnl ___ -- S5, 000,000 f 50,000 $ 5,000,000 _ PERSONAL B ADV INJURY _ GENERAL AGGREGATE 10,000,000 GENL AGGREGATE UMIT APPLIES PER: ,a-1 ` 1 LOC I POLICY 17 FCT PROWCTS- OOMPIOP AGG_ j$ S5,000,000 f B B B AUTOMOBILE X LIABILITY ANYAUTO ALLOS SCHEDULED AUTOS AUTOSXHIREDAUTOS CA5273:59 (ADS) CA5273862 (NA) G5273864 (VA) - 12/31/11 12/31/12- 12/31/11, 12/31/12 CO MBINEOSINGLELIMIT (Ea. acpioee0____$5, BODILYNUURY (Pcr pawn) - 000, 000 IS ---- aODILYINJURY Pm emidem; ----- $ AUTOSNON-OWNED N PROPERTY DAMAGE (PeraccNenl) .$ - f UMBRELLA LIAR OCCUR EACH OCCURRENCE E EXCESS LIAB CLAIMSMADE AGGREGATE S DED (RETENTION$ $ C C C C WORKERS COMPENSATION AND EMPLOYERS'LRBILITY IN ANY PROPRIETOWARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mzndafo,y In NH) If �s describe UMe, DESCRIPTION OF OPERATIONSEebw NIA 1178530 (I4A), 1178529(G) 1178527(FL) 1232492(TX) I 1178531(IL, NY),1232493(WI) I 117es03 tAD0), 44z16117 (!IIi) 12/31/1I 12/31/17 12/31/11 12/31/12 12/31/11 12/31/12 I 12/31/11 12/31/12 % WC STATU- OTH- _�1ORYUMITS.� ER EL EACHACCIDENT E 5, 000, 000 EL. DISEASE- EA EMPLOYEE$ -- 5, 000, 000 E.I. DISEASE -POLICY LIMIT 55, 000, 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addnional Remvaa SaMduM, If mom apace Is mqueed) Location # 5955 - NPRt4P0, the cities of Greeley, Loveland, and Johnstown and the Countiea 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. 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 H. O'Neill 215 North Moon Street - 2nd. Plr AUTHORIZED REPRESENTATIVE Port Collins, CO 80524 USA Q -aP �,— ©1988-2010 ACORD CORPORATION. All rights reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD muttuny 24547699