Loading...
HomeMy WebLinkAbout119979 QUALITY TRAFFIC CONTROL INC - INSURANCE CERTIFICATEUP ILI: BA CERTIFICATE OF LIABILITY INSURANCE 1 DATE 03/13/12 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 PRODUCER 970.635-9401 *S Insurance Group -JT 970-635-9401 t848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 Johnstown Select Accounts INSURED Mike Obester 216 Racquette Drive #5 Fort Collins, CO 80524 NAIC M I INSURER B: PInnacoi insurance I02421U I E: 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. IINNS TYPE OF INSURANCE ADOLISUBRI POLICY NUMBER MMIDDIYYYYY MMIDDYIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR CPP009571408 07/27/11 07/27/12 EACH OCCURRENCE DAMAGES_(EaoNTED ce) DAMAGES Eaocc rr MED EXP(Any one person) Is 500,000 8 100,000 $ 10,000 PERSONAL 8 ADV INJURY $ 500,000 GENERAL AGGREGATE $ 1,000,00 GENIE AGGREGATE LIMIT APPLIES PER. POLICY PRO n LOC PRODUCTS - COMP/OP AGG $ 1,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Pet accitlenQ $ PROPERTY DAMAGE (Per accident) $ 1 $ Is UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION ANO EMPLOYERS' LIABILITY ANY PROPRIETORMARTNERIEXECUTIVE YIN OFFICERIMEMBER E%DLDDEDP (Mandatory in NH) Use, describe under DESCRIPTION OF OPERATIONS below NIA 4130969 04/01/12 04I01113 WCSTATU- �OTH- X TORY LIMItS ER EL EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 E.L. DISEASE -POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) 1 Locations / Traffic Control Operations CITYOF3 City of Fort Collins Attn: Purchasing Division 215 North Mason Street, 2nd FI PO Box 580 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 4d `- ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD