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Home My WebLink About110520 TRAFFIC SIGNAL CONTROLS INC - INSURANCE CERTIFICATE (5)AcIl �® CERTIFICATE OF LIABILITY INSURANCE 6/18/2o"3 1 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 First Mainstreet Insurance, LLC 275 S. Main Street, Suite 100 P.O. Box 847 Longmont CO 80502 CONTACT Debbie Brickhdm NAME: PHONE (303)776-5122 FA%AIC .(303)776-5495 AJp AIL .dbrickhan@FirstMainStreet. com INSURERS AFFORDING COVERAGE NAIC# INSURERAMtn. States Mutual Casualty Co INSURED '\OSZV Traffic Signal Controls, Inc. 255 Weaver Park Road, #100 Longmont CO 80504 INSURER B: INSURER C: INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:13-14 - 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 REOUIREMENT, 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 SUER J= POLICY NUMBER POLICY EFF (MMIODrYYYY1 POLICY EXP fMMIDDNYYYlLIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PP025070701 6/24/2013 6/24/2014 DAMAGE TO RENTED PREMISES Ea occurrence) $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENIE AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO LOG $ AUTOMOBILE LIABILITY (Ed aBINEDccidenSINGLE LIMIT 1,000,000 BODILY INJURY(Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 025071101 6/24/2013 6/24/2014 R BODILY INJURY(Per accident) $ PROPERTY DAMAGE $ X NON,OWNED HIREDAUTOS AUTOS(Peraccidenl 8 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAR CLAIMS -MADE DED I X I RETENTION $ PP025070701 6/24/2013 6/24/2014 WORKERS COMPENSATION WC STATD- DTH- AND EMPLOYERS'LIABILITY YIN E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNER(EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under 0 SCRIPTION OF OPERATIONS below - - E.L. DISEASE -POLICY LIMIT - $ DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ANach ACORD 101, Additional Remarks Schedule. R more space is required) (970)221-6707 City of Fort Collins PO Box 580 Fort Collins, CO 80522-0580 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 ACORD 2512010/051 Brickham/DBRICK n 1gRR-2n1n AcnRn CnRGnRATIr)M en ri„hto racarvarl INS025 (2010D5)01 The ACORD name and logo are registered marks of ACORD