HomeMy WebLinkAbout110520 TRAFFIC SIGNAL CONTROLS INC - INSURANCE CERTIFICATE (6)ACORI
CERTIFICATE OF LIABILITY INSURANCE
06 E17D2013
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 CERTIFICATEOF 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 IN SUR ED, 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
HARTFORD FIRE INSURANCE COMPANY
250760 P:()- F:()-
NAME:
Pa/c"No Extl: PAX
(A/C, NoI:
ADDRESS:
PO BOX 33015
INSURERS) AFFORDING COVERAGE NAIC9
SAN ANTONIO TX 78265
INSURERA: Multiple Companies
INSURED `\ 615
INSURER B
INSURER C
TRAFFIC SIGNAL CONTROLS, INC.
255 WEAVER PARK RD STE 100
INSURER D:
INSURERE:
LONGMONT CO 80501
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
iND:CATED. 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 I HE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTA
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
(MMIDD/YYYYI
IM MIDPOLIEDIYVVq
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
5
_
PREMISES IEz accmrencel
S
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE a OCCUR
MED EXP(Any one Person)
S
_I I_
u
u
PERSONAL 6 ADV INJURY
$
GENERAL AGGREGATE
9
GENT AGGREGATE LIMIT AHI PPLIES PER:
PRODUCTS - COMP/OP AGG
S
I
POLICY a JECT aIILOC
S
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Es accident)
S
ANYAUTO
BODILY INJURY (Per Pe®on)
$
BODILY INJURY (Per accident)
$
ALL OWNED SCHEDULED
AUTOS u AUTOS
HIRED AUTOS I INON-OWNED
L.__I AUTOS
_
U
_
u
PROPERTY DAMAGE
(Par accident)
S
5
UMBRELLA LIAB U OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR CLAIMS -MADE
f I
u
u
DED LRfiEiCal
I
S
A
_wommws COMPENSATION
'AND EMP }Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE—
OFFICER/MEMBER EXCLUDED] u
(Mandatory In NHI
If •Ies, describe antler
DES CRIPTION OF OPERATIONS below
NIA
I I
u
76 WEG RQ1437
07/01/2013
07/01/2014
TLA
X TWCVMIU$ OTH-
ER
E.L.EACH ACCIDENT
it10O 000
E.L. DISEASE - EA EMPLOYE
S 100 000
E.L. DISEASE- POLICY LIMIT
5500,006
uu
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more apace is required)
Those usual to the Insured's Operations.
CERTIFICATE HOLDER 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 PRESENTATIVE
la'2 7a4_ ler^
215 N MASON ST FL 2
FORT COLLINS, CO 80524
0 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marics of ACORD