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HomeMy WebLinkAboutFIRST TRANSIT INC - INSURANCE CERTIFICATE (4)YSf,AXIf WIU3 ACC>Ra CERTIFICATE OF LIABILITY INSURANCE DATE(MMMDNYYY) 12/18/2013 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 LL BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED o REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H 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 1-Lll-YYY 11UU Arthur J. Gallagher Risk Management Services, Inc. 250 Park Avenue 3rd Floor New York, BY 10177 INSURED FIRST TRANSIT INC 600 Vine Street, Suite 1400 Cincinnati, ON 45202 Cf3VFRADFS CFRTIFICATF MIIMRFR• 37420229 CONTACT W NAME a D. Ste enenn Tan h Y D r v PHONE 212-994-7085 212-994-7047 _ EAU. - HIS. Nak .o E4 IL ADDRESS. Tanya SteDhemonPaj9.COM W INSURER(S) AFFORDING COVERAGE _ INSURER A: INSURANCE CO OP THE STATE OF PA429INSURERB. 12311141 NATIONAL Gigi FIRE INE 00 OP IIIP1NN5INSURERC. MSN R SHIU INS CO INSURER 0 INSURER E RFVI.glnU MHMRFR- 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. INSR111101.SUBRI POLICY EFF POUCY EYP Tq TYPE OF INSURANCE swBRINAI POLICY NUMBER DIYYYY); IMIUDDIYYYYI mn A GENERAL LIABILITY OL1737923 (10101 AGG) 12/3111 12/31/14 EACHOCCURRENCE $5,000,000 I COMMERCPLGENERALLIASILHY DAMAGE TO RENTED PREMISES(EaoaMreixq) 55,000.000 _--___— CMW44ADE Lx I OCCUR MEDEXPIAnymrixI $50.000 PEpSpgALa AOV INAMY $5.000,000 GENERAL AGGREGATE 3 10.000,000 GENT AGGREGATE LNG APPLIES PER. (PRODUCTS - COMP)OP AGO $5,000,000 POLICY 2 PRfY = LOC $ N AgmegBILE UABlNY CAS273862 (NA) COMBINEDSINGLE LIMD (ea accaem) 1i 5,000, 000 B C115273859 (TX) 12131/1 12/31/U BODILY $ ■ ANY AUTO r CAS273859 (ADS) 12/31/1 Persoe 12/31/14'. A �BCIF.OIILED S AUTOS I---- CA4887241 (VA) 12/31/1 tWVRV(Per BODILY IwURY (Per accloan)' I1/31/34 3 - -- - _ _ Nafenu D PROPERTY DAMAGE 3 oOINNED UA TQd AIFTOS (Per-A&n0 4 UMBRELLA UAB OCCUR EACHOCCURRENCE 4 4 EXCESS LLIB Cl/14B4MOE AGGREGATE -�— ---- $ — OED RETENTION C 1rORltERB COMPENSATION 1178531(IL,NC,BH, UT,VT) 12/31/1 12/31/14 E WCSTATII- THY AND EMPLOYERS' LIABILITY YIN - __- _ -- C ANY PROPRIETORIPARTNERJEXECUTIVE 1178530(XA), 1178529(CA) 12/31/1 12/31/14 E.L. EACHACC87ENT 3 5,000,000 OFFICERNEMBER FXCWOED7 .MIA ---- El INSEASE-EA — 3S, 000, 000 C (MsaMary In Np 1178583(AOS), 44216118(SM 12/31/1 12/31/14 C Il yeaaeB un DESCRIPTION OF OPERATIONS bah N 1178527 (PL) 1232192 (TI 13/31/1 12/31/14 El p9FJ19E-PmX.Y IIMf $3, 000, 000 DESCRPTION OF OPERATIONS I LOCATION I VEHICLES (flesh ACORD t01, A4dMMAM RMeal u, ScM4ula, N more ,Pau 1.ImenleMl Location 4 5955 - NFRMPO, the cities of Greeley, Loveland, and JohnstoNn and the Countieb of Lariner and Meld are shown as addltional insureds solely with respect to the General and Auto liability as evidence herein as required by Nritten contract. The General liability policy form evidenced herein includes a Separation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Transit Service THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Jame B. O'Neill 215 North Meson Street - 2ad. Plr AUTHORIZED REPRESENTATIVE `^— Port Collins, CO 80524 \ USA —J ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD vinayny 37428229 z AGENCY CUSTOMER ID: LOC a: ACORa AMITIONA1 RFMGRKS SCHFnIII F AGENCY IUMEDINSURED Arthur J. Gallagher Risk Management Services, Inc. FIRST TRANSIT INC POLICY NUMBER 600 Vine Street, Suite 1400 CARRIED�CSncinneCi. ON 45202 EFFECTrve MIE: Pace of AW WI I IUNAL MCNIAM Na THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: __ FORM TITLE: _. Workers Compensation: - Policy 11: 1232493 (WI), 62790764 (M, AZ, (L1) fi 62790766 (NJ, PA) - Policy Term: 12/31/13 to 12/31/14 - Carrier Name: NEW HAMPSHIRE INS CO (NAIC N:23841) - Limits: E.L. Bach Accident / E.L. Disease -Ea Employee / E.L. Disease -Policy Limit - $5,000,000 CORD 101 (2008/01) ® 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Y51Up1XU)1 AM CERTIFICATE OF LIABILITY INSURANCE °12/18/213 12/18/2013 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 pol(cy(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 1-Lll-YYa-/iDV Arthur J. Gallagher Risk Management Services, Inc. 250 Park Avenue 3rd Floor Hew York, NY 10177 INSURED FIRST STUDENT INC 600 Vine at Ste 1400 CINCINNATI, OR 05202 iUyEC" Tanya. 0. Stephenson PHONE HO E ENS, 112-998-7085 _ _. _ IPAX t212-M-7g87 -- onEss: Tanya_8tephenson0a1g.cm INSURERIS) AFFORDING COVERAGE 1 _ NRC0 INSURER A: INSURANCE CO OP THE STATE OP PA 1%29 INSURERS. NATIONAL UNION FIRE INS CO a P31T9 19AA5 INSURERC: NEW HAMPSHIRE INS CO 238e1 INSURER D INSURER E rnVFRArFS rFRTIFIrATF NIIMRFR• 37420801 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. IMaR LTRTYPE OF INSURANCE RODL�SUBR, ICY EXP INSR POLICY NUMBER POLIOY EFF POLMMUDINYYYY Omrr LIMITS - A GENERAL LIABILITY I01,1737923 (10MM AGO) 12/31/1 12/31/14 EACH OCCURRENCE S 5,000,000 1rCOMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PFEMISES(Eaoccwnlrca) f 5 000,000 CLNMSMADE X I OCCUR MEDEXP(MYonepenon) $50 000 PERSONAL S My KAMY $5 000, 000 _ GENERAL AGGREGATE_ S10000.000 OM AGGREGATE LIMY APPLES PER PRODUCTS-COMPOOPAGG $5,000,000 POLICY 1 PIW 1 LOC $ 8 AOTOMMLEMAYNY G5273862 (NA) 1 COMBINED SINGLE LIMIT 5, 000, 000 (_ 8 - 1 CJL5273859 (TX) 12/31/1 12/31/la-LEFFLY WJ0 BODILY INJURY IPe/penen) _ -_ S 8 ANY OWNED BCINEDULEO AU OPINED CA5773859 (ADS) 12/31/1 12/31/la _ INJURY (P., XNPQ $ S_ A _ AtIT05 27ENm CAA8822e1 (VA) 17/31/1 11/31/la-PROPERTY DDAMAGEILY Hx NMDAVT08 AUTOS f — UMBRELLALW OCCUR EACH OCCURRENCE i EXCEe3Lw CLAMs-MADE AGGREGATE __. --_ f DED RETENTION [cc WORNPASCOMPENSATCN 117853l(IL,NC,NH,UT,VT) 12/31/1 12/31/14 X WC LIMIT (EEL AND EMPLOYERs' LIABILITY YIN .EACHTORY ANY PROPRIETORIPARTNER,EXECUTIVE 1178530 (MA), 1178529(G) 12/31/1 12/31/la ACCIDENT E.L. EACH ACCIDENT f 5,000,000 OFFICERIMEMSER EXCLUDED? Q MIA _ 000, 000 (Mandatory N NHI 1178583(AOS),00216118(IW 12/31/1 12/31/14 E.L. DISEASE - EA EMPLOYEES5, 0yn5 &'m� �` DESGRWTION OF OPEMTIONS Nebw 1178527(FL) , 1232092(TX 12/31/1 12/31/14 E.L. DISEASE -POLICY LIMIT $5, 000, 000 DESCRIPTN)N OF OPERATIONS I LOCATIONS I VEHICLES (Aaec11 ACORD 101, AddMmwl Ramans Sdutiu1s. N mom specs Is MuNeE) Location 9 5955 - NFRMPO, the cities of Greeley, Loveland, and Johnstown and the Counties of Lorimer and Weld are show as additional insureds solely with respect to the General and Auto liability as evidence herein an required by written contract with respect to work performed by the named insured. e,CR I Ir1A,M 1 G FIV LV CR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NPRFF0 Transit Service THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Jame B. O'Neill 215 North Mason Street - 2nd. Flr AUTNORQED REPRESENTATIVE Port Collins, CO 80520 USA n 1011A11Mn ACnon CnRPnRATION All n.htc rwewrvwd ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD vinal'ny 37420801 AGENCY CUSTOMER ID: LOC R: ACO " ADDITIONAL REMARKS SCHEDULE Page of AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED FIRST STUDENT INC 600 VIM at "MY NUMBER Ste 1600 CAARIER CINC?NK *I, OM 45202 EFFECTIVE DAM ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: Workers Caeveneation:- Policy Y: 1232493 (WI), 62790764 (AK, AZ, GA) A 62790766 (MJ, PA) - Policy Term: 12/31/13 to 12/31/14 - Carrier Name: NEW NAMPaNIRE INS CO (NAIC #:23841) - Limlts: E.L. Each Accident / E.L. Disease -Ea Employee / E.L. Disease -Policy Limit - $5,000,000 ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rlahts reserved The ACORD name and logo are registered marks of ACORD 1'S31MxIIXIXIE Q A� a CERTIFICATE OF LIABILITY INSURANCE D12/18/201ATE YY) 12/18/2013 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. O IMPORTANT: M the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. N SUBROGATION IS WANED, 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 1-212-994- 1uu Arthur J. Gallagher Risk Management Services, Inc. 250 Park Avenue 3rd Floor New York, NY 10177 INSURED FIRST STUDENT INC 600 Vine St Ste 1400 CINCINNATI, ON 45202 CONTACT m NAME: Tanya D. Stephensmn FAK PHONE 212-994-7085 mKow_212-99a-70a7 ADDRESS: _ Tanya_StephanaOn?aj9•COm INSURER(S) AFFORDING COVERAGE NAIC e INSURER A. INSURANCB CO OF THE STATE OP PA _ _ 19{19 INSURER B: NATIONAL UNION FIRE INS CO OP PITTS 19{65_ INSURER C: NSW RARPSHIRS INS CO 238{1 INSURER 0 INSURER E COVFRAC.FS CERTIFICATE NUMRFR- 37421408 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. YMR — SUBRi POLICYEXPLn - - TYPE OF INSURANCE-- POLICY NUMBER YDLICmYY LYO A OPJERAL LIABILITY GL1737923 (10101 AGO) 12/31/1 12/31/14 EACH OCCURRENCE 115,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO PREMISES (Ea gOpueelwN. f51000,000 CWMSAUDE f X I OCCUR LEDEXP(Mymwpeeon) $ 50,000 PERSONAL A ADV INJURY f 5/000/000 IENERALAOGREGATE f 10-000,000 GEWL AGGREGATE LIMIT APPLES PER: PRODUCTS-CUMPIOPAGG $ 5,000,000- I X I� [11 _ POLICY LOC f 8 AUTOM09RELMMLITY G5273862 (NA) 51NGLE LIMB LCOMB�In1 E ''5,000,000 f B X G5273859 (TX) 11/31/1 11/31/1{ BODILY INJURY (Per pemon) $ 8 MY AUTO ALL OWNED -- BCEDULED G5273859 (ADS) 12/31/1 12/31/1{ j - AUTOS G18822a1 (VA) 12/31/1 11/31/1{ BODILY INJURY (Per I) f j j NON-OWNEDI�RTY DAMAGE f WED AUTOS AUTOS (Pe auSeee) ------ $ UMBRELLA LIMB OCCUR EACH OCCURRENCE_ _ $_ EXCESS LIAR CUIMS-M_ A_D_E _AGGREGATE _ $ DED 1 1 RETENTION $ WORKERS COMPENSATION 1178531(IL, NC. NN, UT, VT) 12/31/1 12/31/24 j WC STATV OTIF TORY LIMITS [cc AND EMPLOYERS' LIABILITY TIN ... _- .._. ANY PROPRIETORPARTNERIEXECURVE 1178530 (MA). 1178519(G) 13/31/1 11/31/14 EL EACH ACCO>ENT f 5,000,000 OFFICERIMEMBER EXCLUDED? N NIA (New" Is MHl I1178583(AOS),11216118(IYI 12/31/1 12/31/14 E.L OUIEASE-EA EMPLOYEE$ 5,000,000 8�OFOERATIONS bakm ;1178527(PL) , 1232{92(TX 12/31/1 12/31/14 EL. DISEASE - POLICY LMR If 5,000,000 DESCRIPTION OF OPERATIONS l LOCATIONS I VEHICLES (ABFck ACORD 101, MdKlonel Remarks SCheOYM, N moo spew N rpuirM) NPRUPO, the cities of Greeley, Loveland, and Johnstown and the Counties of Lariner and Wald 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 NVNO@0 Transit Service THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Atta: Same B. O'Neill 215 North Mason Street - 2ad. Plr I AUTHORIZED REPRESENTATIVE / Port Collins, CO 80524 ` 1 USA (C) 1988.ZO10 ACORD CURPURATIUN. All nghtS reserved. ACORD 25 (201010S) The ACORD name and logo are registered marks of ACORD vinayny 37a2Ia08 PIIWMRWR R AGENCY CUSTOMER ID: LOC a: ADDITIONAL REMARKS SCHEDULE AGENCY IWINIED J. Gallagher Risk Management Services, Inc. S ArtrFIRST STUDENT nRsr WED sDDaerr INC MMYNN CARRIER 600 Vine St Ste 1000 MAIC CODE CIMCIMMATI, OM 45202 EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: Workers Compensation: - Policy e: 1232493 (NI), 62790764 (AK, AZ, CIA) A 62790766 (NJ, PA) - Policy Term: 12/31/13 to 12/31/14 - Carrier Name: NEW HAMPSHIRE INS CO (NAIC a:23841) - Limits: E.L. Each Accident / R.L. Disease -Ea Smployee / R.L. Disease -Policy Limit - $5,000,000 Page _ of ACORD 101 (2000/01) ® 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD m 0 0 i�snuwzeiuz Arthur J. Gallaghcr Risk Management Services, Inc. 250 Park Avenue 3rd Floor New York, NY 10177 Electronic Service Requested 3-DIGIT 805 3578 1.1752 AT 0.381 I��I�IrIr111nII�Lll�ll�rll�r�r1111�11'II" 1111911111111"1 NFRMPO Transit Service 17 215 NORTH MASON STREET - 2ND. FLR FORT COLLINS, CO 80524-4402 EBIX BPO This document was brought to you by Ebix/CertificateeNow and Arthur J. Gallagher & co. of New York in New York, NY. - Any documents forwarded with the certificate request were reviewed for the sole purpose of completing the certificate. - If you have questions regarding the content of this document, please contact - the Producer/Agent listed on the certificate of insurance. - The data included in this notice and in the attached document is confidential to - Ebix/CertificateeNow and Arthur J. Gallagher & Co. of New York. - cc: The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. Certificate Delivery by Certificates Now - www.ConfirmNet.com - 877,669,8600