HomeMy WebLinkAbout110520 TRAFFIC SIGNAL CONTROLS INC - INSURANCE CERTIFICATE (7)TRAFSIG-01 DFLOYD
, 11. R CERTIFICATE OF LIABILITY INSURANCE
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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 endomement(s).
PRODUCER
TrueNorth
PO Box 847 -
Longmont, CO 80502 -_-' _ - -
CONTACT Kurt Mann
NAME:
PHONE FAX•
1ac No Eat:(303) 776-5122 ac No: (303) 776-5495 -
ADDRESS: kmann@truenorthcompanies.com '
INSURER(S) AFFORDING COVERAGE
NAIL p
INSURER A: Mtn. States Mutual Casualty Co
-
INSURED T�%
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: 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.
INSR
TR
TYPE OF INSURANCE
D
p B
POLICY NUMBER
MMIDDNYW
MM IDD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMSWADE I —XI OCCUR
CPP025070701
06/24/2014
06/24/2015
EACH OCCURRENCE
$ 1,000,00
PREMISES Edoccvnenca
$ 100,00
MED EXP (Any one person)
$ 10,000
PERSONAL B ADV INJURY
$ 1,000,00
GENT AGGREGATE LIMIT APPLIES PER
X POLICY PRO
ECT LOC
OTHER
GENERAL AGGREGATE
S 2,000,00
PRODUCTS - COMPIOP AGG
$ 2,000,00
S
A
POMOBILE LIABI
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS X NON-OWNED
HIRED AUTOS N OTO WNED
BAP025071101
06/24/2014
06/24/2015
COMBINED SINGLE LIMIT
Ea accident)
$ 1,000,00
BODILY INJURY(Per person)
$
BODILY INJURY (Pera¢ident)
8
PROPERTYDAMAGE$
A
X
Xd
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CI-AIMSWADE
CPP025070701
06/24/2014
06/24/2015
EACH OCCURRENCE
$ 1,000,00
AGGREGATE
$
X
$DED 1,000,00
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED'
(Mandatory in NH)
If yes, descried under
DESCRIPTION OF OPERATIONS below
N /A
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$
E. L. DISEASE - EA EMPLOYE
$
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached U more space Is required)
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
All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD