HomeMy WebLinkAbout110520 TRAFFIC SIGNAL CONTROLS INC - INSURANCE CERTIFICATE (8),acoizo® CERTIFICATE OF LIABILITY INSURANCE
DATE IA1MrDDm'YY)
6izl�zol9
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 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 SUBROGA710NIS 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
HARTFORD FIRE INSURANCE COMPANY
co.l7r
NAME'
PNONE
(NC, Na, EN)
EA\
IIJL. No):
250760 P: F:
EMAIL
ADDRESS:
INSVRER(SI AFFORDING COVERAGE NAK>
PO BOX 33015
PO
SAN ANTONIO TX 78265
INSURERA: Multiple Companies
INSURED
'\1..i
52.0
INSURER O:
INSURER C
I `^U
TRAFFIC SIGNAL CONTROLS, INC.
INSURER0-
255 WEAVER PARK RD STE 100
INSURER E,
LONGMONT CO 80501
NSDRERr
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.
IA'SR
TIPFOFF'SURASCE
ADD
S"A
"rn
POLInINU SER
POL.I(]'EFF
01"a`1 T']
POLI"-El
LltDyg
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
CLAIMSWADE OCCUR
DAMAGE TO RENTED
PREMISES (Ed ocounence)
$
MED EXP (Any one person)
S
PERSONAL S ADV INJURY
AGGREGATE LIMIT APPLIES PER:
GEN'L
GENERALAGGREGATE
$
POLICV� PRO -
JECT ❑ LOC
PRODUCTS - COMP/OP AGG
5
OTHER:
$
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea amidenp
S
BODILY INJURY (Per person)
S
ANY AUTO
ALLOWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Perawident)
$
PROPERTY DAMAGE
(Per acdded)
HIRED AUTOS NONOWNED
AUTOS
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
5
AGGREGATE
E
EXCESS LAB
CLAIMSb1ADE
DE
RETEN'
E
x'oFFP3rrnnm,:�'rn rron
rLVO EVPLOIYRSLL9FlLlLY
ANY PROPRIETOR/PARTNERIEXECUTIVEYIN
X PER OTL
er`.I E ER
E.L. EACH ACCIDENT
$100, 000
A
OFFICEWMEMBER EXCLUDED?
(ManrlaloryinNH) ❑
WA
76 WEG RQ1437
07/01/2014
07/01/2015
EL DISEASE- EA EMPLOYEE
'100, 000
I1 yes, doPNibe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$
5 Q 0 r 0 0
DESCRIPTION OF OPERATIONS / LOCATIONS/ VFH1CP OR 3101. Additional Ronerks Schedule. may be attachad B more Spam 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
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZEDREPRESENTATNE
City of Fort Collins
N MASON ST FL 2
FORT COLLINS, CO 80529
FORT
/ Lr
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD