HomeMy WebLinkAboutVEOLIA TRANSPORTATION INC - INSURANCE CERTIFICATE"� CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD YVV)
O6/25/2014
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(iss) 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
Aon Risk Services Central, Inc.
Chicago IL Office
CONTACT
NAME:
PHONE (g66) 283-7122 FAX (800) 363-0105
(A/C. No. Ext): AIC. No.:
200 East Randolph
Chicago IL 60601 USA
E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC9
INSURED (/
(
INSURERA: Old Republic Insurance Company
24147
Veolia Trans Dortation, Inc, o
720 Butterfield Rd., suite 300
INSURER B: ACE Property & Casualty Insurance Co.
20699
INSURERC:
Lombard IL 60148 USA
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 570054308969 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. Limits shown are as requested
INSR
LTR
TYPE OF INSURANCE
INSD
MD
POLICY NUMBER
MMIDD/YY1()
MMIDIVYYYY71
LIMITS
A
X
COMMEROIALGENERALUABILITY
MWZY
CURRENCE
S5,000,000
CI -AIMS -MADE X❑DLLUR
S Ea ocwnence$1,000,000
(Any one person)
$10,000
rRI�E
L&ADV INJURY
$5,000,000
GEN'L AGGREGATE LIMIT APPLIES PER'.
AGGREGATE
$5,000,00POLICY
❑JEo- �LOC
TS-COMP/OP AGO
$5,000,000
OTHER:
A
A
AUTOMOBILE LIABILITY
Mw2X 26684
Mw-rB 21267
07/01/20140710112015
07/01/2014
07/01/2015
COMBINED SINGLE LIMIT
aacpldeM
S5,000,000
X ANY AUTO
BODILY INJURY (Per person)
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS NON -OWNED
AUTOS
BODILY INJURY (Per amdent)
PROPERTY DAMAGE
Per amdent
B
X
UMBRELLA LIAR
OCCUR
G21122056
07/01/201407/01/2015
EACH OCCURRENCE
$10,000,000
EXCESS LIAR
N
CLAIMSMADE
AGGREGATE
$10,000,000
DED
RETENTION
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE N
OFFICER/MEMBER EXCLUDED?
NIA
MWC30213900
07101211407012015
PER DTH-
X STATUTE
EL EACH ACCIDENT
$1,000,000
EL DISEASE -EA EMPLOYEE
$1,000,000
(Mandatory in NH)
If ye d.sc !,e uneer
DESCRIPTION OF OPERATIONS balm
EL. DISEASE-POLICYUMIT
$1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks schedule, may be atboHed If more space is required)
Re: Dial A Ride service Contract.The City of Fort Collins, its officers, agents, and employees are included as additional
insured with respect to General and Automobile Liability where required by contract.
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.
City Of Fort Collins AUTHORIZED REPRESENTATIVE
Attn: James O'Neil
215 Mason street, Floor For
Fort Collins CO 80522522 USA
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD