HomeMy WebLinkAbout162251 REDFLEX TRAFFIC SYSTEMS INC - INSURANCE CERTIFICATE (7)�Y521AM12WX1$
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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 pollcy(les) 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 endorsemen a .
PRODUCER LIC #0726293 1-925-299-1112
Arthur J. Gallagher 6 Co.
Insurance Brokers of California, Inc,
CONTACTNAME Certificate Department
PHONE FAX
IAB;,No- .925-299-1112 AIC No): 925-299-0328
ADDRESS: sherri_jordangajg.com
3697 Mt. Diablo Boulevard, suite 300
INSURERM AFFORDING COVERAGE
NAICS
Lafayette, CA 94549
INSURER A: LIBERTY NUT FIRE INS CO
23035
Client No. RHDFTRA-02
INSURED
Redflex Traffic Systems, Inc.
INSURERS: LIBERTY INS CORP
62604
INSURER CNESTCRNSTE1 SURPLUS LINES INS CO
10172
INSURER n:
23751 N. 23rd Avenue, Suite 150
INSURER E:
Phoenix, AZ 85085-185e
INSURER F:
COVERAGES CERTIFICATE NUMBER: 42162101 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.
U15R
LIR
TYPE OF WSURA ICE
INSABOel
o
IPOUCYNUMBER
MMAIDYEFF
POUCY�
LIMrt3
A
GENERAL UABR-DY
E
TB2-Z91-653980-034
04/01/1
04/01/15
EACH OCCURRENCE
$ 1,000,000
E
COMMERCIAL GENERAL 111BILITY
CLAIMS -MADE 1XI OCCUR
DAL7AGE TO RENrEO
PREMISES Ea ocalnePa
S 1,000,000
MED EXP(Any d,l9 pssP)
35,000
PERSONALSAOV INJURY
f 11000,000
E $25E BI/PD DSD
GENERALAGGREGATE
S 2,000,000
GENt AGGREGATE
LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGO
$2,000,000
POLICY
E PR0. E LDUJECT
f
A
AUTOYOBILELIARDIFY
E
A32-Z91-453980-026
0
. __
—_
COMBINED SINGLE LIMIT
6eccdPi - —
1, 000, 000
BODILY INJURY (PP Person)
_
$
E
ANYAUTO
AIL OWNED .SCHEDULED
AUTOS AUTOS
BODILY INJURY(PN aviarM)
S
PROPERTY DAMAGE
Pmemdenl
S
NONOWNED
HIRED AUTOS AUTOS
<- <HAPD Ded
$
E
CO"/CO" E DSDA:$5,000
B
E
UMBRELLA LIAR
E
OCCUR
TB7-Z91-653980-046
0610111
04/01/15
EACHOCCURRENCE
$ 5.000,000
AGGREGATE
$ 5,000,000
EXCESS LIKE
CLAIMS MADE
_
OEO E RETENTION 10,000
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LLIBILIfY Y I M
ANYPROPWETORIPARTNERIEXECUTNE❑
MC2-Z91-e53980-074
04/01/1
04/01/15
WC TH-
E QRYUM1U- ER
TORY.
EL EACH ACCIDENT
s 1,000,000
IMEMBE OFFICERR EXCLUDED?
NIA
El. DISEASE -EA EMPLOYEE
$ 1,000,000
(11-dam Ia NH)
IIy81i CRIKIOPTIOe hider
DESN OF OPERATIONS pelow
EL. DISEASE-PoLICY LIMIT
S 1,000,000
C
PROFESSIONAL/CYBSR LIM.
G27435075
04/01/1
04/01/15
$50K.SIR MClm/Agg 2,000,000
SIR 50,000
(Be. attached Supp1. Page...)
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Almch ACORD 101, AddlU al Renada Scheduk. If man%0 Is Uu )
RR2 Activities performod by or ou behalf of the permittee or contractor as required by contract.
ADDITIONAL INSURE13 : The City of Fort Collins, CO, its officers, directors, agents, representatives and employees
as required by written contract. Additional insured for General Liability and Designated Insured for Auto Liability.
<see attached for policy endorsement forme>
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
300 Laporte Ave. AUTHORIED REPRESENFATNE
Fort Collins, CO 00521 //,yy g. ��
USA
®1988.2010 ACORD CORPORATION. All rluhts reserved.
HIM
ACORD 25 (2010/05)
valmesa
42162101
The ACORD name and logo are registered marks of ACORD
�PRIaxl2axR
ACORiY
L i
AGENCY CUSTOMER ID:
LOC e:
ADDITIONAL REMARKS SCHEDULE
Page _ Of
AGENCY
Arthur J. Gallagher i CO.
Insurance Brokers of California, Inc.
NAMEDINSURED
Radflex Traffic Systems, Inc.
23751 N. 23rd Avenue, Suite 150
Phoenix, AZ 85085-1856
POLICY NUMBER
CARRIER
NMC CODE
ERECrlVE DATE:
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE:
INSURED E THIRD PARTY FIDELITY COVERAGE -
Carrier: TRAVELERS CAS A SURETY 00 OF AMER(Al,ZV1 NAICs3119e-
Policy e: 105581296 1 Effective: 04/01/2014 to 04/01/2015 1 Limit: $500,000 Aggregate limit for Employee Theft 1,
Employee Theft of Client Property I Retention: $50,000-
PROPERTY/CARGO COVERAGE -
Carrier: LIBERTY MUTUAL PIRG INS CO/LIBERTY MUTUAL INSURANCE CO. (AM3e81:: A,AVI NAIC823035 Policy
U:YU2-L9L-253980-06e/SPOKC100431051 Effective: 0e/01/2016 to 04/01/2015-
Blanket Personal Property: $23,210,0001 Installation-PP/PPO. $1,000,000 1 Installation / Transit: $250.000 (Blanket
Personal Property includes Personal Property of Others and Valuable Papers and records at insured locations)•
ACORD 101 (2008/01) 02008 AGOHO GOHPOHATIUN. All rlgnts reserveo.
The ACORD name and logo are registered marks of ACORD