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HomeMy WebLinkAbout119979 QUALITY TRAFFIC CONTROL - INSURANCE CERTIFICATE (23)---I*i QUALTRA-02 VMATHIAS ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)08/28/2018 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 have ADDITIONAL INSURED provisions or 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 endorsement(s). PRODUCER N iulE: PFS Insurance Group ) (970) 635-9401 4848 Thompson Parkway Suite 200 (AICNNo, Ext): (970 635-9400 NC, No EI Johnstown, CO 80534 ADDoR` : valeriem@mypfsinsurance.com INSURED Quality Traffic Control, Inc. INSURER C: Pinnacol Assurance Co 41190 Mike Obester 209 Racquette Drive #5 INSURER D : Fort Collins, CO 80524 INSURER E : rrnvl=oAr-Gc CFRTIFIC`ATF NUMBER: RFVISI01N NUMBER: vTHIS 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 LTIRIDDNYYYI TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X WH004764 08/27/2018 08/27/2019 DAMAGE TO RENTED MI E Ea occurrence) REMISES 100,000 $ MED EXP An one person)$ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY 7X] JECT LOC OTHER: AUTOMOBILE LIABILITY COMBINED C a accident) SINGLE LIMIT $ BODILY INJURY Perperson) $ ANY AUTO BODILY INJURY Per accident BODILY $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE Per accdent AUTOS ONLY AUOTO� ONLDY $ $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS -MADE NHA245612 08/27/2018 08/27/2019 AGGREGATE $ 1,000,000 DED I X RETENTION $ 0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ECUTIVE AFFICERR/MEMBER/EXCLU 4130969 04/01/2018 04/01/2019 X PER OTH- TAT TE E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 ED? ❑ (Mandatory in NH) N / A E.L. DISEASE -POLICY LIMIT 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) If required by written contract, the Certificate Holder is included as Additional Insured for ongoing operations under General Liability. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. 300 LaPorte Ave Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD