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HomeMy WebLinkAboutTRANSDEV NORTH AMERICA INC - INSURANCE CERTIFICATEA oR" CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
I 06/29,2019
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
AOn Risk Services Central, Inc.
Chicago IL Office
CONTACT
NAME:
(A/C..NNo. Ext): (866) 283-7122 (aC No.): (800) 363-0105
E-MAIL
ADDRESS:
200 East Randolph
Chicago IL 60601 USA
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Old Republic Insurance Company
24147
Transdev North America, Inc.
INSURERB: ACE Property & Casualty Insurance Co.
20699
720 E. Butterfield Road, suite 300
Lombard IL 60148 USA
INSURER C:
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 570077246311 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
ADDL
INSD
UBR
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DDMlYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
MWZY 1 1 10
7 01/ 2 019
777717=
EACH OCCURRENCE
$5,000,000
CLAIMS -MADE X❑OCCUR
DAMAGES RENTED
PREMISES Ea occurrence
$1,000,000
MED EXP (Any one person)
$10, 000
PERSONAL & ADV INJURY
$5,000,000
GEN'LAGGREGATE LIMITAPPLIES PER:
GENERAL AGGREGATE
$5,000,000
X POLICY ❑ PRO ❑ LOC
JECT
PRODUCTS - COMP/OP AGG
$5,000,000
OTHER:
A
AUTOMOBILE LIABILITY
Mwzx 26684-19
EXC Of statutory Limits
07/01/2019
07/01/2020
COMBINED SINGLE LIMIT
Ea accident
$5,000,000
A
X ANYAUTO
MWTB 21267-19
07/01/2019
07/01/2020
BODILY INJURY ( Per person)
BODILY INJURY (Per accident)
OWNED SCHEDULED
Statutory Limits
AUTOS ONLY AUTOS
HIREDAUTOS NON -OWNED
ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
B
UMBRELLA LAB
X
OCCUR
XOOG28126608004
07/01/2019
07/01/2020
EACH OCCURRENCE
$10,000,000
IDED
EXCESS LAB
CLAIMS -MADE
AGGREGATE
$10,000,000
RETENTION
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANYPROPRIETOR/PARTNER, EXECUTIVE YIN
MwC31381919
07/01/2019
07/01/2020
X SPER TATUTE °RH
E.L. EACH ACCIDENT
$1,000,000
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
N I A
E.L. DISEASE -EA EMPLOYEE
$1,000,000
if DESCRIPTION OF OPERATIONS below yes, describe under
D
E.L. DISEASE -POLICY LIMIT
$1,000,000
A
E&O-PL-Primary
MWZZ31382119
07/01/2019
07/01/2020
Each Claim
$10,000,000
Claims Made
Aggregate
$10,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 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, 2nd Floor
Fort Collins CO 80522522 USA
Fort
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