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PARKING SENSE USA INC - INSURANCE CERTIFICATE (3)
Client#: 1264024 PARKISEN ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDYYYY) 10/01 /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 pollcy(les) 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Pam Rush US[ Insurance Services NW CL1 PN°NE 503-265-5411 825 NE Multnomah, Suite 1500 E-MAIL Ext: Nc,No: 610-537-2282 _ADDRESS_ pam.rush@usi.com _ Portland, OR 97232 INSURERS) AFFORDING COVERAGE NAICa 503 224-8390 INSURER A : TnvNan Peppsrry Cas. Co. M Amerla 2$674 INSURED INSURER B : Tr.wlen, indamnity Company a CT 25682 Parking Sense USA, Inc INSURER C:Tnaelaalntlamn"CampanY 25658 375351H 10 West, Building 2, Suite 1 INSURER O: Boerne, TX 78006 INSURER E: ' I IINSURER F: 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 CONTRACTOR 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 LTR TYPE OF INSURANCE ADDL INSR SUB WVD POUCY NUMBER POLICY EFF POLICY EXP MMIDD;YYYY)_(MM/DD/YVYY LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR ZPL51 M382421 915 9/15/2019 09/15/2020 EACH $1 000000 p�OCCURRENCE PREMISES Ea occurrence $1 000 000 MED EXP (Any one person) $10 000 PERSONAL$ ADV INJURY $1 000,000 GENL AGGREGATE LIMIT APPLIES PER: PoLICV ❑ JECT—I LOC OTHER: GENERAL AGGREGATE $2 000,000 PRODUCTS-COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO owSCHEDULED AUTOS AUTOS SCHEDULED HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY BA5N3419461915G 9/15/2019 09/15/2020 COMBINED dED SINGLE LIMIT 1,000,000 BODILY INJURY Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per spot t $ B UMBRELLA LIAR X CAB OCCUR CLAIMS -MADE CUP9K16455A1915 9/15/2019 09/15/2020 EACH OCCURRENCE s5,000,000 X AGGREGATE $5 000 000 DED I X RETENTION$10000 _ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? 51 (Mandatory in NH) It yes. describe under DESCRIPTION OF OPERATIONS below N/A UB4J2053311915G D911512019 09/15/2020 X PER OTH- E.L EACH ACCIDENT $1 OOO OOO E.L DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE - POLICY LIMIT 0,000,000 DESCRIPTION OF OPERATIONS LOCATIONS: VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) " Workers Comp Information " Pro Prieto rs'Partners'Executive Officers,'Members Excluded: Parking Sense Ltd.. Based in New Zealand (See Attached Descriptions) City of Fort Collins P.O. BOX 580 Fort Collins. CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016'03) 1 of 2 #S26764938,M26550942 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD S1BZP