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TRANSDEV NORTH AMERICA INC - INSURANCE CERTIFICATE (2)
CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/25/2015 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 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. No. Ext): (866) 283-7122 (A/C 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. INSURER B: 720 Butterfield Rd suite 300 INSURER C: Lombard IL 60148 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570058419048 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 ILTR TYPE OF INSURANCE NSD WVD POLICY NUMBER MMlDD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY MwZY 1 1 1 1 EACH OCCURRENCE $ 5 , 000 , 000 CLAIMS -MADE X❑ OCCUR DAMAGE T N PREMISES Ea occurrence $1 , 000 , 000 MED EXP (Any one person) $10 , 000 PERSONAL B ADV INJURY $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5 , 000 , 000 X POLICY ❑ PRO ❑ JECT LOC PRODUCTS - COMP/OPAGG $5,000,000 OTHER. • AUTOMOBILE LIABILITY MWZX 26684 07/01/2015 07/01/2016 COMBINED SINGLE LIMIT Ea accident $5 , 000 , 000 Auto Liab - Excess BODILY INJURY ( Per person) A X ANY AUTO MwTB 21267 07/01/2015 07/01/2016 BODILY INJURY (Per accident) ALL OWNED SCHEDULED Auto Li ab - Primary AUTOS AUTOS PROPERTY DAMAGE - HIRED AUTOS NON -OWNED (Per accident AUTOS UMBRELLA LIAB EACH OCCURRENCE AGGREGATE EXCESS LIAB HOCCUR CLAIMS -MADE DED RETENTION A WORKERS COMPENSATION AND mwc30434SOO 07/01/2015 07/01/2016 X STATUTE EORH EMPLOYERS' LIABILITY YIN workers Comp E.L. EACH ACCIDENT $1 , 000 , 000 ANY PROPRIETOR / PARTNER / EXECUTIVE N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) ❑ N / A E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E. DISEASE -POLICY LIMIT $1, 000 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The city, its officers, agents, and employees included as Additional Insured with respect to General Liability and Automobile Liability policies 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: Craig Dublin PO BOX 580 Fort Collins CO 80522 USA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD