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HomeMy WebLinkAboutTRANSDEV NORTH AMERICA INC - INSURANCE CERTIFICATE (3)AC �® �., CERTIFICATE OF LIABILITY INSURANCE06/25/2015 DAT (MMIDDNYYY) 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: GONE Ext): (866) 283-7122 FA 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: ACE Property & Casualty Insurance Co. 20699 720 Butterfield Rd Suite 300 INSURER C: Lombard IL 60148 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570058418807 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 LTR TYPE OF INSURANCE ADDL INSD WVD POLICY NUMBER MMlDDlYYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY MWZY 4 47 1 1 1 1 EACH OCCURRENCE $ S , 000 , 000 CLAIMS -MADE X❑ OCCUR DAMAGE T N E PREMISES(Ea occurrence) $1 , 000 , 000 MED EXP (Any one person) $10, 000 PERSONAL &ADV INJURY $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ S , 000 , 000 ❑ PRO ❑ X JECT LOC PRODUCTS - COMP/OP AGG $S,000,000POLICY OTHER A A AUTOMOBILE LIABILITY MWZX 26684 MWTB 21267 07/01/2015 07/01/2015 07/01/2016 07/01/2016 COMBINED SINGLE LIMIT Ea accident $ 5 , 000 , 000 BODILY INJURY ( Per person) AUTO BODILY INJURY (Per accident) ALL OWNED SCHEDULED IPROPANY AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS ERTY DAMAGE Per accident B X UMBRELLA LIAB X OCCUR XOOG27834048 07/01/2015 07/01/2016 EACH OCCURRENCE $10,000,000 EXCESS LABCLAIMS-MADE AGGREGATE $10,000,000 DED RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER /EXECUTIVE Y❑ MWC30434500 07/01/2015 07/01/2016 X STATUTE OTH E.L. EACH ACCIDENT $1 , 000 , 000 OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N / A E.L. DISEASE -EA EMPLOYEE $1 , 000 , 000 If yes, describe under DESCRIPTION OF OPERATIONS b.1— E.L. DISEASE -POLICY LIMIT S1,000,000 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 For Mason street, 2nd522 FloUSA Fort Collins CO 80522 USA `m t` 0 cc w cc 0 0 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD