HomeMy WebLinkAbout162251 REDFLEX TRAFFIC SYSTEMS INC - INSURANCE CERTIFICATE (10)Aco ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
`...�" 7/17/2015
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 endorsements .
PRODUCER CONTACT
Arthur J. Gallagher & Co. Insurance Brokers PHONE g252991112 NAME: Certificate Department FAX 925-299-0328
of California, Inc. I LIC #0726293 - -1atc. NOI. ---
3697 Mt. Diablo Blvd., Suite 300 E—MAIL : CertRequests@ajg.com
Lafayette CA 94549 INSURERS) AFFORDING COVERAGE NAIr x
INSURED
Redflex Traffic Systems, Inc.
23751 N. 23rd Avenue, Suite 150
Phoenix, AZ 85085-1854
INSURER A: Liberty Insurance Corporation 42404
INSURER a Vestchester_S_urplus Lines Insurance 10172
INSURER c: LibertyMutual Fire Insurance Coma 23035
INSURER D : LM Insurance Corporation 33600
INSURER E : First Liberty_Insurance Corporation 33588
INSURER F :
rnvFRar.�c rCDTICIrATC NII IIIAQCD• ?AAR1 d75? 017111CW%R1 R11111aIDC111.
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.
INSR
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
POLICY EFF
MMIDDlYYYY
POLICY EXP
MMIDD/YY
LIMITS
D
X
COMMERCIAL GENERAL LIABILITY
Y
TB5Z91453980035
4/1/2015
/1/2016
EACH OCCURRENCE
$1,000,000
iiENTEb--- -
PREMISES Ea occurrence
$1,000,000
CLAIMS -MADE i X J OCCUR
X
MED EXP (Any one person)
$10,000
$25K BI/PD DIED
PERSONAL & ADV INJURY
$1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY JECT PRO ❑ LOC
GENERAL AGGREGATE
$2,000,000
X
PRODUCTS - COMP/OP AGG
$2,000,000
X
_
$
OTHER: CAP of $25M
C
AUTOMOBILE
LIABILITY
Y
AS2Z91453980025
4/1/2015
4/1/2016
Ea accident) _ $1,000,000
X
ANY AUTO
BODILY INJURY (Per person) $
ALL OWNED AUTOSULED
AUTOS
BODILY INJURY (Per accident) $
HIRED AUTOS NON -OWNED
AUTOS
AMAGE --- --
Per accident)- $
X
COMP/COLL X DED`: $5,000
<-'HAPD Ded $
A
X
UMBRELLA LIAB
X
OCCUR
TH7Z91453960045
4/1/2015
4/1/2016
EACH OCCURRENCE
$5,000,000
AGGREGATE
$5,000,000
EXCESS LIAB
CLAIMS -MADE
DED X I RETENTION$$10,000
$
E I WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
N/A
WC6Z91453980075
/1/2015
/1/2016
X STATUTE ERH
E.L. EACH ACCIDENT
-
$1,000,000
E.L. DISEASE - EA EMPLOYE
--
$1,000,000
(Mandatory in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT 1
$1,000,000
B PROFESSIONAL & CYBER LIABILITY
[See attached Remarks Page]
G27435075002 4/1/2015
411/2016
Each Claim $2,000,000
Aggregate $2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
RE: Activities performed by or on behalf of the permittee or contractor as required by contract.
ADDITIONAL INSURED(S): The City of Fort Collins, CO, its officers, directors, agents, representatives and employees as required by written
contract.
I V-r% 1 IF I11r% I I- r7VLUCK t AIMt tLLAIIUIV
City of Fort Collins Purchasing Division
P.O. Box 580
Fort Collins CO 80522 USA
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
Oc 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:
LOG #:
AC V ADDITIONAL REMARKS SCHEDULE
Page of
AGENCY
NAMED INSURED
POLICY NUMBER
CARRIER T
AIC CODE
EFFECTIVE DATE:
GI1JIJIIMOF-0Ill a1 F_M4il
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE:
THIRD PARTY CRIME/FIDELITY COVERAGE
Carrier: TRAVELERS CAS & SURETY CO OF AMER [A+,XV] NAIC#31194 Policy #: 105581296 1 Effective: 04/01/2015 to 04i0112016 I Limit: $500,000
Aggregate limit for Employee Theft fo Client Property I Retention: $50,000
PROPERTY COVERAGE
Carrier: LIBERTY MUTUAL FIRE INS CO/LIBERTY MUTUAL INSURANCE CO. [AM BEST: A,XV] NAIC#23035 Policy #: YU2-L9L-453980-065 I
SFOMC10043106 I Effective: 04i01/2015 to D4/01/2016 Blanket Personal Property: $21,885,000 1 Installation - PP/PPo: $1,000.000 1 Transit: $250,000
(Blanket Personal Property includes Personal Property of Others and Valuable Papers and records at insured locations).
GENERAL LIABILITY:
' Additional Insured if required by written contract per attached form LC0443 0512
` Coverage is Primary & Non -Contributory if required by written contract per form LC0443 0512
' Waiver of Subrogation if required by written contract per attached form LC0443 0512
' Noticed of Cancellation if required by written contract per attached form LM9901 0511
' Separation of Insureds applies per policy form. (Severability of Interest/Cross Liability Clause)
AUTOMOBILE LIABILITY:
' Designated Insured if required by written contract per attached form CA2048 1013
' Waiver of Subrogation if required by written contract per attached form AC8407 0713 (All Other)
' Waiver of Subrogation if required by written contract per attached form AC8448 0613 (Florida)
' Noticed of Cancellation if required by written contract per attached form LIM 99 01 05 11
' Separation of Insureds applies per policy form. (Severability of Interest/Cross Liability Clause)
• CA9948 and MSC90 Endorsements included.
WORKERS' COMPENSATION:
• Waiver of Subrogation if required by written contract per attached form WC04036 0484 (California)
• Waiver of Subrogation if required by written contract per attached form WC000313 484 (Other States)
' Waiver of Subrogation if required by written contract per attached farm WC420304 1084 (Texas)
' Noticed of Cancellation if required by written contract per attached form WM9018 0611
EXCESS LIABILITY:
" Underlying Policies: General Liability, Automobile Liability, and Employers' Liability
" Noticed of Cancellation if required by written contract per attached form LM99D1 0511
" Separation of Insureds applies per policy form. (Severability of Interest'Cross Liability Clause)
AGVKD 101 (2008101) :0 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD