HomeMy WebLinkAbout162251 REDFLEX TRAFFIC SYSTEMS INC - INSURANCE CERTIFICATE (11)DATE
(MMID
'4" R" CERTIFICATE OF LIABILITY INSURANCE ]/1]I2015 DNYVY)
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
NAME: Certificate Department
Arthur J. Gallagher & Co. Insurance Brokers PHONE 925-299-1112 F4X 925-299-0328
of California, Inc. I LIC #0726293 �-�)- (A/C.No):
3697 Mt. Diablo Blvd., Suite 300 EMAIL . CertRequests@ajg.com
Lafayette CA 94549 INSURERS) AFFORDING COVERAGE NAIC #
INSURER A: Liberty Insurance Corporation 42404
INSURED INSURERB:Westchester Surplus Lines Insurance 10172
Redflex Traffic Systems, Inc. INSURER c : LibertyMutual Fire Insurance Coma 23035
23751 N. 23rd Avenue, Suite 150 INSURER D:LM Insurance Corporation 33600
Phoenix, AZ 85085-1854
INSURER E : First Liberty Insurance Corporation 133588
INSURER F:
r0%1FRAf;FS r'FRT1F1(_ATr PWIRARFR• 679341696 Ar\/ICI(1rd MIIMRro-
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.
-- -- - - -
ILTR TYPE OF INSURANCE _ POLICY EFF POLICY EXP LIMITS
LTR INS WVD POLICY NUMBER MMIDDIYYYY MlDD/YYY
D
X
COMMERCIAL GENERAL LIABILITY
Y
TB5Z91453980035
/1/2015
4/1/2016
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE �X OCCUR
PREMISES Ea occurrence
$1,000,000
X
MED EXP (Anyone person)
$10,000
25K BI/PD DIED
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
X POLICY PRO LOC
JECT
PRODUCTS -COMP/OP AGG
E2,000,000
E
X OTHER: CAP of $25M
C
AUTOMOBILE
LIABILITY
Y
AS2Z91453980025
4/1/2015
11/2016
BIN INGLE LIMIT
Ea accident
$1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
AUTOWNED SCHEDULED
BODILY INJURY (Per accident)
$
HIRED AUTOS NON -OWNED
AUTOS
E -
0PERT`TDA _GE_
Per accident)
X
<-'HAPD Ded
COMP/COLL X DED`: $5,000
$
A
X
UMBRELLA LIAB
X
OCCUR
TH7Z91453980045
1/2015
1/2016
EACH OCCURRENCE
$5,000,000
AGGREGATE
EXCESS LAB
CLAIMS -MADE
$5,000,000
DED X RETENTION$$10,000
$
E
i WORKERS COMPENSATION
j AND EMPLOYERS' LIABILITY Y / N
'ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
N/A
WC6Z91453980075
4/1/2015
4/1/2016
X I PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
_
$1,000,000
--
E.L. DISEASE - EA EMPLOYEE
$1,000,000
(Mandatory in NH)
If yes, describe under
' DESCRIPTION OF OPERATIONS below
--
E.L. DISEASE - POLICY LIMIT
-
$1,000,000
B
PROFESSIONAL & CYBER LIABILITY
G27435075002
1/2015
1/2016
Each Claim $2,000,000
[See attached Remarks Page]
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.
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
300 Laporte Ave.
Fort Collins CO 80521 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.
AUT�HOf/RIZED �REEPRRfE�SENTATIVE
+
* 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:
LOCH:
A`oRo ADDITIONAL REMARKS SCHEDULE Page of
AGENCY
NAMED INSURED
POLICY NUMBER
CARRIER
NAIC CODE
EFFECTIVE DATE:
ADDITIONAL REMARKS
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 #: 1055812961 Effective: 04/01/2015 to 04101120161 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,XVI NAIC#23035 Policy #: YU2-L9L-453980-065
SFOMC10043106 I Effective: 04/01/2015 to 04/01/2016 Blanket Personal Property: $21,885,000 1 Installation - PP/PPo: S1,000.000 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 LM99D1 0511
" Separation of Insureds applies per policy form. (Severability of InteresUCross 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 form 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)
ACORD 101 (2008101) O 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD