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113758 COLORADO TIME SYSTEMS LLC - INSURANCE CERTIFICATE (2)
o CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08/03/2015 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 Marsh USA, Inc. Two Alliance Center 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 Attn: Adanta.CertRequest@marsh.com / Fax: 212-948-4321 457102-CTS-GAUWX-14-15 INSURED 'Colorado Time Systems, Inc. 1551 E. 11th St. Loveland, CO 80537 INSURER A: Chubb Custom Insurance Company 38989 INSURER B : Continental Casualty Company 20443 INSURER c : National Union Fire Ins Co Pittsburgh PA 19445 INSURER D : American Casualty Company Of Reading, Pa 20427 INSURER E : Liberty Insurance Underwriters Inc. 19917 COVERAGES CERTIFICATE NUMBER: ATL-003879952-09 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. INSRPOLICY LTR TYPE OF INSURANCE INSO WVD SUER POLICY NUMBER EFF MMIDD/YYYY POLICY EXP MM DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 79937909 08/01/2015 08/01/2016 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE OCCUR AMAGIE PREM SESOEa oNcurrDence $ 100,000 X MED EXP (Any one person) $ EXCLUDED SIR $10,000 Per Occ. PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 4,000,000 POLICY [ PE� LOC PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY AGGREGATE $ 10,000,000 OTHER B AUTOMOBILE LIABILITY BUA 2098343798 08/01/2015 08I0112016 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS Comp/Coll Ded: $1,000 $ C X UMBRELLA LIAB X OCCUR BE 041757064 08/01/2015 08/01/2016 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 EXCESS LIAR CLAIMS -MADE DED X RETENTION $10 000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 20765228 08/0112015 08/01/2016 X I PER oTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E L. DISEASE - POLICY LIMIT $ 1,000,000 E Excess Umbrella 100005445605 01/01/2115 18101/1016 Each Occurrence 25,000,000 Aggregate 25,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: RFP 8107 - Athletic Field Scoreboards City of Fort Collins is listed as additional insured as their interests may appear, during and until completion of the project, on a primary and non-contributory basis, on the General Liability (via 80-02-2367) and Automobile (via CA 2048 02/99) policies, as required by written contract. A Waiver of Subrogation applies in favor of the additional insureds on the Workers Compensation policy, where required by written contract. r7 City of Fort Collins PO 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 of Marsh USA Inc. Manashi Mukherjee auwa tc.k—.A e.L © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD