HomeMy WebLinkAbout162251 REDFLEX TRAFFIC SYSTEMS INC - INSURANCE CERTIFICATE (12),aco�zo® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/VYYY)
1 3/31 /2016
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 Certificate Department Arthur J. Gallagher I Co. Insurance Brokers PHONE 925-299-1112 ac Nor 925-299-0328
of California, Inc. I LIC #0726293 E-MAIL -
3697 Mt. Diablo Blvd., Suite 300 . CertRequests@ajg.com
Lafayette CA 94549 INSURER(S) AFFORDING COVERAGE NAIC F
INSURER A; Liberty Insurance Corporation 42404
INSURED REDFTRA-02 INSURER B: Westchester Surplus Lines Insurance 10172
Redflex Traffic Systems, Inc. INSURER C: LibertyMutual Fire Insurance Coma 23035
5651 W. Talavi Blvd., Suite 200 INSURER D: First Liberty Insurance Corporation 33588
Glendale, AZ 85306
INSURER E :
Cf)VFRAGFR CFRTIFICATF NIIMRFR• 644739072 RFVISION NIIMRFR-
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
ADDIL
IN D
UBRI
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YY
POLICY EXP
MWDDNY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
TB5Z91453980036
4/1/2016
4/1/2017
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE ❑X OCCUR
PREMISES (Ea occurrence)
$1,000,000
X
MED EXP (Any one person)
$10,000
$25KBI/PDDED
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE
$2,000,000
X POLICY PRO LOC
JECT
PRODUCTS - COMP/OP AGG
$2,000,000
$
X OTHER: CAP of $25M
C
AUTOMOBILE
LIABILITY
Y
AS2Z91453980026
4/1/2016
4/1/2017
Ea accident
$1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
ALL
OSNED SCHEDULED
AUTAUTOS
BODILY INJURY (Per accident)
$
NON -OWNED
HIRED AUTOS AUTOS
Per accident DAMAGE$
X
COMP/COLL X DED`: $5,000
<- HAPD Ded
$
A
X
UMBRELLA LIAB
X
OCCUR
TH7Z91453980046
4/1/2016
4/1/2017
EACH OCCURRENCE
$5,000,000
AGGREGATE
$5,000,000
EXCESS LIAB
CLAIMS -MADE
DED X RETENTION$$10,000
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
WC6Z91453980076
4/1/2016
4/1/2017
X PER OTH-
STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$1,000,000
OFFICER/MEMBER EXCLUDED? ❑
N/A
E.L. DISEASE - EA EMPLOYE
$1,000,000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
1 $1,000,000
B
PROFESSIONAL & CYBER LIABILITY
G27435075003
4/1/2016 4/1/2017
Each Claim $2,000,000
[See attached Remarks Page]
Aggregate $2,000,000
SIR - Each Claim $50,000
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
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. Box 580
Fort Collins CO 80522 USA AUTHORIZED REPRESENTATIVE
O 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:
_ LOC #:
�® ADDITIONAL REMARKS SCHEDULE Page Of
AGENCY
POLICY NUMBER
CARRIER
ADDITIONAL REMARKS
NAIC CODE
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE:
NAMED INSURED
EFFECTIVE DATE:
THIRD PARTY CRIMEIFIDELITY COVERAGE
Carrier: TRAVELERS CAS & SURETY CO OF AMER [A+,XV] NAIC # 31194 Policy #: 1055812961 Effective: 04/01/2016 to 04/01/2017 Limit $500,000
Aggregate limit for Employee Theft of Client Property I Retention: $50,000
PROPERTY COVERAGE
Carrier: LIBERTY MUTUAL FIRE INS CO [AM BEST: A,XV] NAIC# 23035 Policy#: YU2-1-91- 453980-066
Effective: 04101/2016 to 04101/2017 Blanket Personal Property: $19,600,000 1 Installation- PP/PPO: $1,000,000 Transit: $10,000
(Blanket Personal Property includes Personal Property of Others and Valuable Papers and records at insured locations). Misc. Locations $2,000,000
per occurrence Mobile Equipment $100,000 (1) item/$1,000,000 Any one occurrence.
GENERAL LIABILITY:
• Additional Insured if required by written contract per attached form LCO443 0512
*Coverage is Primary & Non -Contributory if required by written contract per form LCO443 0512
*Waiver of Subrogation if required by written contract per attached form LCO443 0512
*Notice 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
• Coverage is primary if required by written contract per policy form CA 00 01 (03/10)
*Waiver of Subrogation if required by written contract per attached form CA 04 44 10 13
*Notice of Cancellation if required by written contract per attached form LIM 99 02 08 11
• Separation of Insureds applies per policy form. (Severability of Interest/Cross Liability Clause)
• CA 99 48 10 13 and MSC90 Endorsements included.
*Medical Payments $5,000 Limit- Subject to Statutory Laws
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 WC4203 046 (Texas)
*Notice of Cancellation if required by written contract per attached form WM9018 0611
EXCESS LIABILITY:
*Underlying Policies: General Liability, Automobile Liability, and Employers' Liability
*Notice 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)
DOMESTIC TRANSIT:
Carrier: Liberty Mutual Ins. Co. [Am Best Rated A,XV] NAIC # 23043
Policy# SFOMC10043107
Transit Limit: $250,000
.,..vRu �u I tcwory I� (02008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD