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HomeMy WebLinkAboutTRANSDEV NORTH AMERICA INC - INSURANCE CERTIFICATE (5)ACD ® CERTIFICATE OF LIABILITY INSURANCE DATE(BM M/DDDi YYY) 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 have ADDITIONAL INSURED provisions or 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: (A/CC..NN . Ezt): C866) 283-7122 A/C. 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. INSURERB: ACE Property & Casualty Insurance Co. 20699 720 E. Butterfield Road, suite 300 Lombard IL 60148 USA INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570071797910 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 INSR LTR TYPE OF INSURANCE NSD WVD POLICY NUMBER MM/DD/YYYY MM DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY MWZY 1 1 1 1 7 1 1 EACH OCCURRENCE $5,000,000 CLAIMS -MADE X❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $1, 000 , 000 MED EXP (Any one person) $10 , 000 PERSONAL &ADV INJURY $5,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $5,000,000 X POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OPAGG $5,000,000 OTHER: A AUTOMOBILE LIABILITY MWZX 26684 07/01/2018 07/01/2019 COMBINED SINGLE LIMIT Ea accident $5,000,000 EXC of statutory Limits A X ANYAUTO MWTB 21267 07/01/2018 07/01/2019 BODILY INJURY ( Per person) BODILY INJURY (Per accident) OWNED SCHEDULED statutory Limits AUTOS ONLY AUTOS PROPERTY DAMAGE HI RED AUTOS NON -OWNED Per accident ONLY AUTOS ONLY B X UMBRELLA LIAB X OCCUR XOOG28126608003 07/01/2018 07/01/2019 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION A WORKERS COMPENSATION AND MWC31381900 07/01/2018 07/01/2019 X STA UTE OTH EMPLOYERS' LIABILITY Y❑ E.L. EACH ACCIDENT $1 , 000 , 000 ANY PROPRIETOR / PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA A E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1 , 000 , 000 A E&o-PL-Primary MWZZ 313821 07/01/2018 07/01/2019 Each Claim $10,000,000 Claims Made Aggregate $10,000,000 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 215 Mason street, 2nd Floor For Fort Collins Co 80522 USA :JtG_f�cO CCI�/i d 0 rn rn r` 0 0 r` uO O Z d !6 t) t= 01 U J ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD