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HomeMy WebLinkAbout162251 REDFLEX TRAFFIC SYSTEMS INC - INSURANCE CERTIFICATE (15)AcoRo►® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
1 3/31/2017
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 endorsements .
PRODUCER CONTACT
NAME: Certificate Department
Arthur J. Gallagher & Co. Insurance Brokers PHONE 925 299-1112 FAx 925-299-0328
lE-MAIL
of California, Inc. LIC #0726293 AIEx
3697 Mt. Diablo Bl
vd., Suite 300-M ADDRESS, CertRequests@ajg.com
Lafayette CA 94549 INSURER(S) AFFORDING COVERAGE NAIC #
INSURED
Redflex Traffic Systems, Inc.
5651 W. Talavi Blvd., Suite 200
Glendale, AZ 85306
INSURER A: Liberty Insurance Corporation 42404
REDFTRA-02 INSURERB:Westchester Surplus Lines Insurance 10172
INSURER c: Liberty Mutual Fire Insurance Compa 23035
INSURER D: First Liberty Insurance Corporation 33588
INSURER E :
rnvronr_rc PrDTICIr ATC 11111RADCD• 1 2241;nI423 DCVICInIU INI IM92CD-
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 ADDLTYPE OF INSURANCE POLICY EFF POLICY EXP
LTR INSD' WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
1 Y
TB5Z91453980037
4/1/2017
4/1/2018
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE a OCCUR
PREMISES Ea occurrence
$1,000,000
X
MED EXP (Any one person)
$10,000
$25K BI/PD DED
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
X71 POLICY PRO- JECT ❑ LOC
PRODUCTS - COMPIOP AGG
$ 2,000,000
$
X OTHER: CAP of $25M
C
AUTOMOBILE LIABILITY
Y
Y
AS2Z91453980027
4/1/2017
4/1/2018
Ea accident lMrr
$1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
<-'HAPD Ded
$
X COMP/COLL X DED`: $5,000
A
X
UMBRELLA LIAB
X
OCCUR
TH7Z91453980047
4/1/2017
4/1/2018
EACH OCCURRENCE
$5,000,000
AGGREGATE
$5,000,000
EXCESS LIAB
CLAIMS -MADE
DED I x RETENTION $ $10,000
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑
y
WC6Z91453980077
4/1/2017
4/1/2018
X STATUTE EERH
_
E.L. EACH ACCIDENT
$1,000,000
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
N/A
E.L. DISEASE - EA EMPLOYEE
$1,000,000
If es, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
S1,000,000
B
PROFESSIONAL & CYBER LIABILITY
G27435075004
4/1/2017
4/1/2018
Each Claim $2,000,000
Aggregate $2,000,000
SIR - Each Claim $50,000
DESCRIPTION OF OPERATIONS / LOCATIONS I 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 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.
AU�T,HOf/.RI,ZEEDD �REPRESENTATIVE
® 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:
LOC #:
oRO ADDITIONAL REMARKS SCHEDULE Page of
AGENCY NAMEDINSURED
POLICY NUMBER
CARRIER NAIC CODE
d EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE:
THIRD PARTY CRIMEIFIDELITY COVERAGE
Carrier: TRAVELERS CAS & SURETY CO OF AMER [A+,XV] NAIC # 31194 Policy #: 105581296 1 Etfect:-c 04/01/2017-04/01/2018 '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«. YU2Z91453980067
Effective 04/01/2017-04/0112018 Blanket Personal Property: $19.120.000 1 Installation- PPIPPO: $1,000,000 Transit: $10,000
(blanket tersonal rropeny 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: Liberty Insurance Corporation (AM Best Rated A XV)
• Additional insured if required by written contract per attached form LC0443 05' 2
'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: Liberty Mutual Fire Ins. Company (AM Best Rated A XV)
• Designated Insured if required by written contract per attached form CA2048 10' 3
• Coverage is primary on owned autos only per policy form CA 00 01(03/10)
'Waiver of Subrogation if required by written contract per attached torm 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: First Liberty Insurance Corporation (AM Best Rated A XV)
• 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 04B (Texas)
`Notice of Cancellation if required by written contract per attached form WM9018 0611
EXCESS LIABILITY: Liberty Insurance Corporation (AM Best Rated A XV)
'Underlying Policies: General Liability, Automobile Liability. and Employers' Liability
"Notice of Cancellation if required by written contract per attached form LM9901 05".1
"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# SFOMC10043108
Transit Limit: $250.000
ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD