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110520 TRAFFIC SIGNAL CONTROLS - INSURANCE CERTIFICATE (6)
CERTIFICATE OF LIABILITY INSURANCE s73�2017 THIS CERTIFICATEIS 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 HARTFORD FIRE INSURANCE COMPANY 250760 P: F: PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: PHONE (A/C, No, Ext): FAX (AlC, Nog ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL# INSURERA: Hartford Fire Ins Co INSURED TRAFFIC SIGNAL CONTROLS, INC. 255 WEAVER PARK RD S TE 100 LONGMONT CO 80501 INSURER B : INSURER C : INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. LVSB TYPE OFRVSURA.NCE ADDI SUBA POLICYNUAWLR ( EFF POLICYERP LLWTS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS -MADE ❑ OCCUR DAMAGE TO RENTED PREMISES (Ea occurcence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY JE 0. ❑ LOC PRODUCTS -COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY A COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE HIRED NON -OWNED AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA LU1B OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DE RETENTION S $ WOBLERSCOMPENSATION ANDEP1 YF"LL46RAYP ANY PROPRIETORIPARTNERIEXECUTIVEYIN X PER OTH- STATUTE OR E.L. EACH ACCIDENT $10 0 , 0 0 0 A OFFICER/MEMBEREXCLUDED? WandatoryinAW) F]76 WA WEG RQ1437 07/01/2017 07/01/2018 E.L. DISEASE -EA EMPLOYEE $100, 000 If yes, describe under DESCRIPTION OF OPERATIONS belowI E.L. DISEASE -POLICY LIMIT S 5 0 0, 000 [:N DESCRIPMNOFOPERATIONS/LOCATIONS/VEHICPMRD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. 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 .. 215 N MASON ST FL 2c2 FORT COLLINS, CO 80524 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD