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HomeMy WebLinkAbout119979 QUALITY TRAFFIC CONTROL INC - INSURANCE CERTIFICATE (16)QUALTRA-02 VMATHIAS FACORN DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 08/28/2017 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 endorsement(s). PRODUCER CONTACT _MME: PFS Insurance Group I a"c° No, E:t): (970 635-9400 FaAic, No 970 635-9401 4848 Thompson Parkway Suite 200 E-MAIL ) - I )'( , Johnstown, CO 80534 ADDRESS: valeriem mypfsinsurance.com INSURED Quality Traffic Control, Inc. Mike Obester 209 Racquette Drive #5 Fort Collins, CO 80524 r1f1VP0AnrQ C-ERTIFII'ATE NUMBER* INSURER c : Pinnacol Assurance Co 41190 INSURER D , INSURER E : INSURE_R__F:__ 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. INSIR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY P LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR X CA000022348-02 08/27/2017 M27/2018 CURRENCE �AAGE 5 (RENTED50,000 S R occurD Any oneperson) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ 1,000,000 $ $ 5,000 $ 1,000,000 GE_N'L AGGREGATE LIMIT APPLIES PER: X POLICY L Tpef LOC OTHER: $ 2,000,000 $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED N-OWNED AUTOS ONLY AUTONOS ONLY Ea accideD SINGLE LIMIT BODILY INJURY Perperson) BODILY INJURY Per accident Pi�eOfaCGdeTMr$ AMAGE $ $ $ $ B X UMBRELLA LIAB X OCCUR EXCESS LIAB CLAIMS -MADE DED ETENTION $ O NHA240886 08/27/2017 08/27/2018 EACH OCCURRENCE AGGREGATE $ 1,000,000 $ 1,000,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N 4130969 04/01/2017 04/01/2018 ANY OFFICER/MEMBERER /EXCLUDED? ECUTIVE N / A (Mandatorym NH) If yes, describe under DESCRIPTION OF OPERATIONS below ', X PER STATIJIFX ' OTH- _E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT 1,000,000 $ $ 1,000,000 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) If required by written contract, the Certificate Holder is included as Additional Insured for ongoing operations under General Liability. CERTIFICA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. 300 LaPorte Ave Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE P"A ;�' 7/w ACORD 25 (2016/03) © 1988-2015 ACORD CORPORAI ION. All rlgnts reservea. The ACORD name and logo are registered marks of ACORD