Loading...
HomeMy WebLinkAboutCOI - Roadsafe Traffic Systems LP - Expires 2021-10-031 A � E� CERTIFICATE OF LIABILITY INSURANCE 0/3/2021 FDATE(MMIDDIYYYY) 10/5/2020 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 Lockton Companies 1185 Avenue of the Americas, Suite 2010 New York NY 10036 646-572-7300ADDRESS: CONTACT FAX Arc No Ext : Arc No E-MAIL INS ER AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins Co Pitts. PA 19445 INSURED ROADSAFE TRAFFIC SYSTEMS LP 1483533 1808 FRAZER AVENUE SPARKS NV 89431 INSURER B : Lexinglon Insurance Company 19437 INSURER C : AIU Insurance Cowany 19399 IN URER D. • AXIS Surplus Insurance Company 26620 INSURER E • Mercer Insurance Coml2any 114478 -Nqi ER F • Evanston Insurance Company 35378 r_nvFRAr-=s ROAT4001 CFRTIFICOTF NIIMRFR• 17040951 RFVIRI[JN Nt1MRFR- XXXXXXX 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 ADDL SUBR WVD POLICY NUMBER POLICY EFF IMMIDDIYYYY POLICY EXP 1MM1DD/YYYylLIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR FX y y GL 1729018 10/3/2020 10/3/2021 EACH OCCURRENCE 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence SOO OOO MED EXP (Any oneperson) 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JEST 1 LOC OTHER: GENERAL AGGREGATE $ 5 000 000 PRODUCTS - COMP/OP AGG $ 4,000,000 $ A A A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY X NON -OWNED S ONLY Y Y CA 4594477 (ADS) CA 4594478 (MA) CA 4594479 (VA) 10/3/2020 10/3/2020 10/3/2020 10/3/2021 10/3/2021 10/3/2021 COMBINED SINGLE LIMIT Ea accident $ 3,000,000 X BODILY INJURY (Per person) $ }txxjl xxx BODILY INJURY (Per accident $ XXXXXXx X Per acEcidenDAMAGE $ XXXXXXX $XXXXXXX B UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y 023627546 10/3/2020 10/3/2021 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 DED I X I RETENTION $0 $ XXXXXXX C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory hi NH) If yes, under DESCRIPTIION OF OPERATIONS below N / A Y WC 046912919 (AOS) 10/3/2020 10/3/2021 X STATUTE oER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE I1 1 000 000 E.L. DISEASE - POLICY LIMIT 1 000 000 D FEXCESS EXCESS GENERAL LIAB. AUTO EXCESS y y P-001-000044004-03 27307505 MKLV6XL30000237 10/3/2020 10/3/2020 10/3/2020 10/3/2021 10/3/2021 10/3/2021 $3,000,000 Occ/S6,000,000 Agg $2,000,000 $5,000,000 Occ/$5,000,000 Agg DESCRIPTION OF OPERATIONS r LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) %or-m I Irmom 1 C rIVLur_r% tr/11Y%.rGLLP111V14 0" LILLaL.1ll11G1IL 17040951 Cityy of Gilroy 7351 Rosanna Street Gilroy, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE A►COR❑ 25 /2046/n2l ©19$8-2015 ACORD CORPORATION. All riahts reserved The ACORD name and logo are registered marks of ACORD ' a Attachment Code : D582370 Master ID: 1483533, Certificate ID: 17040951 Workers Compensation Policies Policy Number Carrier Limits VV%- V-TV71L7LL ,1'IA, YY11 WC 046912920 (CA) WC 046912921 (FL) New Hampshire Insurance AIU Insurance Company AIU Insurance Company $110001000/$1,0oo,000/$1,000,000 $11000, 000/ $1, 000, 000/ $1, 000, 000 $1, 000, 000/ $1, 000, 000/ $1, 000, 000