HomeMy WebLinkAboutEris Underground LLC - Insurance Certificate ACORD® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY)
2/13/2025
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 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
CRS Insurance Brokerage PHONE Andrew Safe FAX
9780 S Meridian Blvd Suite 400 - 303-996-7800 WC.No:303-757-7719
Englewood CO 80112 E-MAIL
g ADDRESS: asafe@crsdenver.com
INSURERS AFFORDING COVERAGE NAIC N
INSURER A:Pinnacol Assurance j 41190
INSURED ERISUND-01 INSURER B:Selective Ins. Co. of America I 12572
Eris Underground LLC
13169 Bryant PI INSURER C:
Broomfield CO 80020 INSURERD:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 1898802695 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.
INSR - - -'ADDL$UBR' - --- -
LTR TYPE OF INSURANCE IN D WVD i POLICY NUMBER MINIDD YYYY AtM/DD YYYY LIMITS
B X COMMERCIAL GENERAL LIABILITY i S 2501672 2/1412025 1 2/14/2026 EACH OCCURRENCE $1,000.000
CLAIMS-MADE I X OCCUR DAMAGE TO RENTED
----- -- ' PREMISES_{EaoccurrQnce)_ $500,000
MED EXP(Any one person) $15.000
PERSONAL&ADV INJURY I $1,000,000
GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000
- -
X ; POLICY X PRO- LOC I PRODUCTS-COMP/OP AGG $3,000,000
OTHER: - $
B AUTOMOBILE LIABILITY I S 2501672 2/14/2025 2/14/2026 COMBINED SINGLE LIMIT $
---• i i 1Ea.acadenll---------------
X ANY AUTO i BODILY INJURY(Per person) $
ALL OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY Per accident) $
T HIRED AUTOS X I AUUTOSWNED PROPERTY DAMAGE $
-
$
8 UMBRELLA LIAB X OCCUR S 2501672 I 2/14/2025 2/1412026 ; EACH OCCURRENCE $5,000.000
X EXCESS LIAB CLAIMS-MADE
-- � I AGGREGATE $5,000.000
DED X RETENTION$ $
A WORKERS COMPENSATION 4218169 7/1/2024 7/12025 X PE (E)FTH-
AND EMPLOYERS'LIABILITY Y/N STATUTE
ANY PROPRIETOR!PARTNER!EXECUTIVE ' E.L.EACH ACCIDENT $1,000.000
OFFICER'MEMBER EXCLUDED? Y N/A'
(Mandatory In NH) I r
If yes,describe under E.L.DISEASE-F1{EMPLOYE $1.000.000
DESCRIPTION OF OPERATIONS below ! 'rE.L.DISEASE-POLICY LIMIT $1.000.000
B 'Equipment Floater i S 2501672 i 2/14/P025 2/14/2026 Limit/DeductlWe 100,000/1,000
!
i I I
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS.
300 Laporte Avenue AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
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