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Home My WebLink About398578 EQUINOX PUMP & CONTROLS LLC - INSURANCE CERTIFICATEw..y.-1.li--Ou UlanceoruKerage r-axiu:Io:snerry Date: 12/12009 09:24 AM Page: 2 e ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID ME EQUIN-1 12/01/0 DATE (MM/DD/ E U/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CRS Insurance Brokerage ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Commercial Risk Solutions DBA HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6600 E. Hampden Ave., 2nd Flr. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver CO 80224 Phone: 303-996-7800 Fax:303-757-7719 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Continental Western Group INSURER B: Pinnacol Assurance Equinox Pump & Controls , LLC INSURER C: P . O . BOX yo INSURER D: Henderson CO 80640 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE POLI (MMIDD/YY) DATE (MM/DD/YY) LIMITS A X GENERAL LIABILITY ICOMMERCIAL GENERAL LIABILITY CLAIMS MADE IF:RP7 OCCUR CWP2709759 08/21/09 08/21/10 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY - $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PROJECT LOC PRODUCTS- COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CWP2709759 08/21/09 08/21/10 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO NO COVERAGE WITH CBS ALTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ NO COVERAGE WITH CBS EACH OCCURRENCE $ _ AGGREGATE $ $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? It yes, describe under SPECIAL PROVISIONS below _4109726 11/01/09 11/01/10 X TORV LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1 , 0 0 0 , 0 0 0 E.L. DISEASE- POLICY LIMIT $ 1, 000 , 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins is included as additional insured on the General Liability With respect to operations of the named insured for the certificate holder. ^Ahi!`CI I ATIAN CERTIFICATE HOLDF-K CIFORTC City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. © ACORD CORPORATION 198 25 (2001/08) l-rom: Mary then Sullivan At: CRS Insurance Brokerage FaxID: 303-757-7719 To: Sherry Date: 12/1/2009 09:24 AM Page: 3 of IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.