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Home My WebLink AboutGREENBACK OPERATIONS INC - INSURANCE CERTIFICATEUP IU: RIC CERTIFICATE OF LIABILITY INSURANCE DATE02/29D/YYYV) 1 z/zs/1 z 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 endorsements . PRODUCER 970-635-9400 PFS Insurance Group - JT 4848 Thompson Pkwy, Ste 200 970-635-9401 Johnstown, CO 80534 Dave Janssen CONTACT PHONE FAX A/C No Ext : A/C No E-MAIL ADDRESS: PRODUCER CUSTOMER ID q: CGRS--1 INSURER(S) AFFORDING COVERAGE NAIL# INSURED C G R S, Inc. & CA TESTCO, LLC GreenBack Operations, Inc. Ft. C Ft. Collins,Academy Court CO 80524 INSURER A: Endurance American Spec INSURER B : Endurance American Spec INsuRERc:PinnacolAssurance 524210 INSURER D: Hartford Insurance Co. 00914 INSURER E : Zurich -American Ins Co. 16535 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. INSR LTR TYPE OF INSURANCE ApDL SUBR I POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDp LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7XI OCCUR ECC101014122-00 03/01/12 03/01/13 EACH OCCURRENCE $ 1,000,000 X AMA E RENTE PREMISES Ea occurrence IS 50,000 MED EXP (Any one person) $ 5,000 PERSONAL&ADV NJURv $ 1,000,000 BLANKET ADD'L INS 03101/12 03101/13 GENERAL AGGREGATE $ 2,000,000 BLANKET WAIVER GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 1 1l PRO-n LOC PRODUCTS COMP/OP AGG $ 2,000,000 $ D AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS 34UUNKD8613 03/01/12 03/01/13 COMBINED SINGLE LIMIT (Ea awident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ D SCHEDULED AUTOS HIREDAUTOS $1000 DIED COMP $1000 DIED COLL X PROPERTY DAMAGE (Per accident) $ X $ D NON-OWNEDAUTOS Blkt Al & Waiver X $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 4,000,000 AGGREGATE $ 4,000,00 A EXCESS LIAR CLAIMS -MADE EXS101014123-00 03/01112 03/01/13 DEDUCTIBLE X $ RETENTION $ O C E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIE /PARTNERXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A IWC4632690 4029480 CO CA 01/01/12 01101/12 01/01/13 01/01/13 WC STATU. OTH- X T RY X EL. EACHAcaoervT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 EL. DISEASE- POLICY LIMIT 1 $ 1,000,000 D Equipment Floater 34UUNKD8613 03/01/12 03101/13 Rented 200,000 A Pollution/Prof ECC101014122-00 03/01/12 03/01113 IPerclaim 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) If required by written agreement, the certificate holder is included as additional insured for ongoing operations under general liability. City of Fort Collins PO Box 580 Fort Collins, CO 80522 CITYOFC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE ACORD 25 (2009/09) V ItRHJ-Z000 ACURU CURPURATION. All rights reserved. The ACORD name and logo are registered marks of ACORD