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HomeMy WebLinkAbout398578 EQUINOX PUMP & CONTROLS LLC - INSURANCE CERTIFICATE (4)EQUIN-1 OP ID: TLG A4ciR15' CERTIFICATE OF LIABILITY INSURANCE PATE06119DYYYY) s11s/1z 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 303-996-7801 QRS Insurance Brokerage — Commercial Risk Solutions DBA _ 303-757-7719 6600 E. Hampden Ave: - -' - Denver, CO 80224 CNTACT NAME' - _ -- PHONE FAX Alc No Ell, ac No: E-MAILADDRESS: - Jeffrey Berven , INSURERS AFFORDING COVERAGE NAICN INSURER A: Continental Western Group 10804 INSURED Equinox Pump 8, Controls, LLC P.O. Box 100 Henderson, CO 80640 INSURER B: Plnnacol Assurance INSURER C INSURER D: INSURER E : 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. NSR TR TYPE OF INSURANCE POLICY NUMBER MMIDOIIYYYY MMIO�IIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X CWP2709759 08121/11 08121112 PREMISES Eaoccu a ce $ 100,00 CLAIMS -MADE FT OCCUR MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY - $ 1,000,00 GENERAL AGGREGATE - $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,00 $ X1 POLICY RO LOG PIFCT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (CEO, accident 1,000,00 BODILY INJURY (Per person) $ A X ANY AUTO CWP2709759 08121/11 06/18112 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par accident) $ PROPERTY DAMAGE Peraccident S NON -OWNED X HIRED AUTOS X AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 A EXCESS LIAB CI -AIMS -MADE CU2960780 10/26/11 06/18/12 DED X RETENTION $ 0 $ B - WORKERS COMPENSATION EMPLOYERS' LIABILITY AND EMPLOYERS' LIABILITY ANY PROPRIETORRARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA 4109726 11I01111 11I01112 X WC STATU- I�T RYAND E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,0D If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addlflonal Remarks Schedule, If more space le required) Citv of Fort Collins is included as additional insured on the General Lia ility with respect to ongoing operations of the named insured for the certificate holder as required by written contract. All policy terms, conditions and exclusions apply. CIFORTC City of Fort Collins 215 N. Mason, 2nd Floor Fort Collins, CO 80524 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 91W © 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD EQUIN-1 OP ID: TLG CERTIFICATE OF LIABILITY INSURANCE OAT06/19D/YYYY) 06/19N 2 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 conferrights to the certificate holder in lieu of such endorsements . PRODUCER 303-996-7801 CRS Insurance Brokerage Commercial Risk Solutions DBA- 303-757-7719 6600 E. Hampden Ave. Denver, CO 80224 CONTACT PHONE FAX A/C No EX[: - ac No: E-MAL s: ADDRE ... Jeffrey Berven INSURERS AFFORDING COVERAGE NAIC a INSURER A: Continental Western Group 10804 INSURED Equinox Pump & Controls, LLC P.O. Box 100 Henderson, CO 80640 INSURER B: Plnnacol Assurance INSURER C: INSURER D: INSURER E 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 TR TYPE OF INSURANCE AODL INSR UB MD POLICY NUMBER MMIDD/YYYY ICY EXP MMIDD/YYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X CWP2709759 08/21/11 08/21/12 PREMISES HEa occurrence $ 100,00 CLAIMS -MADE O OCCUR MED EXP (Any one person) $ 5,00 PERSONAL BADVINJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 _ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGO $ 2,000,000 $ X POLICY PRO LOC AUTOMOBILE LIABILITY Ee BINacciDI SINGLE LIMIT $ 1,000,00 BODILY INJURY (Per person) $ A X ANY AUTO CWP2709759 08/21/11 06/18/12 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE NO COVERAGE WITH CRS DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVEYIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 4109726 11/01/11 11/01/12 X WC STATU- OTH- T RY LIMIT R EL EACH ACCIDENT $ 1,000,00 EL DISEASE - EA EMPLOYEE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT I $ 1,000,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) City of Fort Collins is included as additional insured on the General Liability with respect to ongoing operations of the named insured for the certificate holder as required b� written contract. All policy terms, conditions and exclusions apply. 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, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 9 ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD