HomeMy WebLinkAbout398578 EQUINOX PUMP & CONTROLS LLC - INSURANCE CERTIFICATE (5)EQUIN-1 OP ID: DR
'`�� Rom'' CERTIFICATE OF LIABILITY INSURANCE
DAT07/20/12 )
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
CRS Insurance Brokerage
Commercial Risk Solutions DBA - 303-757-7719
6600 E. Hampden Ave.
Denver, CO 80224 - -
CONTACT -
PNONE FF - -- '
ac Ne Exit: ac No):
E-MAIL -- - -- - - - - --- -
ADDRESS:
Jeffrey Bervrven
INSURERS AFFORDING COVERAGE
NAIC r
INSURER A: Continental Western Group
10604
INSURED Equinox Pump $ Controls, LLC
INSURER B: Pinnacol Assurance
P.O. Box 100
Henderson, CO 80640
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
MMIODYEFF
MMMMIUDCDY UP
UNITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
PREMISES Ea aru,ance
S 100,00
A
X COMMERCIAL GENERAL LIABILITY
X
CWP2709759-CANCELLED
08/21/11
07/12/12
CLAIMS -MADE � 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 - COMPIOP AGO
$ 2,000,00
X POLICY PRO- LOC
EDT
$ - -
AUTOMOBILE LIABILITY
Ea,.,deD SINGLE LIMIT
$ 1,000,00
BODILY INJURY (Par pereon)
$
A
X ANY AUTO
CWP2709759-CANCELLED
08/21111
07/12/12
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
X HIRED AUTOS X NON -OWNED
AUTOS
X
UMBRELLALWB
X
OCCUR
EACH OCCURRENCE
$ 2,000,00
AGGREGATE
$ 2,000,00
A
E%CESSIJAB
CLAIMS -MADE
CU2960780-CANCELLED
10/26111
07112/12
DEC X RETENTIONS 0
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYB ANY PROPRIETORPARTNER/ ECUTIVEY/N
EXCLUDED? ❑
(Mandatory in NH)
VIA
4109726
11/01/11
11/01/12
MOISEASE
$ 1,000,00OrFiCERIMEMBEB
PLOYEE
$ 1,000,00H
y de.,be under
DESCRIPTION OF OPERATIONS below
CY LIMIT
$ 1,000,00
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 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
U 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD