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HomeMy WebLinkAbout133693 C G R S INC & GREENBACK OPERATIONS INC - INSURANCE CERTIFICATEUP ID: RC ACORO CERTIFICATE OF LIABILITY INSURANCE O02/2612ATE 01 YY) 02/26/2013 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 Phone: 970-635-9400 CONTACT PFS Insurance Group -JT Fax: 970-635-9401 4848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 Dave Janssen PHONE Fax AIC, No EXt : AIC, No): E-MAIL ADDRESS: PRODUCER CGRS--1 CUSTOMER ID p: INSURER(S) AFFORDING COVERAGE NAICN INSURED C G R S, Inc. & INSURER A: Admiral Insurance Company CATESTCO,LLC GreenBack Operations, Inc. 1301 Academy Court Ft. Collins, CO 80524 INSURER B: Admiral Insurance Corn any INSURER C: Pinnacol Assurance 41190 INSURER D: Hartford Insurance Co. 29424 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. INBR AODLPSUBR POLICY EFF POLICY EXP LTR TYPE OFINSURANCE POLICY NUMBER MMIDDIYYYY MMIDD/YYYY LIMITS A A A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE j OCCUR X FEI-ECC-13290-00 BLANKET ADDI INS BLANKET WAIVER 03/01/2013 03/0112ID13 03/01/2014I 03/01/2014 LEACH OCCURRENCE DAMAGE TORENTED PREMISES (Ea occurrence) $ 1,000,000 $ SO,000 MED EXP (Any one person) PERSONAL&ADVINJURY $ 5,000 $ 1,000,000 X GENERALAGGREGATE s 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY J. PHIIFCT -LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ D D D D AUTOMOBILE AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Blkt At & Waiver 34UUNKD8613 $1 OOO DIED COMP $1000 DIED COLL 03/01/2013 03/01/2014 COMBINEDSINGLE LIMIT C $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY accident) $ PROPERTY DAMAAGG PROPEE (Per accident) $ X X $ X $ A HUMBRELLA LIAB X OCCUR EXCESS LIAB CLAIMS -MADE FEI-EXS-13291-00 03/01/2013 03/01/2014 EACH OCCURRENCE $ 4,000,00 AGGREGATE $ 4,000,000 DEDUCTIBLE RETENTION $ 0 $ X $ C E WORKERS COMPENSATION AND EMPLOYERS' LIAaILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N OFFICERIMEMBER EXCLUDED? ❑ (Mandatory inN)i If yes describe untler DESCRIPTION 01 NIA 4029480 CO WC4632690CA 01/01/2013 01/01/2013 01/01/2014 01/01/2014 WCSTATU- OTH- X TORY_LIMITS ^ ER ELEACH ACCIDENT $ 1,000,000 E.L. DISEASE - EAEMPLOYEEI!$ 1,000,000 1 E.L. DISEASE -POLICY LIMIT I$ 1,000,000 A Polluton/Prolfater IFEI,ECC-13290-00 03/01/2013 03/01/2014IPerclaim 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD lot, 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. CITYOFC City of Fort Collins PO 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 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD