HomeMy WebLinkAbout110722 AIR RESOURCE SPECIALISTS INC - INSURANCE CERTIFICATEOP ID: TA
1A1C,C)�RL7" CERTIFICATE OF LIABILITY INSURANCE
oATE
10130/l3 r
01303
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 Ileu of such endorsements .
PRODUCER 970-223-1SO4
Front Range Insurance Group
1100 Haxton Drive Suite 100
Fort Collins, CO 80525
David A Wooldridge LUTCFAAI
NAMEAcT
PHONE
AIC Me:
AI
ADDRESS:
CUSTOMER ID s: Al RRE•1
INSURE S AFFORDING COVERAGE
MAC 8
INSURED Air Resource Specialists, Inc 1�� 12Z
Jim Allan
1901 Sharp Point Dr.,#E
Fort Collins, CO 80525
INSURER A:PinnaeolAssurance
41190
INSURER 13:Cincinnati Insurance Companies
10677
INeuaeac:WestehesterSurplus Linesins
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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
Jim
TYPE OF INSURANCE
POLICY NUMBER
MMIDDIYYYY)
IMMODrYYYYI
LIMITS
C
GENERAL LIABLITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FX70CCUR
X Professional Liab
X
G23802910007
023802910007
G23602910007
0611IM3
06111/13
06I11/13
06/11114
06/11114
06111/14
EACH OCCURRENCE
$ 1,000,000
PREMISES (Ee occurrence
$ 50,00
MED EXP (Any oneperson)
$ 5,00
PERSONAL I ADV IN JURY
$ 1,000,00
X
Contractors Pollu
GENERAL AGGREGATE
$ 3,000,00
GEN'L AGGREGATE
X POLICY
LIMIT APPLIES PER.
IRI-
JECT LOC
PRODUCTS-COMROP AGG
S 3,000,00
$
B
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNEDAUTOSEBA0145843
HNOA Physical Dmg
EBA0145843
EBA0145843
.EBA0145843
06/11113
06/11/13
06/11/13
06/11/13
06111114
06/11114
06/11/14
0611V14
COMBINED SINGLE LIMIT
(Ea madent)
f 1,000,0D
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
S
PROPERTY DAMAGE
(Per accident)
$
X
X
HNOAPhyDrrrg
s 50,OOC
X
s
C
X
UMBRELLA UAB
EXCESS LIAB
X OCCUR
CLAIMS -MADE
G24224818003 06111 /13
O6/NI14
EACH OCCURRENCE
$ 2,000,00
AGGREGATE
S 2,000,00
DEDUCTIBLE
RETENTION $
$
S
A
WORKERS COMPENSATION
AfO EMPLOYERS' LIABLMY
ANY PROPRIETORIPARTNER,EXECUTIVEYIN
OFFICERIMEMBER EXCLUDED?
(MandMery In NH)
If Yes, describe under
DESCRIPTION OF OPERATIONS below
N I A
147755.2 05101H3
OW114
W C STATU- X OTH-
T RV IMIT
E.L.EACH ACCIDENT
S 11,00111110010
E.L. DISEASE- EA EMPLOYEES
1,000,000
E.L. DISEASE- POLICY LIMIT
$ I'M0,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(AaeMACORD101,AddibmWRe *s Schedule,If..WmisrginQ
The city Fort Collins it officers, agents and employees are listed as
Additional Insured wi�h respect to the General Liability Policy
CERTIFICATE HOLDER CANCELLATION
CITY OF
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
Director of Purchasing
AUTHORIZED REPRESENTATIVE
PO Box 580
Fort Collins, CO 80522
%� G
ACORD 25 (2009109)
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