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HomeMy WebLinkAbout133693 CGRS INC - INSURANCE CERTIFICATE (2)UN IU: 1 A`ORO TE (MNVD) CERTIFICATE OF LIABILITY INSURANCE DA12/16r2 Vol3 1 zrl6a 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 PRODUCER PFS Insurance Group -JT 4848 Thompson Pkwy, Ste 200 Dave Janssen INSURED C G IRS, Inc. & �� INSURER A: Admiral Insurance Company 24856 CATESTCO, LLC a ions, Inc. INSURER e:AdmiralInsurance Company 24856 1301 Academy Court INsuRERc: Pinnacol Assurance 41190 Ft. Collins, CO 80524 INSURER o: Hartford Insurance Co. 29474 INSURER E : Zurich -American Ins Co. 16535 INSURER Is: 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. ILYR TYPE OF INSURANCE POUCY MLM R MpMNDr� MOO, p LAM A A A GENERAL LIAMUTY X COMMERCIAL GENERAL LIABILITY CLAIMS-01ADE a OCCUR X FEI-ECC-13290-00 BLANKET ADD'L INS BLANKET WAIVER 03/01/2013 0=112013 03101/2014 03/01/2014 EACH OCCURRENCE s 1,000,000 PREMISES Es�oaurranc S 50,000 MED EXP(Any one pennon) s 5,011 PERSONAL &ADV INJURY s 1,000,00 X GENERAL AGGREGATE s 2,000,00 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: X PRO-LOC PRODUCTS-COMP/OP AGG S 2,000,00 S D D D D AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS Blkt Al &Waiver 34UUNKD8613 $1000 DED COMP $1000 DIED COLL 03101/2013 03/01/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILYINJURY (Per accitlenp $ PROPS PROPERTY DAMAGE (PERACCIDENT) $ X X S X s A UMBRELLA LIAB EXCESS LIAR X OCCUR CWMS-MADE FEI-E7(5-13291-00 03/01/2013 03/01/2014 EACH OCCURRENCE s 4,000,0 X AGGREGATE s 4,000,00 11 DEDUCTIBLE RETENTION 5 O $ X 1 S C E WORKERS COMPENSATION ALIM NY EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIE%ECUTNE YIN (MandawEn NH)❑ ry in NH) If yea describe under DESCRIPTION OF OPERATIONS below NIA 29480 CO 632690 CA 01/01/2014 01/01/2014 01/01/2015 01/01/2015 X wC STATU- X IT T. E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 p A Equipment Floater Pollution/Prof 34UUNKD0613 FEI-ECC-13290-00 03101/2013 03101/2013 03/01/2014 03/01/2014 IRented 200,00 lPer claim 1,000,00 DESCRIPTION OF OPERATIONS I LOCATONS I VEHICLES (ANach ACORD'IDf, Addldonal Remari s Sahsdub, If man space Is required) If required by written agreement, the certificate holder is included as additional insured for ongoing operations under general liability. r:FRTIFIr:ATF HOI nFR CANCELLATION 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. City of Fort Collins PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD