HomeMy WebLinkAbout110722 AIR RESOURCE SPECIALISTS INC - INSURANCE CERTIFICATE (2)OP ID: SC
,a►%,. R CERTIFICATE OF LIABILITY INSURANCE
D06/11'1201DDffYY1
06/11/2014
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 polic Ales) 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 endorsement(s).
PRODUCER Phone: 970-223-1804
Front Range Insurance Group
1100 Haxton Drive Suite 100 Fax:
Fort Collins, CO 80525
David A. Wooldridge LUTCFAAI
CONTACT
NONE; NAME:
FAX
C No E AIC No:
E21AIL
ADDRESS.
CUSTOMER ID r: At RRE-1
INSURER AFFORDING COVERAGE
NAICIT
INSURED Air Resource Specialists, Inc
Jim Allan
1901 Sharp Point Dr., #E
Fort Collins, CO 80525
INSURERA: Plnnacol Assurance
41190
INSURERS -Cincinnati Insurance Companies
10677
INSURER c: Westchester Surplus Lines Ins
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,
LTR
TYPE OF INSURANCE
JuSs
vi,vo
POLICY NUMBER
MMIDD
MMIDDIYYYY
LIMITS
Lei
GENERALLIASLLITY
X COMMERCIAL GENERAL LIABILITY
CLAIMSMADE OCCUR
X Professional Liab
X
G23802910008
G23802910008
G238029100DO
06/1112014
06/11/2014
06/11/2014
06/11/2015
0611112015
0611112015
EACH OCCURRENCE
$ 1,000,00
PREMISES JEe occurrence
$ 50,00
MED EXP (Any on e Person)
$ 5,000.
PERSONAL BADVINJURY
§ 1,000,000
X
Contractors Pollu
GENERAL AGGREGATE
$ 3,000,00
GENTL AGGREGATE LIMIT APPLIES PER.
PRO LOC
X POUCY AI F
PRODUCTS-COMPIOP AGG
§ 3,000,00
S
B
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
HNOA Physical Dmg
X
EBA0145843
EBA0145843
EBA0145843
EBA0145843
06/1112014
06111/2014
06/11/2014
06M 1/2014
06/11/2015
06/11'2015
06111/2015
06/11/2015
COMBINED SINGLE LIMIT
IEa actldent)
$ 1,000,00
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
S
PROPERTY DAMAGE
(Per accident)
$
X
X
HNOAPhyDmg
$ 50,00
X
$
c
X
IIMSRELLA UAB
EXCESS UAB
X OCCUR
CLAIMS
czazz4atsaoa
asrlvzo,a
osnlam5
EACH OCCURRENCE
S Z000,000
AGGREGATE
$ 2,ODO,00
DEDUCTIBLE
RETENTION $
§
Is
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILT'
ANY PROPRIETORIPARTNEbEXECUTIVE YIN
OFFICERw.II EXCLUDED? F-1
(MAndAtory In NH)
I yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
1477552
05/01/2014
05/01/2015
W C STATU1 OTH-
X TORY LIMITS R
EL. EACH ACCIDENT
$ 1,000,00
E.L. DISEASE - EA EMPLOYEE
$ 1,000,00
E.L. DISEASE -POLICY LIMIT
$ 1,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Agach ACORD 101, Additional R.merb Sch$ Wr, If more spec. I� ngWl-d)
The city Fort Collins it officers, agents and employees are listed as
Additional Insured with respect to the General Liability Policy and the
Commercial Auto Policy
CITY OF
City of Fort Collins
Director of Purchasing
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NO nCE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
01988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD