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HomeMy WebLinkAbout133693 CGRS INC - INSURANCE CERTIFICATE (3)OP ID: RC '4�� CERTIFICATE OF LIABILITY INSURANCE D12/18ATE /2014 I 12/18/2014 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 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 PFS Insurance Group -JT 4848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 Dave Janssen CONTACT PHONE FAX INC, No Ext: INC, No: EJOAIL ADDRESS: PRODUCER CGRS--1 CUSTOMER ID 0: INSURERS AFFORDING COVERAGE NNC 0 INSURED C G R.S, Inc. 8: INSURER A: Admiral Insurance Company 24856 CATESTCO, LLC GreenBack Operations, Inc. 1301 Academy Court Ft. Collins, CO 80524 INSURER B: Hanover American Ins. Co. 36064 INSURER c:Allmerica Financial Benefit 41840 INSURER D: Pinnacol Assurance Co 41190 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. INSR LTR rypE OF INSURANCE DDL SUB POLICY NUMBER POLICY EFF MMIDDM POLICY EXP MWDDNYYYI LIMITS A A A GENERAL LIABILITY X COMMERCIAL GENE RALLIABILITY CLAIMS -MADE FRI OCCUR X FEI-ECC-13290-01 BLANKET ADD'L INS BLANKETWAIVER 03/01/2014 03/01/2014 03/01/2016 03/01/2015 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 60,00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 X GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER'. POLICY X PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ C C C C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Blkt Al B Waiver AW4-A232142 $1000 DIED COMP $1000 DED COLL 03/01/2014 03/01/2015 COMBINED SINGLE LIMIT (Ea awiaenq $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per awdent) $ PROPERTYE (PER ACCIDENT)IDENT) $ X X $ X $ A UMBRELLA LIAR EXCESS LAB X OCCUR CLAIMS -MADE FEI•EXS-13291 03/01/2014 03/01/2015 EACH OCCURRENCE $ 4,000,00 X AGGREGATE $ 4,000,00 DEDUCTIBLE RETENTION $ 0 $ X1 $ D E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICERNEMBER EXCLUDED' ❑ (Mandatory in NH) N yes, describe under DESCRIPTION OF OPERATIONS below NIA 4029480 CO WC4632690 CA 01/01/2015 01/01/2015 01/01/2016 01/01/2016 TWOOTH- X RV MIT X E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 B A Equipment Floater Pollution/Prof RZ4-A231842 FEI-ECC-13290-01 03/0112014 03/01/2014 03/01/2015 03/01/2016 Rented 200,00 Per claim 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addllonal Remarks Schedule, If... apace Is required) If required by written agreement, the certificate holder is included as addifional 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 26 (2009/09) The ACORD name and logo are registered marks of ACORD