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CUSTOM AIR INC - INSURANCE CERTIFICATE
Client#: 33379 CUSAIRPC ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 1 9/26/2018 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER Holmes Murphy - Colorado 7600 East Orchard Road, Suite 330 South Greenwood Village, CO 80111 CONTACT Lauren Valdes NAME: PHONE 720-622-9105FAR A No Ext : A/C No E-MAIL Ivaldes holmesmur h com ADDRESS: py•INSURER(S)AFFORDINGCOVERAGE NAIC# INSURER A: Firemen insurance Company of WA, D.C. 21784 INSURED Custom Air, Inc. 3910 South Decatur Street Englewood, CO 80110 INSURER B : Pinnacol Assurance company 41190 INSURER C : AGCS marine Insurance Company 22$37 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 CONTRACTOR 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 TYPE OF INSURANCE ADDL INSR SUB WVD POLICY NUMBER POLICY EFF MM/DD/YYYYJ POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERALLIABILITY CLAIMS -MADE OCCUR PD Ded: $500 CPA310954727 10/01/2018 10/01/201 EACH��OCCURRENCE $1 000000 PREMISESOEaoNcu ence $300,000 X MED EXP (Any one person) $10 000 PERSONAL& ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: j� PRO- LOC X1 POLICY I JECT OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY CPA310954727 10/01/2018 10/01/201 INED SINGLE LIMIT COMBEaaccident $ 1, r 000 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CPA310954727 _ 10/01/2018 10101/2019 EACH OCCURRENCE $8 000 000 AGGREGATE s8,000,000 DED I X I RETENTION $0 $ B ° WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS bolo N / A 4061749 10/01/2018 10/01/2018 10/01/2018 10/01/2019 X PERTUTE OTH- E.L. EACH ACCIDENT $1,000 000 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE - POLICY LIMIT 1 $1,000 000 C C Leased/Rented Eq. Installation Fit. SML93068983 SML93068983 10/01/201 10/01/201 $50,000; $1,000 Ded $150,000; $1,000 Ded DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CI of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE 1/GAIA.lI+ l A4 V 1 V © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD tiC4onAA7/M4Qn'7A'7 MA IUV1