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567543 ELITE INDUSTRIES INC - INSURANCE CERTIFICATE (2)
ELITIND-02 SUZANNEH ,4coRn CERTIFICATE OF LIABILITY INSURANCE DATE 19/2 V8 � 10//018 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER C NTACT Joe Anderson INME: l0 PHONE Greenwood Plaza Blvd. (A/C, Ext): (720) 212-2029 (A 5 6C, No):(303) 799-0156 Suite 500 E- oREss: JoeA@thinkccig.com Greenwood Village, CO 80111 , ------ INSURED INSURER B : Pinnacol Assurance 41190 Elite Industries Inc. INSURERC: _ 2401 S. Downing St. INSURER0: Fort Collins, CO 80522 INSURER E INSURER P : Cr1VFRARFS ri=PTIFI(_ATF KII IMRFR- RFVICIr11J NII IMRFR- 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 TYPE OF INSURANCE ADDL SUBRI POLICY NUMBER POLICY EFF POLICY EXP LIMITS M/ /Y /YY A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X CWP9647699 03/01/2018 03/01/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES(Eao rre 500,000 $ MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L F1POLICY AGGREGATE LIMIT APPLIES PER . � JE� LOC OTHER. GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED N0N- TIT AUTOS ONLY AUTOS ONLY X CWP9647699 03/01/2018 03/01/2019 COMBINED SINGLE LIMIT Ea accident) ---- _ BODILY INJURY Perperson) 1,000,000 X $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE CWP9647699 03/01/2018 03/01/2019 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 DED X RETENTION $ 0 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ Mandatory in NH) EXCLUDED'? If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4187389 11/01/2018 11/01/2019 X PER OTH- T E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 $ I E.L. DISEASE - POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) As required by written contract or written agreement, City of Fort Collins is included as Additional Insured for ongoing operations under General Liability and Automobile Liability. ICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD