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HomeMy WebLinkAbout110722 AIR RESOURCE SPECIALISTS INC - INSURANCE CERTIFICATE (3)i—� AIRRESO-01 QCTRUJILL DATE (MMIDoMM) 6/4/2020 ACO�P®" �— CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED_ AS, A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVmY 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(§), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT; If the certificate holder is an ADDITIONAL INSURED, the poltcy(tes) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms aTd-conditions this certificate does not Confer rights to, the certificate holder of the policy, certain policies may requirean endorsement A statement on in lieu of such endorsement(s). PRODUCER CONTACT Assured Partners dtla Front Range Ins Group 2002 Caribou Drive, #161 P.O. Box 270550 PHONE FAX (A/c, Ne Ext :.(970) 22361804 (FAX No): 1 1 Fort Collins, CO 80525 INSURERS AFFORDING COVERAGE NAIC # INSURER A:WestchesterSurplus Lines Insurance Com an-_ 10172 INSURED INSURER B.:Cincinnati Indemnity Company 23230 INSURER C : Pinnacol Assurance 41190 _. Air Resource Specialists, Inc INSURER D : 1901 Sharp Point Dr, Unit F Fort Collins, CO 80525 INSURER E INSURERF: COVERAGES CERTIFICATE NUMRER- REVISION N1IMRFR! THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCEI 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 TYPEOFINSURANCE ADOL INSD SUER VD POLICY NUMBER POLICY EFF POLICY EXP LINITS A X COMMERdALGENERALDABIDW__.. CLAIMS -MADE �X OCCUR _ X .-_ G23802910014 _.-......_ 6111/2020 6/11/2021 OCCURRENCE $ 1.,000,000 DAMAGEACH PREMIESMeoccrrTO RENTED $ _ 50,000 X MED EXP (Any oneperson) $_ _ 5,000 Contractors P011utio PERSONAL B ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY ❑ pre7 LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OPAGG $ 3,000,000 OTHER B AUTOMOBILE LIABILITY COMBBII tlED SINGLE LIMIT (Ea aentlX _ $ 1,000,000 BODILY INJURY Perperson) $ ANY AUTO X EBA0145843 6/11/2020 6/11/2021 BODILY INJURY Par acddenl $ OWNED SCHEDULED AUTOS ONLY AUTOS SWT1Ep X Poor ac CeraDAMAGE $ AUTOS ONLY X AUTO ONLY A UMBRELLA LIAB X_ OCCUR EACH OCCURRENCE $ 2;000,000 X ExceSSLwB CLAIMS -MADE G24224878010 6/11/2020 6/11/2021 AGGREGATE $. 2,000,000 DED RETENTION$ `` ANDRFFMMPLOYERF ENSLIAATIONBILITYX YIN ANY. P.ROP.RIETORIPARTNERIEXECUTIVE ❑ Ka'.1 �ERIMFIM EXCLUDED? ((MMan awry n ) NIA 1477652 6/1/2020 � 5/1/2021 OTH- STEARTUTE ER E.L. EACH ACCIDENT 1,000,000 $ - - E.L. DISEASE - EA EMPLOYE - $ 1,000,000 Ryyes,tlescdbewder DESCRIPTION. OF.OPERATIONS belay - E.L. DISEASE - POLICY LIMIT - 1;000,000 $ B Property EPP0145843 6/11/2020 6/11/2021 BPP 1,334,770 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addidonal If required by written contract, signed by both parties prior to loss, Remarks Schedule, my be attached If more apace Is required) the following endorsements apply on a blanket basis: General Liability: CG2010 (04/t3) -Additional Insured -Owners, Lessees or Contractors CG2037 (04113) - Additional Insured - Owners, Lessees or Contractors -Completed Operations ENV3143 (03/05)- Waiver of Transfer of Rights of Recovery E40252 (12/18)- Primary and Noncontributory -Other Insurance Conditions SEE ATTACHED ACORD 101 SHOULD ANY OF THEABOVE.DESCRIBED POLICIES BE CANCELLED BEFORE. C" of Fort Collins Financial Services THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN City ACCORDANCE WITH THE POLICY PROVISIONS. 115 N. Mason St - 2nd Floor PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE Hybl° a w„ 2016/03) © f 868+2016 ACORD CORPORATION. All rights reserve-i The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: AIRRESO-01. LOC #: 1 CSCTRUJILLO ACORD` ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED ssuredPartners dba Front Range Ins Group 9 P Air Resource Specialists Inc 1901 Sharp Point Dr, Uni( F Fort Collins, CO 80525 POLICY NUMBER SEE PAGE 1 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE t THIS ADDITIONAL.REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/LocationsNehicles: Auto Liability: AA288 (01116) - Additional Insured, Waiver of Subrogation, Primary/Noncontributory Workers Compensation: 359b - Waiver of Subrogation Excess Liability: Following Form over General Liability; Auto Liab and Employers Lability The City Fort Collins, it officers, agents and employees are included as Additional Insured per conditions and forms shown.. ACORD 101 (2008/01) © 2008 ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks of ACORD