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Home My WebLink About133693 C G R S INC - INSURANCE CERTIFICATECGRSINC-01 LPREWITT . lls R CERTIFICATE OF LIABILITY INSURANCE �� DATE DIYYYY) 2/29/2016 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 terns 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 PFS Insurance Group 4848 Thompson Parkway Suite 200 Johnstown, CO 80534 CONTACT NAME: HONE Ne E t:(970) 635-9400 A/C,Ne; (970) 635-9401 (AMAIL ADDRESS: info@mypfsinsurance.com INSURER(S) AFFORDING COVERAGE NAIC p INSURER A: Admiral Insurance Company 24856 INSURED INSURER B:Allmerlca Financial Benefit C G R S, Inc. & CA TESTCO, LLC INSURER C: Pinnacol Assurance Co 41190 INSURER D : Hanover American Ins. Co. 36064 1301 Academy Ct INSURER E : Fort Collins, CO 80524 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 INSURANCEADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 0 OCCUR FEI-ECC-13290-03 03/01/2016 03/01/2017 DAMAGE PREMISES Ea occurrence 50 000 r $ X IVIED EXP (Any one person) $ 5,000 Blanket Add1 Insd X Blanket Waiver PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY a PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident)r $ 1 000 000 r BODILY INJURY (Per person) $ B ANY AUTO AW4-A232142-03 03/01/2016 03/01/2017 ALLOWNED SCHEDULED AUTOS AUTOS I BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accidentBlanket $ NON -OWNED HIREDAUTOSAUTOS NX $ Adtl'I InsdBlanket Waiver UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ A EXCESS LIAB CLAIMS -MADE FEI-EXS-13291-03 03/01/2016 03/01/2017 DED I X I RETENTION$ 0 Aggregate $ 10,000,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE 4029480 01/01/2016 01/01/2017 X PER OTH- STATUTE X ER E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N I A E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ 1,000,000 D Leased/Rented Equip RZ4-A231842-03 03/01/2016 03/01/2017 $1,000 Deductible 200,000 A Pollution/Profession FEI-ECC-13290-03 03/01/2016 03/01/2017 Limit 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) If required by written agreement, the certificate holder is included as additional insured for ongoing operations under general liability and auto liability. GtKI IF IGAIt ML)LUtK City of Fort Collins Purchasing Division 215 N Mason St 2nd FI 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 @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD