HomeMy WebLinkAbout110722 AIR SPECIALISTS INC - INSURANCE CERTIFICATE--s"I'l OP ID: CT
ACORN DATE (MM/DD/YYYY)
`� CERTIFICATE OF LIABILITY INSURANCE 06/08/2018
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 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 Phone: 970-223-1804 CONTACT
a Insurance GroupNAME:
Front Range PHONE FAX
2002 Caribou Drive, Ste. 101 Fax: _WC. No. Ext): (A/C, No):
Fort Collins, CO 80525 E-MAIL
John W. Bell ADDRESS:
PRODUCER AIRRE-1
rusmuco In r•
INSURED Air Resource Specialists, Inc
Jim Allan
1901 Sharp Point Dr., #F
Fort Collins, CO 80525
INSURER(S) AFFORDING COVERAGE NAk
INSURER A:Pinnacol Assurance 41190
INSURER B: Cincinnati Insurance Companies 10677
INSURER C: Westchester Surplus Lines Ins
INSURER D :
rnVGRAnPQ rF=PTIFICATF NIIMRFR• 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
OF INSURANCE
ADDTYPE
3.
UBR
POLICY NUMBER
MMNDY EFF
POLICY EXP
MM DD/YYYY
LIMITS
C
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 1XI OCCUR
X Professional Liab
X
G23802910011
G23802910011
G23802910011
06/11/2018
06/11/2018
06/11/2018
06/11/2019
06/11/2019
06/11/2019
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENT D
PREMISES Ea occurrence
$ 50,00
MED EXP (Any one person)
$ 5,00
PERSONAL & ADV INJURY
$ 1,000,00
X
Contractors Pollu
GENERAL AGGREGATE
$ 3,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO LOC
PRODUCTS - COMP/OP AGG
$ 3,000,00
$
B
B
B
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
HNOA Physical Dmg
X
EBA0145843
EBA0145843
EBA0145843
EBA0145843
06/11/2018
06/11/2018
06/11/2018
06/11/2018
06/11/2019
06/11/2019
06/11/2019
06/11/2019
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X
BODILY INJURY (Per person)
$
X
X
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$ 50,0010
HNOA Phy Dmg
X
$
C
X
UMBRELLA LIAB X
EXCESS LIAB
OCCUR
CLAIMS -MADE
G24224818007
06/11/2018
06/11/2019
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
$ 2,000,000
DEDUCTIBLE
RETENTION $
$
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
1477552
05/01/2018
05/01/2019
WC STATU- OTH-
X TCRY LIMITS ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
C
Bus Pers Prop
EPP0145843 06/11/2018
06/11/2019
ALL LOCS 814,200
BUS Inc 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
The City Fort Collins, it officers, agents and employees are listed as
Additional Insured with respect to the General Liability Policy and the
Commercial Auto Policy
rcoTlnrA,rc: unl nr-o rANCFI I ATInN
CITY OF
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
Financial Services
AUTHORIZED REPRESENTATIVE
215 N. Mason St. - 2nd Floor
PO Box 580
Fort Collins, CO 80522
U 1988-2UU9 AGUH:U GUKF'UKA I IUN. All rlgnts reserves.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD