HomeMy WebLinkAbout133693 CGRS INC - INSURANCE CERTIFICATE (11)CGRSINC-01 LPREWITT
ACORO F-11OT2/27/2018
E (MMlDDJYYYY)
�� 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 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).
CONTACT
PRODUCER NAME:
PFS Insurance Group
4848 Thompson Parkway Suite 200 (A/CC,Nro, Ert): (970) 635-9400 (A/CC, No):(970) 635-9401
Johnstown, CO 80534 n M R'E :info mypifsinsurance.com
INSIIRERISI AFFORDING COVERAGE NAIC #
INSURED
C G R S, Inc. & CA TESTCO, LLC
1301 Academy Ct
Fort Collins, CO 80524
/"CDTIEI/'ATC LII IaaDCD.
A:Admiral Insurance Company
B:Allmerica Financial Benefit Insurance C
c : Pinnacol Assurance Co
D:The Hanover Insurance Company
E:
F:
RFVICI(lAl All IMRFR•
THIS IS TOCERTIFYTHAT 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 ADDLINS" SUBR WVD POLICY NUMBER POLICY EFFDDfyYYYI POLICY EXPLTR LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
1,000,000
$TO
CLAIMS -MADE OCCUR
FEI-ECC-13290-05
03/01/2018 03/01/2019
DAMAGES( RENTED
R MI E_ Ea occurrence)
PREMISES
50,000
$
Blanket Add'I Insd
X
MED EXP An one person)$
5,000
X
Blanket Waiver
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY I JE� 7-1LOC
OTHER
B
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accid t
1,000,000
$
BODILY INJURY Perperson)
$
X ANY AUTO
AW4A232142
03/01/2018
03/01/2019
BODILY INJURY Per accident
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
PROPERTY
TMDAMAGE
NON -AWNED
AUTOS ONLY AUTOS ONLY
X HIRED Ix
X Blanket Add'I Insd Blanket Waiver
$
$
A
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 10,000,000
EXCESS LIAB
CLAIMS MADE
FEI-EXS-13291-05
03/01/2018
03/01/2019
AGGREGATE
$ 10,000,000
DED I X RETENTION $ 0
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y
ANY PROPRIETOR/PARTNER/EXECUTIVE ]
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
N /A
4029480
01/01/2018
01/01/2019
X I PER OTH-
T T R
E.L. EACH ACCIDENT
1,000,000
$
E.L. DISEASE - EA EMPLOYE
1,000,000
$
E.L. DISEASE - POLICY LIMIT
1 1,000,000
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
D
Leased/Rented Equip
RH4A231842
03/01/2018 03/01/2019
1$1,000 Deductible
200,000
A
Pollution/Profession
FEI-ECC-13290-05
03/01/2018 03/01/2019
Limit Per Claim
1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / 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.
City of Fort Collins Purchasing Division
215 N Mason St 2nd FI
PO Box 580
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.
REPRESENTATIVE
A/`r%Dr% 9C /9A4R/r141
n 19R8-2n15 ACORD CORPORATION. All riahts reserved.
The ACORD name and logo are registered marks of ACORD