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HomeMy WebLinkAbout133693 CGRS INC - INSURANCE CERTIFICATE (14)CGRSINC-01 LPREW ACORD CERTIFICATE OF LIABILITY INSURANCE 1DATE (MM/DD/YYYY) 2/12/2017 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 PFS Insurance Group 4848 Thompson Parkway Suite 200 Johnstown, CO 80534 INSURED C G R S, Inc. & CA TESTCO, LLC 1301 Academy Ct Fort Collins, CO 80524 j'Nolac, No :(970) 635-9401Cc, E-MDRE • info@mypfsinsurance.com INSUREMS) AFFORDING COVERAGE NAIC 0 INSURER A: Admiral Insurance Company 24856 INSURER B : Allmerlca Financial Benefit Insurance Company 41840 INSURER c : Pinnacol Assurance Co 41190 INSURER F : r1nW1=0AnGc CERTIFIreTE NUMBER: REVISION NUMBER: vTHIS 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR/YYYY MM/DD/YYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE �X OCCUR ,FEIECC1329004 03/01/2017 03/01/2018 DAMAGE TO RENTED PR I occurrent 50,000 $ Blanket Add'I Insd X MED EXP (Any oneperson) $ 51000 X Blanket Waiver PERSONAL & ADV INJURY $ 1,000,000 GERL AGGREGATE LIMIT APPLIES PER: POLICY �X j RET LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 ,000,000 $ X ANY AUTO AW4A232142 03/01/2017 03/01/2018 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUUTOpSyyN X AUTOS ONLY X AUTOS ONLY X Blanket Add'I Insd X Blanket Waiver BODILY INJURY Per accident (Par.E�aeT DAMAGE $ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10'000r000 EXCESS LIAB CLAIMS -MADE FEIEXS1329104 03/01/2017 03/01/2018 X AGGREGATE $ 10,000,000 DED I X RETENTION $ 0 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE QFFICER/MEMBER EXCLUDED? andatory in NH) NIA 402%80 01/01/2018 01 /01 /2019 X IPER T OTH- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE 1,000,000 $ E.L. DISEASE - POLICY LIMIT 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below D Leased/Rented Equip 03/01/2017 03/01/2018 $1,000 Deductible 200,000 A Pollution/Profession �RH4A231842 FEIECC1329004 03/01/2017 03/01/2018 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. CERTIFICA 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. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD