Loading...
HomeMy WebLinkAboutCOI - C G R S, Inc. & CA Testco, LLC - Expires 2024-03-01CGRSINC-01 LPREWITT "AC RL CERTIFICATE OF LIABILITY INSURANCE �� DATE(MM/DD/YYYY) 12I20/2023 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 CONTACT NAME: PHONE FAX (A/c, No, Ext): (970) 635-9400 (A/C, No):(970) 635-9401 nDOAalEss: info@mypfsinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Admiral Insurance Company 24856 INSURED CGRS, Inc. & CA TESTCO, LLC 1301 Academy Court Fort Collins, CO 80524 INSURER B : Everest National Insurance Company 10120 INSURER C : Zurich American Insurance Co 16535 INSURER D :Travelers Property Casualty Company of America 25674 INSURER E : INSURER F : VERAGES 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 POLIC ES 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 TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF IMM/DD/YYYYI POLICY EXP (MM/DDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY FEI-ECC-13290-10 3/1/2023 3/1/2024 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) $ CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 X Blanket Add'I Insd PERSONAL &ADV INJURY $ 1,000,000 X Blkt Waiver of Subro GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE X LIMIT APPLIES YeT- PER: LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ B AUTOMOBILE X X X LIABILITY ANY AUTO OWNED X _ X SCHEDULED AUTOS X CF2CA00249-231 3/1/2023 3/1/2024 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY accidentDAMAGE $ $ A L_ X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE FEI-EXS-13291-10 3/1/2023 3/1/2024 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 $ DED X RETENTION$ 0 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N I A WC4632690-13 1/1/2024 1/1/2025 PER X I STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D A Leased/Rented Equip Pollution/Profession QT-630-1T403592-TIL-23 FEI-ECC-13290-10 3/1/2023 3/1/2023 3/1/2024 3/1/2024 $1,000 Deductible $25,000 Deductible 200,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requi ed) As required by written contract the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The City of Gilroy, its officers, officials and employees are named as Additional Insured for ongoing and completed operations on a Primary and Non -Contributory basis under General Liability and Automobile Liability. 30 Day Notice of Cancellation applies except 10 days for nonpayment of premium. CERTIFICATE HOLDER CANCELLATION City of Gilroy, its officers, officials and employees 7351 Rosanna Street Gilroy, CA 95020 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