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��--� CGRSINC-01 JFERGUSON '4�Rim CERTIFICATE OF LIABILITY INSURANCE DATE A E (MM/ 022 ) 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 CONTACT PFS Insurance NAME: PFS Insurance Group 4848 Thompson Parkway Suite 200 (A/CC, No , Ext): (970) 635-9400 FAX No): (970) 635 -9401 Johnstown, CO 80534 n o"alEss : info@mypfsinsurance . com INSURERS AFFORDING COVERAGE NAIC # INSURER A : Admiral Insurance Company 24856 INSURED INSURER B : Everest Indemnity Insurance Company 10851 C G R S, Inc. & CA TESTCO, LLC INSURER C : Pinnacol Assurance Co 41190 1301 Academy Court INSURER D : Travelers Property Casualty Company of America 25674 Ft. Collins, CO 80524 _ INSURERE : 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. INT R TYPE OF INSURANCE ADDDL SUBOR POLICY NUMBER POLIICDY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000, 000 CLAIMS-MADE X OCCUR FEI-ECCA3290-09 3/1 /2022 3/1 /2023 DAMAGE TO RENTED 100,000 X X PREMISES Ea occurrence $ X Blanket Add' I Insd MED EXP (Any oneperson) $ 10 , 000 X Blkt Waiver of Subro PERSONAL & ADV INJURY $ 11000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000'000 POLICY PRO-- LOC PRODUCTS - COMP/OP AGO $ 2' 000'000 JECTOTHER: $ B AUTOMOBILE LIABILITY Ea accciden SINGLE LIMIT $ 11000,000 IX ANY AUTO X X CF2CA00249-221 3/1 /2022 3/1 /2023 BODILY INJURY Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED Ix NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AkkUTOS ONLY X Blanket Add'Ilnsd Sut Waiver of $ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10 '000 '000 X EXCESS LIAB CLAIMS-MADE X X FEI-EXS -13291 -09 3/1 /2022 3/1 /2023 AGGREGATE $ 101000 ,000 DED X RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X STATUTE ER E. L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N X 40294$0 1 /1 /2022 1 /1 /2023 11000 , 000 OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E. L. DISEASE - EA EMPLOYE $ 11000 , 000 If yes, describe under 11000 , 000 DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ D Leased/Rented Equip QT6301T403592TIL22 3/1 /2022 3/1 /2023 $ 1 ,000 Deductible 2002000 A Pollution/Profession FEI-ECC-13290-09 3/1 /2022 3/1 /2023 $25,000 11000 , 000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) This is a snapshot of C G R S, Inc. & CA TESTCO, LLC coverage at the date listed above. To be listed as a certificate holder please send your request to info@mypfsinsurance.com . If required by written contract: the Certificate Holder is included as Additional Insured on a Primary and Non-Contributory basis for ongoing and completed operations under General Liability and Automobile Liability. A Waiver of Subrogation applies to those named above for General Liability, Automobile Liability and Workers' Compensation . Umbrella provides excess coverage over the General Liability, Automobile Liability and Workers' Compensation . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Information Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS . AUTHORIZED REPRESENTATIVE CA ACORD 25 (2016/03) @ 1988 -2015 ACORD CORPORATION . All rights reserved . The ACORD name and logo are registered marks of ACORD