|
• •
<br />---� CGRSINC-01 JMAT7
<br />A10 R CERTIFICATE OF LIABILITY INSURANCE °Aoy D Y'
<br />17
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endomement(s).
<br />PRODUCER CONTACT
<br />NAME:
<br />PFS Insurance Group PRONE- --- FAx - — - ---
<br />6848 Thompson Parkway Suite 200 (AIC, No, En)_ (970) 635-9400 Lglc.mgj- 970) 635-990'1
<br />I _ _
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />INSURER(S) AFFORDING COVERAGE,__- NAILS
<br />1MBO124856
<br />MBR( TYPE OF INSURANCE IADOJSUBR' POLICY NUMBER POLICY EFF I POLICY EJIP
<br />wEDI is, UNITS
<br />:AdRERAmiral Insurance Company—
<br />INSURED
<br />INSURER B: Alimerica Financial Benefit Insurance Companyl41840_
<br />C O R S, Inc. a CA TESTCO, LLC
<br />aasuRERc:Pmnacol Assurance Co _ _ 41196
<br />1301 Academy Ct
<br />IN~sRmtD:Hanover American Ins. Co. -36064
<br />Fort Collins, CO 80524
<br />_ --
<br />INWRERE:
<br />S 5,000
<br />I INSURERF:
<br />__
<br />COVERAGES CERTIFICATE NUMBER:
<br />REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS._
<br />MBR( TYPE OF INSURANCE IADOJSUBR' POLICY NUMBER POLICY EFF I POLICY EJIP
<br />wEDI is, UNITS
<br />A I X I CONMERLULGENERA L LIAE11IITY
<br />EACH OCCURRENCE
<br />S 1,000,000
<br />_ I X OCCUR
<br />IFEI-ECC-03
<br />03701/2016 o3rovzm7 l p T "� TEa,a,oil
<br />5_ 50,000
<br />BI Add -I li sd
<br />WINED DCPNA1 ana
<br />S 5,000
<br />X Blanket
<br />_
<br />Blanket Waiver _
<br />I
<br />Nareml)
<br />RSONAL 9AOVISUURY
<br />11000,000
<br />IS_
<br />F GEN'L AGGREGATE UNIT APPLES PER
<br />gGGR
<br />2,000,060
<br />POUCY Xj za- I ' LOC
<br />i
<br />F EGq
<br />1 I PRODUCTS -COMPYyTP AGG
<br />5.____
<br />; 2,0001000
<br />-
<br />OTHER:
<br />I
<br />I-
<br />�
<br />El i AUTOMOBILE
<br />ugeum.tC�ONB1=SINGLE
<br />LIMIT
<br />IS 1,000,000
<br />I X�
<br />ANY Auro
<br />I pW4-A232142-02
<br />!01/20
<br />0316.03101=17
<br />BODILY IwuRY Px
<br />—
<br />S
<br />I.
<br />OWNED 'SCHEDULED
<br />AUTEOpB ONLY '_ I AUTOS
<br />'
<br />I i
<br />1
<br />BODILY
<br />BBpOORppDILY IWURY(Perauci a q�6
<br />_
<br />X
<br />AUTOS ONLY I - i AUT DNLV
<br />IjPeraasEenq GE
<br />{
<br />X
<br />I manitat AER! I= I X BNMel Walver
<br />5
<br />A UMBRELLA UAB i X 11 OCCUR
<br />'
<br />EACH OCOURRENCE
<br />5 10,000,000
<br />I X'1 excess UAB ! T CLAIMS MADE
<br />i ;I E EXS-13291-03
<br />03f01f2D16
<br />_
<br />0310i/2017 AGGREGATE
<br />I
<br />_
<br />S 10.00D,000
<br />i X 1 RETENTIONS MI
<br />;CED
<br />5
<br />C I (YORKERS COMPENSATgN
<br />I Xi_ I OTI4
<br />ER
<br />A PA P RIETO ARTN Tv
<br />ANY PROPRIETOfLPARTNEraE%ECUr11fE TY`NS
<br />OF-MMEMB�EXCWDEOT tNI
<br />N/AI
<br />1
<br />i 01101120171
<br />OrliM 2018 I` ELEACH ACCIDENT
<br />S 1,000,000
<br />.'1,000000
<br />UAarMatory In N
<br />EL DLSEABE-EA E/AROYE_
<br />S
<br />IIyyMM
<br />�
<br />GLD
<br />1,000,000
<br />$PT[ONantler
<br />LTE.SC:RIPTION OF OPERATIONS hebw
<br />CY
<br />5
<br />D teasedlRented EquipRZ4-AZ31847-02
<br />0310112016:
<br />03/01/2017 151.000 Deductible
<br />200,0(70
<br />A PollutionlProfession
<br />I
<br />FEt-ECC-13290-03 : 0310112D16
<br />03/01/2017 (Limit Per Claim
<br />I I
<br />1,000,000
<br />_
<br />DESCRIPTIONOFOPERATIONSILOCATIONSIVEMCLES(ACOMW;Anal Rema Sehe,luk,mayxaRache Ifnamspam Isn ulmd)
<br />If required by written contract, the Certificate Holder is included as Additional Insured under General Liability and Loss Payee as their interest may appear
<br />under with respects to the leased and rented equipment
<br />FILE COPY!
<br />All Star Rents
<br />2525 Clay Bank Road
<br />Fairfield, CA 94533
<br />ACORD 25 (2016103)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS -
<br />1988 -2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
|