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CGRSINC-01 JFERGUSON
<br /> ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 3/7/2023
<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 endorsement(s).
<br /> PRODUCER CONTACT PFS Insurance
<br /> NAME:
<br /> PFS Insurance Group PHONE FAX
<br /> 4848 Thompson Parkway Suite 200 (A/C,No,Ext): (970)635-9400 (A/C,No):(970)635-9401
<br /> Johnstown,CO 80534 ADDRESS:info@mypfsinsurance.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Admiral Insurance Company 24856
<br /> INSURED INSURER B:Everest Indemnity Insurance Company 10851
<br /> CGRS, Inc.&CA TESTCO, LLC INSURER c:Pinnacol Assurance Co 41190
<br /> 1301 Academy Court INSURER D:Travelers Property Casualty Company of America 25674
<br /> Fort Collins,CO 80524
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 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 CONTRACT OR 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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD MM DD Y MM DD W
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCURFEI-ECC-13290-10 3/1/2023 3/1/2024 DAMAGE TO RENTED 100,000
<br /> X X PREMISES Ea occurrence $
<br /> X Blanket Add'I Insd MED EXP(Any oneperson) $ 10,000
<br /> X Blkt Waiver of Subro PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY 7 jE F7LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> Ea accident $
<br /> X ANY AUTO X X CF2CA00249-231 3/1/2023 3/1/2024 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLYAUTOS BODILY INJURY Per accident $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> X Blanket Add'IInsd X BlktWaiver of
<br /> Subro $
<br /> A UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 10,000,000
<br /> X EXCESS LAB CLAIMS-MADE X X FEI-EXS-13291-10 3/1/2023 3/1/2024 AGGREGATE $ 10,000,000
<br /> DED X RETENTION$ 0 $
<br /> C WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> ANY PROP RI ETOR/PARTNER/EXECUTIVE YIN X 4029480 1/1/2023 1/1/2024 1,000,000
<br /> E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> D Leased/Rented Equip QT-630-1T403592-TIL-23 3/1/2023 3/1/2024 $1,000 Deductible 200,000
<br /> A Pollution/Profession FEI-ECC-13290-10 3/1/2023 3/1/2024 $25,000 Deductible 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> 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
<br /> to info@mypfsinsurance.com.
<br /> If required by written contract: the Certificate Holder is included as Additional Insured on a Primary and Non-Contributory basis for ongoing and completed
<br /> operations under General Liability and Automobile Liability.A Waiver of Subrogation applies to those named above for General Liability,Automobile Liability
<br /> and Workers'Compensation.Umbrella provides excess coverage over the General Liability,Automobile Liability and Workers'Compensation.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> For Information Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> AUTHORIZED REPRESENTATIVE
<br /> 1 41��
<br /> ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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