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Home My WebLink About264656 OZ ARCHITECTURE INC - INSURANCE CERTIFICATE (2)Client#: 1082526 OZARC ACORD. CERTIFICATE OF LIABILITY INSURANCE D 9126/2IDDIYYYY) /26/2014 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 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 NAME: USI Colorado, LLC Prof Liab PHONE Ext: 800 673$500 AIL NP: / 1515 Wynkoop Street AIL Suite 200 ADDRESS: INSURERS) AFFORDING COVERAGE NAIL e Denver, CO 80202 INSURER A: Travelers Indemnity Company 25658 INSURED INSURER B: Travelers Indemnity Company 25658 OZ Architecture, Inc. INSURER CHartford Ins Co of the Midwest 37478 3003 Larimer St. Evanston Insurance Company INSURERD: P Y 35378 Denver, CO 80205 INSURER E: Travelers Property Cas. Co. of 25674 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 REOUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. �TRR TYPE OF INSURANCE ADDLSUBF INSR WO POLICY NUMBER MM/ODY EFF MWODNY users A GENERAL LIABILITY X X 680525OL363 10/01/201410/01/201 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY PREMISETO Eacocurrence $1 000000 CLAIMS -MADE OCCUR MED EXP (My one person) $10 000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $2,000,000 POLICY X PRO LOC $ E AUTOMOBILE LIABILITY X X BA53351-402 10/01/201410/011201S COMBINED SINGLE LIMIT Ea accident)1,000,000 X INJURY person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS URY (Par accident) $ X DAMAGE t8 $ MIRED AUTOS X NON -OWNED AUTOS B X UMBRELLALIAB X OCCUR X X CUP3391T130 10/01/201410/011201RRENCE ESTATU- $4000000 E $4000000 EXCESS LIAB CLAIMS�MADE DED X RETENTION$10000 $ CWORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? N/A X 34WEGNX4686 10I01/201410I01/201ru- OTH' E.L. EACH ACCIDENT $1o00000 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) If describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE -POLICY LIMIT $1,000,000 D Professional AE823861 10/01/2014 10/01/201 $2,000,000 per claim Liability $5,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORO 181, Additional Remarks Schedule, If moreapace Is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and owner are included as Automatic Additional Insured's for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insured under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. (See Attached Descriptions) City of Fort Collins Attn: John Stephen 215 North Mason Street Fort Collins, CO 80522-0000 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 (2010/05) 1 of 2 #S13368020/M13364268 ©1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LXOBC DESCRIPTIONS (Continued from Page 1) 1 The General Liability, Automobile Liability, Umbrella/Excess insurance applies on a primary and non contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, Umbrella/Excess Liability and Workers Compensation. The Umbrella / Excess Liability policy provides excess coverage over the General Liability, Automobile Liability and Employers Liability. Additional Insured: City of Fort Collins and Poudre River Public Library District, 201 Peterson Street, Fort Collins, Co 80524 PbWIP1111IN.J '1 #S1