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AC � DATE (MM�D)
`...+ CERTIFICATE OF LIABILITY INSURANCE 12,21,2018
201E
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
NAME:
Willis of Colorado, Inc. PHONE FAX
1-877-945-7378 Ext)wAIC No: 1-888-467-2378
c/a 26 Century Blvd E-MAIL
P.O. Box 305191 ADDRESS: certificates@willis.com
Nashville, TN 372305191 USA INSURER(S) AFFORDING COVERAGE NAIC#
INSURED
Zayo Group, LLC
1805 29th Strout, Suits 2050
Boulder, CO 80301 USA
INSURERA: Great Northern Insurance Company 20303
INSURERS: Federal Insurance Company 20281
INSURER C : Sentry Casualty Company —28460
INSURER E :
INSURER F :
CI)VFRG[IFS CFRTIFICOTF NIIMRFR- W9538241 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.
- — ��g�� XP
-_-- P111Vp
INS�Rj
LTR f� TYPE OFINSURANCE POLICY NUMBER 1ryY�Y MM D� Y LIMITS
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $ 1, D00, 000
X
_
DAMAGE TO RENTED
1,000,000
CLAIMS -MADE OCCUR
PREMISE$ jai gccur engej $
A
MED EXP (Any one person) $ 10,000
-1--
3604-53-52 '08/01/2018 08/01/2019 PERSONAL &ADV INJURY g 1,000 000
GEWL GATE LIMIT APPLIES PER:
GENERAL AGGREGATE $ 2,000,000
--- 7_
POLICY I X PRO- J LOD
PRODUCTS - COMP/OP AGG $` 2,000,000
OTHER,
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea. accident)
i $ 1,000,000
-�
X ANY AUTO
BODILY INJURY (Per person)
$
B
OWNED SCHEDULED
7359-90-85 08/02/2018
08/01/2019
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS
_.__
— -
HIRED NON -OWNED
PROPERTY DAMAGE
$
AUTOS ONLY : AUTOS ONLY
(Q4f_J4ident)
I
I$
UMBRELLA LIAB -77TOCCUR
EACH OCCURRENCE
$
AGGREGATE
EXCESS LIAB CLA8v1S MADE
$
DED i RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYYIN
C(MandatoryRIInTNH,PARTNER/EXECUTIVE
X 1
TATUTE
$ 1,000,000
EDSEASECHA
OFFICER/MEMBEREXCLUDED? No
i N / A
90-20463-01 00 191 O1/O1/2019
01/01/2020
1,000,000
EMPLOYEE
I
If yes. describe under
DESCRIPTION OF OPERATIONS below
- E.L. DISEASE -POLICY LIMIT 1 $ 1,000,000
C Workers Compensation
90-20463-02 00 191 01/01/2019 01/01/2020 E.L. Each Aecidant $11000,000
6 Employers' Liability
I
E.L. DISEASE - EA EMP $1,000,000
Per Statute
E. L. DISEASE-POL LIMIT $1, 000, 000
DESCRIPTION OF OPERATIONS 1 LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: Account 859200 Certificate Holder is named as an Additional Insured as respects the ongoing operations of the
Named Insured with respects to General and Auto Liability coverage where required by written and signed contract
subject to policy terms, conditions, limits and exclusions.
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
City Of Fort Collins
PO Box 580
Fort Collins, CO 80522
01988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
SR zo 17271197 BATCH: 998650
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