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HomeMy WebLinkAboutCOGENT INC - INSURANCE CERTIFICATEACO ® CERTIFICATE OF LIABILITY INSURANCE DAT (MM//D201) 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 AOn Risk Services Central, Inc. Chicago IL office CONTACT NAME: (A/C. No. Ext): (866) 283-7122 (FAX No.): (800) 363 0105 E-MAIL ADDRESS: 200 East Randolph Chicago IL 60601 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: American Zurich Ins Co 40142 Cogent Inc INSURER B: Zurich American Ins CO 16535 318 Broadway street Kansas City MO 6410S USA INSURERC: Travelers Property Cas Co of America 25674 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570071 '39867 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. Limits shown are as requested ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY GLol 4 1 4 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑OCCUR DAMAGE TRENTED PREMISES Ea occurrence $500,000 MED EXP (Any one person) $10 , 000 PERSONAL &ADV INJURY $1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2 , 000,000 X POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 OTHER B AUTOMOBILE LIABILITY BAP 1060783-02 04/01/2019 04/01/2020 COMBINED SINGLE LIMIT Ea accident $1,000,000 B BAP 1060784-02 04/01/2019 04/01/2020 BODILY INJURY ( Per person) ANYAUTO BODILY INJURY (Per accident) X OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE x HIRED AUTOS E NON -OWNED Per accident ONLY AUTOS ONLY C X ZUP16N4815419NF 04/01/2019 04/01/2020 EACH OCCURRENCE $10,000,000 X UMBRELLA LIAR OCCUR EX Follow Form & Umbrella AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION A WORKERSCOMPENSATIONAND WC106078102 04/01/2019 04/01/2020 X STATUTE ORH EMPLOYERS' LIABILITY Y❑ E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR / PARTNER / EXECUTIVE N OFFICER/MEMSER EXCLUDED? (Mandatory in NH) .1A E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OI'ERAI IONS below E.L. DISEASE -POLICY LIMIT ' $^ v0 0 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE PO Box 2047 Fort Collins Co 80522 USA d 0) M r— In 0 O Z d is U 1_ d U ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD