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THE EXCHANGE PLAZA ASSOCIATION - INSURANCE CERTIFICATE
ACORN° CERTIFICATE OF LIABILITY INSURANCE 6/1/2019 DATE(MM/DD/YYYY) 5/22/2019 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 Lockton Companies 8110 E Union Avenue Suite 700 Denver CO 80237 CONTCT NAME: PHONEFAX A/C, No, Ext : A/C, No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE N IC # (303) 414-6000 INSURER A: The l'ravelers Indemnity Company 25658 INSURED The Exchange Plaza Association INSURER B : Ironshore Indemnity Inc. 23647 1430351 200-207 N College Avenue Fort Collins, CO 80524 INSURER C : ACE Property & Casualty Insurance Co 20699 INSURER D : Pinnacol Assurance Com any 4 t 190 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 16033121 REVISION NUMBER: XXXXXXX 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y N Y-630-9K213399-IND-19 5/20/2019 5/20/2020 EACH OCCURRENCE 1000 000 CLAIMS -MADE OCCUR X DAMAGE TO RENTED PREMISES Ea occurrence i OO OOO X MED EXP (Any oneperson) 5,000 Terrorism Included PERSONAL & ADV INJURY $ 1000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY❑ JECT _X LOG GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG S 2 000 000 $ OTHER: AUTOMOBILE LIABILITY ANY AUTO NOT APPLICABLE COMBINED accident� SINGLE LIMIT $XXXXXXX BODILY INJURY (Per person) $ XXXXXXX AAUTOS ONLY SCHEDULED BODILY INJURY (Per accident $ }{j{}{}�XXX AUTOS ONLY AUUTOS ONLD PROPERTY accid.r,,, GE $ XXXXXXX B X I UMBRELLA LIAB OCCUR Y N HLI18-A-G71364409 5/20/2019 5/20/2020 EACH OCCURRENCE $ 50 000 000 EXCESS LIAB NCLAIMS-MADE HL118-A-G71364409 5/20/2019 5i20/2020 X AGGREGATE $ 50,000,000 DED I X I RETENTION $ 10.000 $ XXXXXXX 1 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY CERIMEMBEPROPRIETORlEXCLUDEIEXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N 4093547 6/I/2018 6/1/2019 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE Is 1,000,000 E.L. DISEASE - POLICY LIMIT 1, 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space is required) if the General Liability policy is cancelled by the issuing company dun,"; the policy term, for other than non-payment of premium, 30 days' notice will be provided to the Certificate Holder named below, 10 days' for non-payment o premium. Excess Liability is following form to the General Liability and includes Terrorism. RE: The Exchange - 200-207 N College AN Fort Collins, CO 8052.1. Liquor Liability: Aggregate Limit; $2.000,000. Each Common Cause Limit; $1,000.000. City of Fort Collins is included as Additional Insured as respects to General Liability if required by written contract, l.tK I It-IUA I t r1UL1UtK UANULLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 16033121 AUTHORIZED REPRESENTATIVE City of Fort Collins PO Box 280 Fort Collins CO 80522 ACORD 25 (2016103) ©1988-20-15 ACORD CORPORATION. All riahts reserved The ACORD name and logo are registered marks of ACORD