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Home My WebLink AboutCOGENT INC - INSURANCE CERTIFICATE (6)�1 ® CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDYYYY) -- OS3D,ZU2D 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 SUBROGATIONIS 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). - __ODUC_E_ R _... _. - - - - PR .CONTACT NAME. A06 Risk Services Central, Inc. Chicago IL Office PHONE (A/C. No. Ext): (866) 283-7122 aC : (800) 363-0165 E-MAIL - - - - ADDRESS: 200 East Randolph Chicago IL 60601 USA INSURER(S) AFFORDING COVERAGE NAIL 0 INSURED INSURER A: Zurich American ins co 16535 cogent, Inc, Automatic Engineering, Fluid .Equipment, LLC, BRI, catalyst, Liberty Facility, LLC, IME solutions, INSURERS: American Zurich -Ins Co 40142 - MEURER C: Travelers Property Cas Co of America 25674 Lee Mathews, vanc0, Vandevanter En99i neeri ng, water Technology Group 318 Broadway St. Kansas City MD 64105 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570081189467 REVISION NUMBER: -THIS ISTO-CERTIFY THAT THE POLICIESOFINSURANCE LISTED BELOW HAVE -BEEN -ISSUED TO THE INSUREDNAMEDABOVE FOR THEPOLICYPERIOD - 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. Limns shown areas requested LNSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EPP POMY taxi filavoorffyinLaDTS X COMMERCIAL GENERAL LIABILITY GLO EACH OCCURRENCE $2,000,000 CLAIW MADE ❑X OCCUR PREMISES iEa occurrence $500,000 MED EXP (Any one Person) _ $10, 000 PERSONAL A ADV INJURY $2 , 000 , 000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAG_GREGATE $4,000,000 X POLICY ❑ PRO' LOC PRODUCTS - COMP/OP AGG $4,000,000 _OTHER: A A pNTOMOeiLEVABiurY BAP 1060783-03- BAP 1060784-03 04/01/202004/01/2021 04/01/2020 04/01/2021 COMBINED SINGLE LIMIT - fEa accident) .$2,000,000 BODILY INJURY ( Per person) ANY AUTO BODILY INJURY (Per accident) X OWNED SCHEDULED AUTOS ONLY AUTOS X HIREDAUTOS X NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident c X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE ZUP16N481542ONF EX Follow Form & Umbrella 04 01/0020 04 OP 2021 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 DED RETENTION B WORKERS COMPENSATION AND EMFLOYERS LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERNEMBER EXCLUDED? (Mandatory In NH) N/A wc106078103 04/01/20204'01'2 1 -X' PERSTATUTE OTH-- ER - E.L.EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may Ee attached If more space Is required) City of Fort Collins, CO are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. u� CERTIFICATE HOLDER CANCELLATION M 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, CO AUTHORIZED REPRESENTATIVE Attn: Beth Diven Po Box 580 Fort Collins CO 80522 USA 01988-2015 ACORD CORPORATION. All rights reserved.. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 5 Additional Insured — Automatic — Owners, Lessees Or ZURICH Contractors THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLO10 6 0 7 8 2 0 3 Effective Date: 4/1 /2020 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section 11— Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured under a written contract or written agreement executed by you, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" and subject to the following: 1. If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a. The Insurance Services Office (ISO) ISO CG 20 10 (10/01 edition); or b. The ISO CG 20 37 (10/01 edition), such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" arises out of. (1) Your ongoing operations, with respect to Paragraph 1.a. above; or (2) "Your work", with respect to Paragraph 1.b. above, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 1., insurance afforded to such additional insured: (a) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (b) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products -completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. 2. If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a. The Insurance Services Office (ISO) ISO CG 20 10 (07/04 edition); or b. The ISO CG 20 37 (07/04 edition), . such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" is caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf, U-GL-2162-A CW (02/19) Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission.