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HomeMy WebLinkAboutCOGENT INC - INSURANCE CERTIFICATE (10)A CC> p t �� l�rlJA LJ CERTIFICATE OF LIABILITY INSURANCE DATE /2018 /YYYY) o3r23r2o1e 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 INSURERS), 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 Marsh USA Inc. One Towne Square, Suite 1100 Southfield, MI 48076 Attn: DetroitGroupCapbve.CertRequest@marsh.com CONTACT NAME: FAX PHONE (A/C. No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Zurich American Insurance Company _ 16535 CN1 19262320--GAWUC-1 7-19 INSURED Cogent, Inc., Automatic Engineering, Fluid Equipment, LLC, BRI, INSURER B : Travelers Property Casualty Co. of America 25674 INSURER C : American Zurich Insurance Company 40142 INSURER D : N/A N/A Catalyst, Liberty Facility, LLC, ME Solutions, Lee Mathews, Vanco, Vandevanter Engineering, Water Technology Group 318 Broadway St. INSURER E : INSURER F Kansas City, MO 64105 COVERAGES CERTIFICATE NUMBER: CHI-008732206-04 REVISION NUMBER: 3 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 SUER POLICY NUMBER MM/DD/YYYY LICY EFF EXP ML C rYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE n OCCUR GLO1060782-01 04/01/2018 04/01/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO ❑ LOC JECT OTHER. GENERAL AGGREGATE $ 2,000,000 X PRODUCTS - COMP/OP AGG $ 2,000,000 $ A A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS NON -OWNED X HIRED lx AUTOS ONLY AUTOS ONLY BAP1060783-01 (COML) BAP1060784-01 (PP) 04/01/2018 04/01/2018 04/01/2019 04/01/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ $ X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ZUP61M83930-18NF 04/01/2018 04/01/2019 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED X RETENTION$O $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE ! OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC1060781-01 Does not apply to the Monopolistic States (ND, OH, WA, and WY), Puerto Rico, or the Virgin Islands 04/01/2019 X PER OTH- STATUTE ER . E.LEACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Fort Collins are included as additional insured for General Liability and Auto Liability as required by written contract or written agreement, per policy terms and conditions as respects General and Auto Liability. t.,r-K I IrII,A I C MULUCI( a,rarl\,CLLH I IVIv The City of Fort Collins Purchasing Department PO Box 580 Fort Collins, CO 80522 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 of Marsh USA Inc. John C Hurley ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD