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102722 OFFICESCAPES - INSURANCE CERTIFICATE
A`COR1 ® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) `r../ 2/21/2018 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: Client Manager US[ Colorado, LLC P.O. Box 7050 PHONE FAX A/C, No. Ext)• 800-873-8500 A/C No): 303-831-5295 ADDRESS: Den. certificate@usi.com Englewood CO 80155 INSURERS AFFORDING COVERAGE NAIC # INSURERA: Zurich American Insurance Company 16535 INSURED JUPITI INSURERB: St Paul Fire and Marine Insurance Co 24767 Jupiter I, L.L.C. dba OfficeScapes 9900 E. 51stAvenue INSURERC: INSURER D : Denver, CO 80238 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 151145264 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. INSR LTR OF INSURANCE ADDLSUTYPE INSD W D POLICY NUMBER M.I IDY EFF EXP .MIDDY YY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR GLO980918304 3/1/2018 3/1/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES fEa occurrence $300,000 MED EXP (Any one person) $ 10.000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY BAP980918404 3/1/2018 3/1/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ZUP11S1702018NF 3/1/2018 3/1/2019 EACH OCCURRENCE $5,000,000 AGGREGATE $ 5,000.000 DED X RETENTION $ 1 o 000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBEREXCLUDED? N (Mandatory in NH) if yes, describe under DESCRIPTION OF OPERATIONS below NIA 1 WC98D918204 3/1/2018 3/1/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional Insured per written notice or contract to General Liability: The City of Fort Collins, Colorado, a Municipal Corporation, its officers and employees CERTIFICATE HOLDER CANCELLATION The City of Fort Collins, a Municipal Corporation Attn: Director of Purchasing & Risk Management;PO 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 lfk\o ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD