HomeMy WebLinkAboutZAYO GROUP LLC - INSURANCE CERTIFICATE (3)Page 1 of 1
A#/ �® CERTIFICATE OF LIABILITY INSURANCE FD12/29ATE /DDNYY
017Y)
12/29/2017
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:
Willis of Colorado, Inc. PHONE 1-877-945-7378 FAX 1-888-467-2378
c/o 26 Century Blvd A/ No Ex A/C No:
E-MAIL certificates@willia.com
P.O. Box 305191 ADDRESS:
Nashville, TN 372305191 USA INSURERS AFFORDING COVERAGE NAICN
INSURERA: Great Northern Insurance Company 20303
INSURED INSURER B: Federal Insurance Company 20281
Zayo Group, LLC
1805 29th Street, Suite 2050 INSURER C: Sentry Casualty Company 28460
Boulder, CO 80301 USA INSURER D:
INSURER E :
COVERAGES (`FRTIFI(_ATF NI IMRFR• W5005511 0t=t1Iclnnl KIIIRAQCC.
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
POLICY EFF POLICY EXP
MM/DD/YYYY MM/DD/YYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
EACH OCCURRENCE
$ 1,000,000
DAMAGE O RENTED
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any one person)
$ 10,000
A
pERSONALB ADVINJURY
$ 1,000,000
3604-53-52
08/01/2017
08/01/2018
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ECT FLOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OPAGG
$ 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
7359-90-85
08/O1/2017
OB/Ol/2018
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
CESS LIAB
�DXED
CLAIMS -MADE
I I RETENTION $
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? No
N/A
90-20463-01
01/01/2018
01/01/2019
PER OTH-
X STATUTE I ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 11000,000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 11000,000
C
Workers Compensation
90--20463-02
01/01/2018
01/01/2019
E.L. Each Accident
$1,000,000
& Employers' Liability
E.L. DISEASE - EA E
$1,000,000
Per Statute
E.L.DISEASE-Pi 4
$1, 000, 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Named Insured also includes Electric Lightwave Communications Inc.
RE: Account 859200 Certificate Holder is named as an Additional Insured as respects the ongoing operations of the
Named Insured with respects to General and Auto Liability coverage where required by written and signed contract
subject to policy terms, conditions, limits and exclusions.
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 580
j'
Fort Collins,li CO 80522 c
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
SR ID: 15473757 BATCH: 554390