13-256.00 Zayo: See Franchise Agreements
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ACORO® CERTIFICATE OF LIABILITY INSURANCE
`� 8/l/2024
DATE(MMIDD/YYYY)
7/31/2023
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 100
Denver CO 80237
CONTACT
NAME:
PHONE FAX
Ex A/C No
E-MAIL
ADDRESS:
INSURERS) AFFORDING COVERAGE
NAIC #
(303) 414-6000
INSURER A: Travelers Property Casualty Company of America
25674
INSURED Za o Group,LLC
1509327 1805 29th Street, Suite 2050
INSURER B : The Travelers Indemnity Company of Connecticut
25682
INSURER C : Travelers Casualty and Surety Company
19038
INSURER D :
Boulder, CO 80301
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: 18616750 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
SUER
POLICY NUMBER
MM DDPOLICY
/YYYY
MM DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
Contractual Liab
Y
N
GLSA-9P531231-23
8/1/2023
8/1/2024
EACH OCCURRENCE
$ 1000 000
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 1,000,000
X
MED EXP (Any one person)
$ XXXXXXX
X
StoyGay- ND,OII,WA,WY
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JE� LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
B
AUTOMOBILE
IX
X
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
y
Ni
CAP-9P531243-23
8/1/2023
8/1/2024
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$ XXXXXXX
BODILY INJURY (Peraccident)
$ XXXXXXX
PROPERTY DAMAGE
Per accident
$XXXXXXX
Comp/Coll Ded
$ 1,000
A
X
UMBRELLA LIAB
EXCESS LIAB
]{
OCCUR
CLAIMS -MADE
Y
N
CUP-9P531255-23
8/1/2023
8/1/2024
EACH OCCURRENCE
$ 10,000,000
AGGREGATE
$ 10,000,000
DED I X I RETENTION $ 10,000
$ XXXXXXX
A
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE - N
OFFICER/MEMBER EXCLUDED? ❑N
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
N
UB-9W 153768-23
UB-9W I53098
8/1/2023
8/1/2023
8/1/2024
8/1/2024
PER OTH-
X 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 / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
Certificate Holder is included as Additional Insured as respects General Liability if required by written contract.
C:tK I II -RA l t r1ULLItK UANUt:LLA I IUIV
18616750
City of Spokane Valley
10210 E Sprague Ave
Spokane Valley WA 99206
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 � .
t71989-2Q ACORO CORP0 ATION_ All riahts reserved
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD