The URL can be used to link to this page

Home My WebLink AboutEXPRESS SERVICES - INSURANCE CERTIFICATE (2)ACORD �• 11 zl oo7CERTIFICATE OF LIABILITY INSURANCE DATE (M&12007Y) PRODUCER Phone 800-888-39I0 Fax 312-527-9473 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HRH Chicago Metro ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE One East Wacker Drive, Suite 1800 HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Chicago IL 60601 INSURERS AFFORDING COVERAGE NAIC# INSURED Express Services, Inc 8516 NW Expressway Oklahoma City OK 73162 INSURERA National Union Fire Ins Cc of INSURER B Insurance Cc Of The State Of 19429 INSURER National Union Fire Ins Co INSURER American Home Assur Cc 19380 INSURER E AIG COVFRAGFS -.. 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR DDSRO N TYPEOPINSURANCE POLICYNUMBER POAICYMMFD/ D1'VE POLIC EX IR TI N LIMITS Tj X GENERALLIABILITY SSL9518899 10/l/2007 10/l/2008 EAAGMHAo�CCrUURRRR�ED $5 000,000 DORX PREMISES Ea occurence $250 000 COMMERCIAL GENERAL LIABILITY MED EXP(Any one person) $ 5,000 CLAIMS MADE Z OCCUR PERSONAL&ADV INJURY $Intl E&O X Staffing —Service GENERALAGGREGAT'c $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG IS Included X POLICY PRO IOC A X AUTOMOBILE LIABILITY SSL9518899 10/l/2007 10/l/2008 COMBINED SINGLE LIMIT $ (Eaacudem) 1, 000, 000 ANY AUTO BODILY INJURY $ ALL OWNED AUTOS (Per person) SCHEDULED AUTOS X BOD ILY INJURY $ HIREOAUTOS (Per acudenQ X NON OWNED AUTOS PROPERTY DAMAGE $ (Poi accitlen0 GARAGE LIABILITY AUTO ONLY -EAACCIDENT $ OTHERTHAN EAACC $ ANY AUTO $ AUTO ONLY AGG p X EXCESSIUMBRELLA LIABILITY BE5151669 10/l/2007 10/l/2008 EACHOCCURRENCE $ 10 000, 000 AGGREGATE $ 10 000, 000 X OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND WC5455644 10/1/2007 10/1/2008 X WC STArIT oTR- EL EACH ACCIDENT E 000 _000 C EMPLOYERS LIABILITY WC 5455640 10/1/2007 10 1 2008 D OFFlCEWMEMBANY OER EXCLUDED? ECUtIVC WC5455639 10/l/2007 10/l/2008 EL DISEASE -EA EMPLOYEE $ 1 000 000 E ff yes obe under descROVISIONS See attached list 10/l/2007 10/1/2008 EL DISEASE - POLICY LIMIT 1 $ 1 000 000 SPEP CIAL below O OTHER 1492435 10/1/2007 10/1/2008 'Crime Fidelity $1,000,000 A Crime/Fidelity SSL9518899 10/l/2007 10/l/2008 E&O Occ/Agg $5,000,000 Staffing E&O Coverage DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS ocation 1016 - Ft Collins, CO ype of Company City Municipality Job Description Clerical and administrative supportlight industrial 11 insurance carriers shown on this certificate have an A M Best Rating of AIXV unless otherwise noted City of Fort Collins Attn James O'Nei1L P O Box 580 Fort Collins CO 801,24 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CAIJCELi,EU RE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE IFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO L IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON INSURER. ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) ' ' - ' GACORE1 CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) 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) DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon ACORD 25 (2001108) Workers' Compensation Policy Schedule Policies Effective 10/1/07 Policies Expiration 10/1/08 B. Insurance Company State of PA Policy No WC5455644 States Covered AK,AL,AR,AZ,CO,CT,DC,DE,GA,III,IA,ID,IL,FN,KS,KY,LA,MA,MD,ME,MI, MN,MO,MS,MT,NC,NE,NH,NJ,NM,NV,NY,OK,PA,SC,SD,TN, UT,VA C. National Union Fire Ins Co Policy No WC 5455640 States Covered WI (ND,OH,WA,WV,WY EMP LIAB ONLY) D. American Home Assurance Company Policy No WC 5455639 States Covered CA E. AIG Casualty Company Policy No WC 5455641 States Covered OR D. American Home Assurance Company Policy No WC 5455642 States Covered FL F. New Hampshire Insurance Company Policy No WC 5455643 States Covered TX