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Home My WebLink AboutCORRESPONDENCE - GENERAL CORRESPONDENCE - RISK SERVICESAon Risk Services, Inc. of Southern California 707 Wilshire Blvd., Suite 6000 Los Angeles, CA 90017 USA City of Fort Collins James B. O'Neill 215 N. Mason Street, 2nd Floor P.O. Box 580 Fort Collins, CO 80522-0508 USA CERTIFICATE OF INSURANCE If the enclosed is no longer required, please return the original document to: Aon Client Services 707 Wilshire Blvd. Los Angeles, CA 90047 If you have questions regarding the content of this certificate, please contact Aon Client Services at the following: Tel: 866-283-7123; Fax: 877-528-1656 Email: aca_loa_angelasears.acn.com Cc: The data included in this notice and in the attached document is confidentia' and the party responsible for bringing you this information. Powered BYne . ,.ss,.s ...ts DATE ACORD. CERTIFICATE OF LIABILITY INSURANCE 12/30/02/30/0D°'""' 4 PRODUCER LTC #0363334 1-213-630-3200 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Aon Risk Services, Inc. of Southern California ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 707 Wilshire Blvd., Suite 6000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Los Angeles, CA 90017 INSURERS AFFORDING COVERAGE PAX 877-528-1656 INSURED INSURER A: National Union Fire Ina. Co. Adecco Technical INSURER B: Illinois National Insurance Co. 4025 Automation Nay, Suite FS INSURERC: Insurance Company of the State of PA Fort Collins, CO 80525 INSURERD:Quanta Indemnity Company i iMci is Cc C- 01 nmYri a f'a anal fv COVERAGES 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE (MM(DD1YYI POLICY EXPIRATION DATE (MMIDD/YY1 LIMITS -LIIELDATE A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FXI OCCUR 6051437 01/01/05 01/01/06 EACH OCCURRENCE $ 2,000,000 FIRE DAMAGE (Any one fire) $ 2, 000, 000 MED EXP (Any one person) $ 100,000 PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS-COMP/OP AGG $4,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS 2046233 01/01/05 01/01/06 COMBINED SINGLE LIMIT (Ea awident) $1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ 2860892 01/01/05 01/01/06 EACHOCCURRENCE $ 5000000 AGGREGATE $ 5000000 $ $ B O C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY See attached addendum 5899367(IL,NN,NY,TX) 5899364 (CA) 5899363 (NI) 01/01/05 01/01/05 01/01/05 01/01/06 01/01/06 01/01/06 - EB- xTTwocRysTLAmTuTs E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYE $2,000,000 E.L. DISEASE- POLICY LIMIT 1 $ 2, 000, 000 D E OTHER FIDELITY BOND (CRIME) Professional Liahility IN & O) CCR 4000118 05 167112912-06 01/01/05 01/01/05 01/01/06 01/01/06 LIMIT $1,000,000 EACH WRONGFUL ACT $1,000,000 General Aggregate $1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSNENICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CFRTIFIL`ATF Nn1 ITFR I 1 w mnuw, meueen. meueve ,arras. f-AML`FI I ATInN1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL James B. O'Neill 215 N. Mason Street, 2nd Floor IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. Box 580 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522-0508 USA Aon Risk Services lac. of Southern CA AGURD 25-5 (7197) 3maonst O AGURD GUIiYVRA I UJIN I VW 2382327 SUPPLEMENT TO CERTIFICATE OF INSURANCE 12DATE /30/04 NAME OF INSURED: Adecco Technical Additional Description of Operations/Remarks from Page 1: AddtionaI Information: Workers Compensation and Employers Liability: Carrier : American Home Assurance Company Policy Number: 5899366 (ND,OH, WA, W2, WV, WY - Stop Gap) Policy Term: 01/01/2005 to 01/01/2006 WC Statutory Limits: H.L. Each Accident: $2,000,000 H.L. Disease -Policy Limit: $2,000,000 H.L. Disease -Each Employee: $2,000,000 Workers Compensation and Employers Liability: Carrier (AIDS ): American Home Assurance Company Policy Number: 5899368 (AOS) Policy Term: 01/01/2005 to 01/01/2006 - WC Statutory Limits : E.L. Each Accident: $2,000,000 E.L. Disease -Policy Limit: $2,000,000 E.L. Disease -Each Employee: $2,000,000 Workers Compensation and Employers Liability: Policy Number: 589365 (FL) Policy Term: 01/01/2005 to 01/01/2006 WC Statutory Limits : E.L. Each Accident: $2,000,000 E.L. Disease -Policy Limit: $2,000,000 H.L. Disease -Each Employee: $2,000,000 *I Inn rnem�� Aon Risk Services, Inc. of Southern California 707 Wilshire Blvd., Suite 6000 Los Angeles, CA 90017 City of Fort Collins James O'Neil II - CPPO, FNIGP 215 North Mason Street, 2nd Floor Fort Collins, CO 80522 USA USA CERTIFICATE OF INSURANCE If the enclosed is no longer required, please return the original document to: Aon Client Services 707 Wilshire Blvd. Los Angeles, CA 90047 If you have questions regarding the content of this certificate, please contact Aon Client Services at the following: Tel: 866-283-7123; Fax: 877-528-1656 Email: ace_los_angelesOare.aon.com cc: The data included in this notice and in the attached document is confidential to ConfirmNet and the party responsible for bringing you this information. Powered BycertmcatesNow1e DATE(MMIDOM 12/30/04 ACpR CERTIFICATE 4F LIABILITY RA-SJSMu ONRTHEICERTFCA PRODUCER LIC #0363339 1-213-630 ONLY AND CONFERS NO HOLDER. THIS CERTIFfCATE DOES NOT AMEND, EXTEND I c of southern California Aecnwnm BY THE POLICIES BELOV Aon Risk Services, n 707 WilshiregBlvd" Suite 6000 PAX 8Y7e528-165690017 INSURED Adecco USA, Inc. 175 BroadholloW Rd- , NY 11747 INSURERS AFFORDING COVERAGE g; Illinois National Insurance Co. C:Insurance Company of the States of PA OVERAGES INSURED 0 THE POLICY THIS PERIOD INDICATED I THE EOFINSURANEISTEO T OR OTHERDOCUMENT W TH RESPECT TO WHICH CERTIFICATE MAY E ISSUED ANY RQUIRECONDITION OF ANY CONTRAC "AV PFRTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED rn HEREIN I SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SL POLICIES. AGGREGATE LIMI I b ZIMUVV1V Nln, v+. ------- POLICY NUMBER 605143T pOUCY EFFECTIVE 01/01/05 POLICYEXPIRATIDN LIMITS INS TYPE OF INSURANCE 01/01/06 EACH OCCURRENCE $ 2,000,000 A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 1K OCCUR flREDAMAGE (Any one fire) $2,000,000 MED EXP (Any one person) $ 100, 000 PERSONAL d ADV INJURY $ 2, 000, 000 GENERAL AGGREGATE $ 4,000,000 GEML AGGREGATE LIMIT APPLIES PER: X POLICY PRO- LOC AGG $4,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 2046233 01/01/05 01/INED SINGLE LIMIT ccident) $ 1,000,000 X jP110DUCTS,UCTS-COMP/OP LY INJURY erson) LY INJURY ccident) PROPERTYHDAMAGE $ $ $ X X GARAGE LIABILITY ANY AUTO ONLY - EA ACCIDENT $ ER THAN EAACC $O ONLY:G $A EXCESS LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ 2860892 01/01/05 0]/H OCCURRENCE $5000000 REGATE $ 5000000 $ Is B C C WORKERS COMPENSATION AND EMPLOYERS LIABILITY See attached addendum 5899367(IL,MN,NY,TX) 5899364 (CA) 5899363 (MI) 01/01/05 01/01/05 01/01/05 01/01/06 01/01/06 01/01/06 X WCSTATU- OTH- 81 $ 2, 000, $2,000, $ 2, 000 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT D E OTHER FIDELITY BOND (CRIME) Professional Liability (E & O) CCR 4000118 05 167112912-06 01/01/05 01/01/05 01/01/06 01/01/06 LIMIT $1,C EACH WRONGFUL ACT $1,( General Aggregate s1,1 DCDl;N1YIIVN VF VYEHAIIVND/LS1tiAi1VNSIVENIGLESrEX[:LUa1VN`3 ADDED BY ENDVRSEMENT/SPEGIAL PI�VISIDNS ty of Fort Collins s O'Neil II - CPPO, FNIOP North Mason Street, 2nd Floor SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 NOME TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSUREF Collins, CO 80522 USA AUTHORf= REPRESENTATIVE ACORD CERTIFICATE OF LIABILITY INSURANCE D � 30/04DmY) 12/30/04 PRODUCER LIC #0363334 1-213-630-3200 Aon Risk Services, Inc. of Southern California THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 707 Wilshire Blvd., Suite 6000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE Los 87g7-5es, CA 28-165656 90017 877- FAX 528 INSURED Adecco USA, Inc. INSURER A: National Union Fire Ins. Co. INSURER B: Illinois National Insurance Co. 175 Broadholloa Rd. INSURERC:Inaurance Company of the State of PA INSURERD:Quaata Indemaity Company Melville, NY 11747 INSURER E: Columbia casualty Company *VE 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE (MMIDD(M 01/01/05 POLICY EXPIRATIONDATE DATE (MM/DD1YYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FxI OCCUR 6051437 01/01/06 EACH OCCURRENCE $ 2,000,000 FIRE DAMAGE (Anyone fire) $ 2,000,000 MED EXP (Any one person) $ 100,000 PERSONAL &ADV INJURY $ 21000,000 GENERAL AGGREGATE $ 4,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY F PRO LOC PRODUCTS-COMP/OP AGG $4,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS 2046233 01/O1/05 01/01/06 COMBINED SINGLE LIMIT (Ea accident) $ 11000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS LIABILITY X1 OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ 2860892 01/01/05 01/01/06 EACH OCCURRENCE $ 5000000 AGGREGATE $ 5000000 $ B C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY See attached addendum 5899367 (IL, MN, NY, TX) 5899364 (CA) 5899363 (MI) 01/01/05 01/01/05 01/01/05 O1/01/06 01/01/06 01/01/06 g WC STATU-S1 OTH- E.L EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $2,000,000 E.L. DISEASE- POLICY LIMIT $ 2,000,000 D E OTHER FIDELITY BOND (CRIME) Professional Liability (E & O) CCR 4000118 05 167112912-06 01/01/OS 01/01/05 O1/01/06 01/01/06 LIMIT s1,000,000 RACK WRONGFUL ACT $11000,000 General Aggregate $1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS City of Fort Collins James O'Neil II - CPPO, FNIGP 215 North Mason Street, tad Floor Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE USA Aon Risk Services. Inc. of So, ACORD 25-5 0 ACORD CORPORATION SUPPLEMENT TO CERTIFICATE OF INSURANCE 12DATE /30/04 NAME OF INSURED: Adecco USA, Inc. Adddional Description of Operations/Remarks from Page 1: Add kiona I Information: Workers Compensation and Employers Liability: Carrier : American Home Assurance Company Policy Number: 5899366 (ND,OH, WA, WI, WV, WY- Stop Gap) Policy Term: 01/01/2005 to 01/01/2006 WC Statutory Limits: H.L. Each Accident: $2,000,000 H.L. Disease -Policy Limit: $2,000,000 H.L. Disease -Hach Employee: $2,000,000 Workers Compensation and Employers Liability: Carrier (AOS ): American Home Assurance Company Policy Number: 5899368 (ADS) Policy Term: 01/01/2005 to 01/01/2006 WC Statutory Limits : H.L. Each Accident: $2,000,000 E.L. Disease -Policy Limit: $2,000,000 E.L. Disease -Hach Employee: $2,000,000 Workers Compensation and Employers Liability: Policy Number: 589365 (FL) Policy Term: 01/01/200S to 01/01/2006 WC Statutory Limits : E.L. Each Accident: $2,000,000 H.L. Disease -Policy Limit: $2,000,000 E.L. Disease -Each Employee: $2,000,000 SUPP (051041