The URL can be used to link to this page

Home My WebLink AboutADECCO TECHNICAL - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE °"�`"'""'°""Y' 12/30/04 PRODUCER LIC #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. INSURERS AFFORDING COVERAGE Los Angeles, CA 90017 FAX 877-528-1656 INSURED Adecco Technical INSURER A: National Union Fire Ins. Co. INSURER B: Illinois National Insurance Co. 4025 Automation Way, Suite P1 INSURER C: Insurance Company of the State of PA INSURERD:Quanta indemnity Com as Fort Collins, CO 80525 INSURER E: Columbia Casualty Company 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 DATE (MMfDD/YY1 POLICY EXPIRATIONJZL DATE (MMIDDrfY) LIMITS • GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR 6051437 01/01/05 01/01/06 EACHOCCURRENCE $ 2,000,000 FIRE DAMAGE (Any one tire) $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 aCCitlent) $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 EACH OCCURRENCE $ 5000000 AGGREGATE $ 5000000 $ $ $ B C 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 X WCSTATU- I OTH- E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEd $2,000,000 E.L. DISEASE -POLICY LIMIT 1 $2,000,000 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 LINIT $11000,000 EACH WRONGFUL ACT $11000,000 General Aggregate $1,000,000 DESCRIPTION OF OPERATIONSAOCATONSNEHICLES/ERCLUSIONS ADDED BY ENDORSEMENTSPECIAL PROVISIONS 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 LIABILTTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. Box 580 REPRESENTATIVES. Fort Collins, CO 80522-0508 AUTHORIZED REPRESENTATIVE USA Aon Risk Services Inc. of Southern CA ACORD 25-S (7/97) jmaonef O ACORD CORPORATION IQRR gaersai SUPPLEMENT TO CERTIFICATE OF INSURANCE 12DATE /30/04 NAME OF INSURED: Adecco Technical Additional Description of Ooerations/Remarks from Page 1: Additional Information: workers Compensation and Employers Liability: Carrier : American Home Assurance Company Policy Number: 5899366 (ND,OH, CPA, wi, WV, NY - Stop Gap) Policy Term: 01/01/2005 to 01/01/2006 CPC Statutory Limits: S.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: Carrier (AOS ): American Home Assurance Company Policy Number: 5899368 (AOS) Policy Term: 01/01/2005 to 01/01/2006 NC 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 (PL) 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 SUPP (05104) ! ACORD. CERTIFICATE OF LIABILITY INSURANCE 1DATE2/30/04/04 /YY) PRODUCER LIC #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 1707 Wilshire Blvd., Suite 6000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW - An ales, CA 90017 877-528-1656 decco Technical 025 Automation Way, Suite P1 Collins, CO 80525 rwT.la :J _TT"cl x-i INSURERS AFFORDING COVERAGE INSURER e:Illinoi B National Insurance Co. INSURERC:Ineurance ComDHnv of the State of PA 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 DATE (MMIDO/YYI POLICY EXPIRATION-LM DATE (MMIDONY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 1K 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 GENT AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOG PRODUCTS -COMPIOP AGG $4,000,000 • AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS 2046233 01/01/05 01/01/06 COMBINED SINGLE LIMIT (Ea accidert) $ 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 $ OTHERTHAN EA ACC AUTO ONLY: AGG $ $ A EXCESS LIABILITY X OCCUR 1:1CLAIMS MADE DEDUCTIBLE RETENTION $ 2860892 01/01/05 01/01/06 EACHOCCURRENCE $ 5000000 AGGREGATE $ 5000000 $ $ B C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY See attached addendum 5899367(IL,MN,NY,TX) 5899364 (CA) 5899363 (NI) 01/01/05 01/01/05 01/01/05 01/01/06 01/01/06 01/01/06 WC - X STATULIML- OTHEEL 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 Liability (E & 0) CCR 4000118 05 167112912-06 1 01/01/05 01/01/OS 1 01/01/06 01/01/06 1 LIMIT $11000,000 EACH WRONGFUL ACT $11000,000 IGeneral Aggregate sl,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS wti•Y.I�IJS. ySh\a.ly->_s� ...._ __ .Tnara ni sm.r.. W.1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Port 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 Port Collins, CO 80522-0508 USA Aon Risk Services Inc. of Southern CA ACURD 25-5 (7t97) 3maonsf O AGUHO GUHPOHATIUN 19U0 2382327