HomeMy WebLinkAboutAFFILIATED COMPUTER SERVICES - INSURANCE CERTIFICATE (7)ACORM CERTIFICATE OF LIABILITY INSURANCE 10/13/2004
ovi6/20o
PRODUCER LOCKTON COMPANIES OF DALLAS, INC.
717 N. HARWOOD, LB#27
DALLAS TX 75201
214-969-6700
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
E H
INSURERS AFFORDING COVERAGE
INSURED
1021193 Affiliated Computer Services,
Inc.,
2828 N. Haskell
Dallas TX 75204
INSURER A: Ace American Insurance Coan
m
INSURER B : American Guarantee & Liability
I IN5URER C: Am. Intemafl SDecialtv Lines
INSURER D United States Fire Ins. & Var.Other
rnVFRA(%Fc AFF171101 AR
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
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMID
POLICY EXPIRATION
DATE MMID
LIMITS
GENERAL LIABILrrY
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE An one Ere
$ 100,000
A
X COMMERCIAL GENERAL LIABILITY
HDOG19905056
07/17/2004
06/30/2005
B
CLAIMSMADE [K] OCCUR
HDOG19905056
07/17/2004
06/30/2005
MEDEXP An one rson
$ 5000
PERSONAL &ACV INJURY
$ 1,000,000
A
X Stop Gap -OH
$1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES
PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
PRO -
POLICY JECT X
LOC
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ISAH07942436
07/17/2004
06/30/2005
COMBINED SINGLE LIMIT
(Ea accident)
$ 2,OOQ000
BODILY INJURY
(Per Person)
$ XXXXXXX
A
ALL OWNED AUTOS
SCHEDULED AUTOS
$5,000 DEDUCTIBLE
X
BODILYINJURY
(Perraccident)
accident)
$ XXXXXXX
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$ XXXXXXX
Physical Damage
X
I eom /collision
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
OTHER THAN EA ACC
XXXXXXX
ANY AUTO
NOT APPLICABLE
$ XXXXXXX
AUTO ONLY: AGG
EXCESS LIABILITY
EACH OCCURRENCE
$ 5,000,000
H
X1 OCCUR 1-:1CLAIMS MADE
AUC9304213-02
05/17/2004
05/17/2005
AGGREGATE
$ 5,000,000
$ XXXXXXX
UMBRELLA
S XXXXXXX
DEDUCTIBLE FORM
$ XXXXXXX
X RETENTION $ 10,000
A
WORKERS COMPENSATION AND
WLRC43969092
07/17/2004
06/30/2005OTH-
A
EMPLOYERS' LIABILITY
WLRC43969092
07/17/2004
06/30/2005
E.L. EACH ACCIDENT
$ 1 000 000
E.L. DISEASE - EA EMPLOYEE
$ 1 000 000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
C
OTHER
3488977
10/13/2003
10/13/2004
Prof. Liab. $5,000,000
D
Professional Liability
2441870604
05/24/2004
05/24/2005
C
3488977
10/13/2003
10/13/2004
DESCRIPTION OF OPERAMOW4LOCAMONSNENICLEWEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Named Insured - ACS Enterprise Solutions, Inc. flea Business Records Corp.
1254346
City of Ft. Collins, CO
300 La Porte Ave.
P.O. Box 580
Ft. Collins CO
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
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE „ t.
ACORD 25-S (7197) For question, regarding this oemrcx., can.nthe number tided in %e?roamee section W~e and sp&c ry the ac.m wa.'AFFearr. ® ACORD CORPORATION 11988