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Home My WebLink AboutEXPRESS SERVICES - INSURANCE CERTIFICATE (9)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE (MMlDDlYVYY) EXPRE-1 08 03 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Gallagher Bryce HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 3142 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tulsa OK 74101 Phone:918-584-1433 Fax:918-582-1329 INSURED Express Services, Inc. 8516 NW Expressway Oklahoma City OK 73162 vVv=r[ CJ INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins Co of INSURER B: American Home Assurance Co INSURER C: Illinois National Ins Co INSURER D: American International South INSURER E: Ins Co 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDlry DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX-] OCCUR SSL9518899 10/01/03 10/01/04 PREMISES (Eaoccurencs) $250,000 MED EXP (Any one person) s5,000 X Staffing Services PERSONAL & ADV INJURY $ Incl. E&O GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $Included A AUTOMOBILE LIABILITY ANY AUTO SSL9518899 10/01/03 10/01/04 CO accident) (EaCOMBINED SINGLE LIMIT $ 1 rQQQ rQQQ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIREDAUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHERTHAN EA ACC AUTO ONLY: AGG $ $ A EXCESSIUMBRELLA LIABILITY X OCCUR 1-1 CLAIMSMADE BE7123490 10/01/03 10/01/04 EACH OCCURRENCE $5,000,000 AGGREGATE s5,000,000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? Des,describePRO under SPECIAL PROVISIONS below WC2981214 (*) 10/01/03 10/01/04 X TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE E$1r 000 000 r E.L. DISEASE -POLICY LIMIT $1 000,000 OTHER A Crime/Fidelity 7144444 10/01/03 10/01/04 Crime 1,000,000 A Staffing E&O Cv . SSL9518899 10/01/03 10/O1/04 E&O Oc/Ag 2,000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS *AL,AR,CO,IA,KS,KY,ME,MO,MS,MT,NC,NH,NJ,NM,NV,OK,SC,SD,TX,UT Location:1016-Ft.Collins,CO; Type of Company: City Municipality; Job Description: Clerical, administrative assistant. All insurance carriers shown on this certificate have an A.M. Best Rating of A++XV unless otherwise noted. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Attn: James O'Neill P.O. Box 580 Fort Collins, CO 80524 CITYFCl 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. ACORD 26 (2001108) CORPORATION 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. 25 Workers Compensation Policies Effective: Co.No.: B. B. A. C. D. E. Policy Schedule Cont 10-1-03 Policies Policy Number: WC2981216 WC2981218 WC2981215 WC2981217 WC2981219 WC2981220 Expiration: 10-1-04 State: CA MN WI and Monopolistic Emp.Liab. CT,FL,IL,IN,LA,MI,NY,PA GA AZ,ID,MA,MD,OR,TN,VA