HomeMy WebLinkAboutAFFILIATED COMPUTER SERVICES - INSURANCE CERTIFICATE (6)DATE (MWDDIYY)
ACORD. CERTIFICATE OF LIABILITY INSURANCE 06/30/2005 07/16/2004
PRODUCER LOCKTON COMPANIES OF DALLAS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
717 N HARWOOD LB#27 HOLDER. THIS CERTIFICATE DOES NOT AMEND,_ EXTEND OR
DALLAS TX 75201
214-969-6700
INSURERS AFFORDING COVERAGE
INSURED INSURER A: Ace American ills. 1.0.
1050096 Affiliated Computer Services Inc. INSURER B : American Guarantee & Liability
ACS State & Local Solutions, Inc. INSURERC
2828 N. Haskell
Dallas, TX 75204
At Au
VVYGRa1laCJ A1-i-a.vvi
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 MWDD
POLICY EXPIRATION
DATE MMIDD
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
HDOG19905056
07/17/2004
06/30/2005
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Any one fire
$ 100,000
MED EXP (Any oneperson)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE
POLICY I
LIMIT APPLIES
JECT X
PER:
LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULEDAUTOS
HIRED AUTOS
NON -OWNED AUTOS
ISAH07942436
07/17/2004
06/30/2005
COMBINED SINGLE LIMIT
(Ea accident)
$ 2,000,000
X
BODILY INJURY
(Per person)
$ XXXXXXX
BODILY INJURY
(Per accident)
$ XXXXXXX
PROPERTY DAMAGE
(Per accident)
$ XXXXXXX
GARAGE LIABILITY
ANY AUTO
NOT APPLICABLE
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
OTHER THAN EA ACC
AUTO ONLY: AGG
XXXXXXX
$ XXXXXXX
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
UMBRELLA
DEDUCTIBLE FORM
RETENTION $
AUC9304213-03
05/17/2005
07/01/2006
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5 000 000
XXXXXXX
XXXXXXX
$ XXXXXXX
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WLRC43969092
07/17/2004
06/30/2005
}( WCRYC STATU• ER-
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE1
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
I $ 1,000,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Named Insured - ACS Enterprise Solutions, Inc. fka 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
ACORD 25-S (7/97) For gwNlonsregarding this certificate. wntactthe number llatedInths'Producae"dionatwwand spaciythedietco6o'AFFGOm'. 0At;UKUGUKYUKAIIUN11000