HomeMy WebLinkAboutPROPERTY ROOM - INSURANCE CERTIFICATE (10)A CORD
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: DATE (MM/DDlYI')
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PRODUCER Serial # A15188
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
AON RISK SERVICES, INC. OF FLORIDA
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1001 BRICKELL BAY DRIVE, SUITE #1100
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
MIAMI, FL 33131-4937
COMPANIES AFFORDING COVERAGE
800-743-8130
COMPANY
A NEW HAMPSHIRE INSURANCE COMPANY
INSURED
COMPANY
ADP TOTALSOURCE, INC.
B
10200 SUNSET DRIVE
MIAMI, FL 33173
'ALTERNATE EMPLOYER: SNELLER ASSOCIATES, INC.
COMPANY
C
DBA BLUE DOT SOLUTIONS INC.
COMPANY
D
Tl !IS IS TO CERTIFY THAT THE POUCrFS OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIC`.' PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MA`.' :'EfTI AIN; THE INSURANCE AFFORDED B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
- -• - . - -
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.POLICY
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
DATE MMIDDIM
POLICY EXPIRATION
DATE (MMIDDIYYI
LIMITS
GENERAL LIABILITY
GENERAL AGGREGATE $
PRODj'.,, P,•COMFfO"AGG $
PERSONAL & ADV INJURY E
CO^d•AERCIAL nPNERAL LIABILITY
CLAIMS MADE I OCCUR
---
EACH OCCURRENCE
is
OWNER'S & CONTRACTOR'S PROT
FIRE DAMAGE (Any one fRe)
E
MED EXP (Anyone person)
Is
AUTOMOBILE
UABIUTY
ANY AUTO
COMBINED SINGLE LIMIT
i
$
ALL OWNED AUTOS
i SCHEDULED AUTOS
BODILYINJURY
Pew person
E
HIRED AUTOS
NON -OWNED AUTOS
-
I
BODILY INJURY
(Per accident)
E
I
PROPERTY DAMAGE
Is
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN AUTO ONLY:
ANY AUTO
EACH ACCIDENT
$
AGGREGATE
$
EXCESS LIABILITY
EACH OCCURRENCE
Is
UMBRELLA FORM
AGGREGATE
is
$
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION AND
IWC 5193014
� 07/01/2005
07/01/2006
we sTATu 'ER
X TORV LIMITS ER
A
EMPLOYERS' LIABILf1Y
EL EACH ACCIDENT
$ 1,000,000
THE PROPRIETOR/ INCL
PARTNER&FXECUTME
OFFICERS ARE: EXCL
EL DISEASE - POLICY LIMIT
$ 1,000,000
EL DISEASE - EA EMPLOYEE
1 $ 1,000,000
OTHER
DESCRIPTION OF OPERATONSILOCATiONSNEMCLESISPECULL ITEMS -_..
.... - .. -
ALL EMPLOYEES WORKING FOR THE ABOVE NAMED CLIENT COMPANY,
PAID UNDER ADP TOTAL SOURCE, INC'S PAYROLL, WILL BE COVERED UNDER
THE ABOVE STATED POLICY. 'THE ABOVE NAMED CLIENT IS AN ALTERNATE EMPLOYER UNDER THIS POLICY.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF FORT COLLINS
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
ATTN: JIM HUME
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
PURCHASING DEPARTMENT
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NOOBLIGATION ORLIABILITY
P. O. BOX 580
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
FT. COLLINS, CO 80522
AUTHORIZED REPRESENTATIVE
AON RISK SERVICES, INC. OF FLORIDA