The URL can be used to link to this page

Home My WebLink AboutAON RISK SERVICES - INSURANCE CERTIFICATE (2)Aon Risk Services, Inc. of Northern California insurance Services 199 Fremont Street, Suite 1400 San Francisco, CA 94105 USA City of Fort Collins James B. O'Neill 215 N. Mason Street, 2nd Floor P.O. Box 580 Fort Collins, CO 80522-0508 USA CERTIFICATE OF INSURANCE If the enclosed is no longer required, please return the original document to: Aon Risk Services, Inc. of Northern California Insurance Services 199 Fremont Street, Suite 1400 San Francisco, CA 94105 LIC #0363334 If you have questions regarding the content of this certificate, please contact Aon Client Services at the following: Tel: 866-283-7122; Fax: 847-953-5390 Email: ACS_Chicago®ars.aon.com cc: Rusty Shawley (FAX), The data included in this notice and in the attached document is confidential to ConfirmNet and the party responsible for bringing you this information. Powered ByCertificatesNowm ACORD. LIABILITY INSURANCE 07/27/05""" CERTIFICATE OF PRODUCER LIC #0363334 1-866-283-7122 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Aon Risk Services, Inc. of Northern California ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Insurance Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 199 Fremont Street, ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 1400 San Francisco, CA 94105 FAX 847-953-5390 INSURERS AFFORDING COVERAGE NAIC# INSURED Adecco Technical INSURER A: National Union Fire Ins. Co. INSURERS: Columbia Casualty Company 4025 Automation Nay, Suite F1 INSURER C: Quanta Indemnity Company INSURER D: Insurance Company of the State of PA Fort Collins, CO 80525 INSURER E: Illinois National Insurance Co. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE 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 ADDI III TYPED INSURANCE POLICY NUMBER POLICYEFFECTIVE POLICYEXPIRATION1M LIMITS A GENERALLIABILm X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR 6051437 01/01/05 01/01/06 EACH OCCURRENCE $2,000,000 DAMAUE PREMISE TO RENTED $2,000,000 MED EXP(Any one person) $100,000 PERSONAL&ADV INJURY $2,000,000 GENERALAGGREGATE $ 4,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS -COMNOP AGG $4,000,000 A AUTOMOBILE LIABILITY ANVAUTO ALLOWNEDAUTOS SCHEDULEDAUTOS HIREDAUTOS NON-ONEDAUTOS W 2046233 01/01/05 01/01/06 aDSINGLE LIMIT (Ea accident) $1, 000,000 X BODILYINJURY (Per person) $ X BODILY INJURY (Peraccident) $ X PROPERTVDAMAGE (Per exident) $ GARAGE LIABILITY ANVAUTO AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC AUTOONLY: AGG $ $ A EXCESS/UMBRELLA LIABILITY X I OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ 2860892 01/01/05 01/03/06 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ $ D D H WORKERSCOMPENSATIONAND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE INC OFFICER/MEMBER EXCLUDEDT EXC If yes, describe under SPECIAL PROVISIONS below 5899364 (CA) 5899363 (MI) 5899367(IL,MN,NY,TX) 01/01/05 01/01/05 01/01/05 01/01/06 01/01/06 01/01/06 X WC STATU- GTH- E.L. EACH ACCIDENT $2,000,000 E.L. DISEASE - EA EMPLOYEE $2,000,000 E.L. DISEASE -POLICY LIMIT $2,000,000 C H OTHER FIDELITY BOND (CRIME) Professional Liability IS & O) CCR 4000118 05 167112912-06 01/01/05 01/01/05 01/01/06 01/01/06 LIMIT 51000,000 BACH WRONGFUL ACT 5,000,000 iGZNERAL AGGREGATE 5,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ty of Fort Collins mes B. O'Neill 5 N. Mason Street, 2nd Floor O. Box 580 it Collins, CO 80522-0508 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WfIfTTEN 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 USA 25(2001/08) 1 Chao Risk Services, Inc. of Northern CA 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. ACORD 25 SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE o�/a7/os NAME OF INSURED: Adecco Technical Additional Description of Ooeration5/Remarks from Pace 1: Additional Information: workers Compensation and Employers Liability Carrier : American Home Assurance Company Policy Number: 5899366 (ND, OR WA, wl, WV, WY, - Stop Gap) 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 -Hach Employee: $2,000,000 Workers Compensation and Employers Liability Carrier : American Home Assurance Company Policy Number: 5899368 (ADS) Policy Term: 01/01/2005 to 01/01/2006 WC Statutory Limits : E. L. Each Accident: $2,000,000 H. L. Disease -Policy Limit: $2,000,000 E. L. Disease -Each Employee: $2,000,000 Workers Compensation and Employers Liability / American Home Assurance Co. Policy Number: 589365 (FL) Policy Term: 01/01/2005 to 01/01/2006 WC Statutory Limits: E. L. Accident: $2,000,000 E. L. Disease -Policy Limit: $2,000,000 E. L. Disease -Hach Employee: $2,000,000 SUPP (05/04)