HomeMy WebLinkAbout- INSURANCE CERTIFICATE (8)MARSH CERTIFICATE OF INSURANCE CERTIFICATE NUMBER
NYC-002466645-03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Marsh USA Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
1166 Avenue of Americas POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
New York, NY 10036 AFFORDED BY THE POLICIES DESCRIBED HEREIN.
Attn: NEWYORK.CERTS@MARSH.COM FAX:212-94"500 COMPANIES AFFORDING COVERAGE
COMPANY
72750-CAS-GAWX-06-07 ADDTL A AMERICAN HOME ASSURANCE COMPANY
INSURED
COMPANY
VOLT INFORMATION SCIENCES, INC.
B INSURANCE COMPANY OF THE STATE OF PA
560 LEXINGTON AVENUE
COMPANY
NEW YORK, NY 10022
C ILLINOIS NATIONAL INSURANCE COMPANY
COMPANY
D ST. PAUL FIRE & MARINE INSURANCE COMPANY
COVERAGES This certificate supersedes and replaces any previously issued certificate for the policy period noted below, 4
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY 8E ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY EFFECTIVE
DATE (MMIDD/YY)
POLICY EXPIRATION
DATE(MI010C Y)
LIMITS
A
GENERALLIABILITY
RMGL3900099
03/31/06
j03/31/07
GENERAL AGGREGATE
Is 2,000,000
PRODUCTS - COMP/OP AGG
Is NIA
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE J OCCUR
PERSONAL &ADV INJURY
$ 1,000,o0o
EACH OCCURRENCE $ 1,000,000
OWNER'S & CONTRACTOR'S PROT
.
FIRE DAMAGE (Any one fire)
$ 250,000
EXP (Any one arson
$ 10,000
rlMED
A
AUTOMOBILE
LIABILITY
RMCA 3755569 (AOS)
03/31/06
0313/107
COMBINED SINGLE LIMIT
$ 1,000,000
X
A
ANY AUTO
RMCA3729647 (TX)
03/31/06
03/31/07
BODILY INJURY
(Per Person)
$
A
A
ALL OWNED AUTOS
SCHEDULED AUTOS
RMCA 3729646 (MA)
RMCA 3755570 VA
( )
03/31/06
03/31/06
03/31/07
03/31/07
BODILY INJURY
(Peraoddent)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN AUTO ONLY:
ANY AUTO
EACH ACCIDENT
$
AGGREGATE
1 $
D
EXCESS LIABILITY
QK09001246
'03/31106
03/31/07
EACH OCCURRENCE
Is 5,000,000
AGGREGATE
Is 5,000,000
X UMBRELLA FORM
$
j OTHER THAN UMBRELLA FORM
A
A
wORKERsOOMPONKTIONAND
EMPLOYERS' LIABILITY
RMWC 4764134 (AOS)
RMWC4764133 (CA)
03/31/06
03/31/06
03/31/07
03/31/07
X TORY LIMITS ERH
EL EACH ACCIDENT
$ 1,000,000
THE PROPRIETOR/
PARTNERSIEXECUTIVE X INCL
NERSlCU
OFFICERS ARE: EXCL
'
EL DISEASE -POLICY LIMIT
$ 1,000,000
EL DISEASE -EACH EMPLOYEE
$ 1,000,000
A OTHER
RMWC 4764071 (OR)
03/31/06
03/31/07
B WORKER'S COMPENSATION
RMWC 4764070 (FL)
03/31/06
03/31/07
SEE ABOVE FOR LIMITS
B CONTINUED
RMWC 4764073 (AR,MA,MI,TN,VA)
03/31/06
03/31/07
C
RMWC 4764072 (WI)
03/31/06
03/31107
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/SPECIAL ITEMS
THE CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED UNDER THE GENERAL AND
AUTOMOBILE LIABILITY POLICIES WITH RESPECT TO SERVICES PERFORMED BY VOLT.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.
THE "SURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL _3p DAYS NRIrTEN NOTICE TO THE
CITY OF FORT COLLINS
ATTN: JAMES B. O'NEIL
CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
215 NORTH MASON STREET
LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
FORT COLLINS, CO 80522
ISSUEROFTHIS CERTIFICATE,
MARSH USA INC.
BY: Dress Allman VALAA_ Q, aj4iA4,,,
'' ""'' ""
MM1(3f92) VALID AS OF: 03/31/06
MARSH CERTIFICATE OF INSURANCE CERTIFICATE NUMBER
NYC-002466645-03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Marsh USA Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
1166 Avenue of Americas POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
New York, NY 10036 AFFORDED BY THE POLICIES DESCRIBED HEREIN.
Attn: NEWYORK.CERTS@MARSH.COM FAX:212-94"500 COMPANIES AFFORDING COVERAGE
COMPANY
72750-CAS-GAWX-06-07 ADDTL A AMERICAN HOME ASSURANCE COMPANY
INSURED
COMPANY
VOLT INFORMATION SCIENCES, INC.
B INSURANCE COMPANY OF THE STATE OF PA
560 LEXINGTON AVENUE
COMPANY
NEW YORK, NY 10022
C ILLINOIS NATIONAL INSURANCE COMPANY
COMPANY
D ST. PAUL FIRE & MARINE INSURANCE COMPANY
COVERAGES This certificate supersedes and replaces any previously issued certificate for the policy period noted below, 4
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY 8E ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY EFFECTIVE
DATE (MMIDD/YY)
POLICY EXPIRATION
DATE(MI010C Y)
LIMITS
A
GENERALLIABILITY
RMGL3900099
03/31/06
j03/31/07
GENERAL AGGREGATE
Is 2,000,000
PRODUCTS - COMP/OP AGG
Is NIA
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE J OCCUR
PERSONAL &ADV INJURY
$ 1,000,o0o
EACH OCCURRENCE $ 1,000,000
OWNER'S & CONTRACTOR'S PROT
.
FIRE DAMAGE (Any one fire)
$ 250,000
EXP (Any one arson
$ 10,000
rlMED
A
AUTOMOBILE
LIABILITY
RMCA 3755569 (AOS)
03/31/06
0313/107
COMBINED SINGLE LIMIT
$ 1,000,000
X
A
ANY AUTO
RMCA3729647 (TX)
03/31/06
03/31/07
BODILY INJURY
(Per Person)
$
A
A
ALL OWNED AUTOS
SCHEDULED AUTOS
RMCA 3729646 (MA)
RMCA 3755570 VA
( )
03/31/06
03/31/06
03/31/07
03/31/07
BODILY INJURY
(Peraoddent)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN AUTO ONLY:
ANY AUTO
EACH ACCIDENT
$
AGGREGATE
1 $
D
EXCESS LIABILITY
QK09001246
'03/31106
03/31/07
EACH OCCURRENCE
Is 5,000,000
AGGREGATE
Is 5,000,000
X UMBRELLA FORM
$
j OTHER THAN UMBRELLA FORM
A
A
wORKERsOOMPONKTIONAND
EMPLOYERS' LIABILITY
RMWC 4764134 (AOS)
RMWC4764133 (CA)
03/31/06
03/31/06
03/31/07
03/31/07
X TORY LIMITS ERH
EL EACH ACCIDENT
$ 1,000,000
THE PROPRIETOR/
PARTNERSIEXECUTIVE X INCL
NERSlCU
OFFICERS ARE: EXCL
'
EL DISEASE -POLICY LIMIT
$ 1,000,000
EL DISEASE -EACH EMPLOYEE
$ 1,000,000
A OTHER
RMWC 4764071 (OR)
03/31/06
03/31/07
B WORKER'S COMPENSATION
RMWC 4764070 (FL)
03/31/06
03/31/07
SEE ABOVE FOR LIMITS
B CONTINUED
RMWC 4764073 (AR,MA,MI,TN,VA)
03/31/06
03/31/07
C
RMWC 4764072 (WI)
03/31/06
03/31107
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/SPECIAL ITEMS
THE CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED UNDER THE GENERAL AND
AUTOMOBILE LIABILITY POLICIES WITH RESPECT TO SERVICES PERFORMED BY VOLT.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.
THE "SURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL _3p DAYS NRIrTEN NOTICE TO THE
CITY OF FORT COLLINS
ATTN: JAMES B. O'NEIL
CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
215 NORTH MASON STREET
LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
FORT COLLINS, CO 80522
ISSUEROFTHIS CERTIFICATE,
MARSH USA INC.
BY: Dress Allman VALAA_ Q, aj4iA4,,,
'' ""'' ""
MM1(3f92) VALID AS OF: 03/31/06