HomeMy WebLinkAboutAFFILIATED COMPUTER SERVICES - INSURANCE CERTIFICATE (3)ACORDD, CERTIFICATE OF LIABILITY INSURANCE 12/1/2008
DATE(MM/DD/YYYY)
7/v2008
PRODUCER LOCKTON COMPANIES, LLC-N DALLAS
717 N. HARWOOD, LB#27
DALLAS TX 75201
214-969-6700
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED Affiliated Computer Services, Inc.
1050096 ACS Enterprise Solutions, Inc.
2828 N. Haskell
Dallas TX 75204
wsURERA Ace American Insurance Company
INSURER B National Union Fire INS. Co. of PA
HE ER c Indemnity Ins. Co. of North America
INSURER D FTillgton Insurance Company
INSURER E.
COVERAGES Af�vuuUI AJ
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
ADD-1-1
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MMIDD/YY)
POLICY EXPIRATION
DATE(MMIDD/W)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$. $1,000000
A
X COMMERCIAL GENERALLIABiLITY
CLAIMS MADE (OCCUR
HUOG23710291
7/1/2008
12/l/2008
DAMAGE TO RENTED
pRthnsEEa cocurencso
100000
MED EXP(Any one person)
$ 000
PERSONAL 8 ADV INJURY
$ $$1,000A0
GENERAL AGGREGATE
$ $2 000 000
GENL AGGREGATE LIMITAPPLIES PER.
PRODUCTS - COMP/OP AGG
$ $2000000
PRO -
POLICY JECT X LOG
A
AUTOMOBILE
LIABILITY
ANY AUTO
ISA 1107837379
7/l/2008
12/l/2008
COMBINED SINGLE LIMIT
(Ea accident)
$ 2,000,000
X
BODILY INJURY
(Par person)
$ XXXXXXX
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$ XXXXXXX
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$ XXXXXXX
GARAGE LIABILITY
ANY AUTO
0
NO'f APPLICABLE
AUTO ONLY - EAACCIDENT
$ XXXXXXX
OTHER THAN EA ACC
$ XXXXXXX
AUTO ONLY AGO
$ XXXXXXX
13
EXCESS/UMBRELLALIABILITY
X OCCUR CLAIMS MADE
9$35056
7/1/2007
12/1/2008
EACH OCCURRENCE
$ 5000000
AGGREGATE
$ 5,000,000
$ XXXXXXX
❑ UMBRELLA
$ XXXXXXX
DEDUCTIBLE FORM
g XXXXXXX
RETENTION $
C
A
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE
OFFICER/MEMBEREXCLUDED'
SPECIAL PROVISIONS below NO
WLP C43499117(ALL OTHER)
WLR C43499154 (AZ, CA)
SCF C42847884 (WI)
7/t/2008
7/1/2008
7/1/200$
12A/2008
12/l/2008
12/t/2008
X WCSTATU- OTH-
IORVLIMUS ER
EL
.. EACH ACCIDENT
$ 1,000,000
E.L.DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY OMIT
$ 1,000,000
OTHER
D
Gn loyel's Excess lndenmily
(r�'j
EPIC5356336
7/I/2008
12/l/2008
S 1 M per per son;$ 1 OM per oco.
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Employers Excess Indemnity coverage provides excess limits over and above the employer's ERISA qualified non -Subscriber benefit plan for Texas employees who
sustain work related injury or disease.
I LD4040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CitXY of Ft. Collins, CO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
30(1 La POdB Ave. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
P.O. Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Ft. Collins CO
REPRESENTATIVES. j
AUTHORIZED REPRESPE ;l AT11E j I�
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