The URL can be used to link to this page

Home My WebLink About114084 EXPRESS PERSONNEL SERVICES - INSURANCE CERTIFICATEACORD„ CERTIFICATE OF LIABILITY INSURANCE P4 7 E(MM7UD/YYYY) s/19/2008 rgooucaR Phone: 800-888-3910 Fax: 312-527-9473 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION H.ilb Royal S Hobbs (HRH) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE One East Wacker Drive, Suite 1800 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Chicago IL 60601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC M INSURED Express Services, Inc. INSUR[RA_Natlnal Uni On Bire In.S CO Of — 8516 NW Expressway :NsugeR D:InElural}c_P Co Of The State Of 19.4.29 __ Oklahoma City OX 73162 INSURER c: National _Union Fire rns�o_ nn\/CO An CC ES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NDING ANY REQUIREMENT, TERN OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS E MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFBORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL, THE LUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSPOLICY TYPBILITY IgpN POLICYNUMBER EFFECTIVE P041CYEXPIRATION — "--""— ihVODlYY1 LIMITS KGENERAL NENALLIABILITY SSL9518899 10/1/2007 1.0/l/2008 EACHOCCURRENCE -DWPREMISe�tpgcqrerme $5Ny..,_000 000 COMMENCIALGENERALUABfUTY � CLAIMS MADE � OCCURSCdf.flnq--S-er11Le.-. $250.000 .._._.....—__.__ PERSOIJAL&---NJURY $ jC,L, AT. GENERALAGGREGE___$$ $� U DC)o GENLAGGRGLIMITAPPL_SPER PROOUCTS�C AGGO X POLCVAP. LOG A X AUTOMOBILE LIABILITY !SSL9518899 10/1/2007 10/l/200$ ANYAVTO COMBINED SINGLE LIMIT (E.nduem) .___..._....._._.___.____. $ 1., 000, 000 - ALLOWNEDAUTOS AUTOS BODILY INJURY (Porperson) S LNONAUTOS SODILYINJURY PROPERTY DAMAGE ST — —"'— (Peracciden0 GARAGE LIABILITY AUTO ONLY -EA ACCIDENT -----�--" S ANYAUTO OTHEHTIIAN LA ACC S _ _ S AWOONLY: AGO A X EXCESSJUMSRELLA LIABILITY OCCUR CLAIMS MADE BE5151669 10/1/2007 10/l/2008 EACHOCCURPENCE S1Q,_Qp Q,,.QL)0 AGGREGATE S DEDUCTIBLE " --'"'—'----- -_ S RETENTION S S $ WORK[RS COIdPENSATION AND MiC5455644 10/1/2007 10/1/200$fC&O WC STATV- OTH.- YLIMISC �_E<i_—_.__..�__._ EMPLOYERS' LIABILITY rA7C5455690 10/l/200'7 10/l/2008 D PgOPHIETOfUPARTNENE%ECU9VE OFFICEWMEMBER EXCLUDED? WC5455639 10/1/2007 10/1/200$4 _ 0ANY EACIiACCIDENT "E Ilyee,de5cribe VAder see attached list 10/1/2007 10/.1/2008DISEASE EAEMPLOYSPECfAL PROVISIONSbolow -- OISEASE-PODGYOMIT SCOTHER 000 000Crime/Fidoli ty 14924,36 10/1/ 0007 10/1/2008me/Fideli.ty $1,000,000 A Staffing E&O Coverage SSL9518899 10/1/2007 10/l/2008 Occ/Agg $5,000,000 DESCRIPTION OFOPERATIONS/LOCATIONS 7VEHICLES/EXCLUSIONS ADDED BY CNOORSEMENT/SPECIAL PROVISIONS Location: 1016 - Ft. Collins, CO Type Of Company: City Municipality lob DOBCripti On: C1Or1Ca.l, a&dnistrative assistant, light industrial assignments All insurance carriers shown on this certificate have an A,M. Rest Rating of AIXV unless Otherwise noted. ontinued... rror'Irlrnrc unl nco _ ... _ __ City Of Fort Collins P.O. Box 580 Fort Collins CO 50524 /08) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WI),L ENDEAVOR TO MAIL 30 DAYS 'WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, HUT FAILURE TO DO .SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY XINU UPON PHE INSURER, ITS AGENTS OR REPRESENTATIVES. IMPORTANT It 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. /OM DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS / SPECIAL PROVISIONS Certificate Holder is listed as an Additional Insured as respects work performed by Temporary Associates except for Negligence or Willful Misconduct of Certificate Holder. Additional Insured does not apply to WC, TUO or Fidelity. Workers' Compensation Policy Schedule: Policies Effective: 10/1/07 Policies Expiration 10/I/08 B. Insurance Company State of PA Policy No. WC5455644 States Covered: AK,AL,AR,AZ,CO,C'r,DC,DE,GA,HI,IA,ID,IL,IN,KS,KY,LA,MA,MD,ME,MI, MN,M0,MS,MT,NC,NE,NII,N7,NM,NV,NY,OK,PA,RI,SC,SD,TN, UT,VA WV — ADDED 7/l/08 C. National Union Fire Ins Co Policy No.WC 5455640 States Covered: WI (ND,OH,WA,WY EMP,LIAI3.ONLY— WV DELETED 7/l/08) D. American Home Assurance Company Policy No.WC 5455639 States Covered: CA E. AIG Casualty Company Policy No.WC 5455641 States Covered: OR D. American Home Assurance Company Policy No.WC 5455642 States Covered: FL F. New Hampshire Insurance Company Policy No.WC 5455643 States Covered: TX