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HomeMy WebLinkAbout131163 ADECCO TECHNICAL - INSURANCE CERTIFICATE'.� DATE(MM/DO/YYYY) :, A_ CORD.,+ CERTIRICATE OF LIABILITY INSI7ItANCE 0a/2o/200a ra0R0ent ADD Risk Insurance Services west, Inc. 'IHIS CERTIFICArh IS ISSUED ASAAIA'FI'EROFINFORMATION ONLY fka Aon Risk Serv, Inc. Of N CA Ins Sery 199 Fremont Street AND CONFIiRS NO RIGHTS UPON77IE CERTITCATE HOLDEILTIiS suite SuiOVEIZAGEAPTORY)FDBYTIIF,l'OLICIESDELOW. CERTIFICATE DOES NOT AIIIEND, EXTEND Olt AIA ERTHE San Francisco CA 94105 USA C INSURERS AFFORDING COVERAGE NAICH rnoNv- 415 486-7000 PAX 415 486-7029 INSURED Adecco Inc. )NSURER A: National Union Fire Ins to of Pittsburgh 19445 INSURERR: Insurance Company of the state of PA 19429 175 Broad H011OW Road Melville NY 11747 USA INSURER C, American Home Assurance Co. 19380 IN.SURIA D: Illinois National Insurance Co 23817 INSURER r. COVERA(6S ,: ; SIR May 'AN n POI IC IISOI'INSUI2AnCl II$'fEU 131iI0\V HAVB BEEN ISSULD'rO THE INSURED NAMED ABOVE POR 1 tit', POLICY PERIOD INDICATED. NOTWN'HS'I'ANDINO ANYIN Olt CONNHON OP ANY CONTRACTOR O'ffill DDCUM(:'Nl'\41'1'HRE.SI'ECI"i'O WHICII'i'IIts CBR'i'IPICA'fE MAYBE ISSUED OR MAY PER'I'AI\,'1'i il'. INSURANCE AFFORDED BYTHE IE POLICII-S DESCRIBED 1IGREIN IS SUBJECT TO ALL Till: TERMS, EXCLUSIONS AND CONDITIONS 017 SUCH POLICIES, AO(ilt E(iA ] li IIAfm$ S'It0\VN h4AY iIA\+E BP:P.N REDUCED BY PAID CLAMS. L A I.IMITSSHOWN ARE AS REQUESTED TR LTIt INBRi TYr%n OI IN,SUR.\RCR POLICY NUMBER POLICY POLICY EXPIRATION DA'TF.fA1M1DD\VV7 UM1l'Y,(MM\UUIYY) 1.0fi'fti I?%RDM V) yJ A 1S95722 Ol/Ol/OS 01/01/09 PACH OCCURRFNCG S2,D00,000 CONWEROAL(iENERAL AABILI IV UAMAGETo REN I RD $2,000,000 PERALLUOULTTV C'IAMSMAUIt ® OCCUR VIIEAIISBS IEe ocmrm¢c) nerve,0' PIIRWNAL N ADV INJURY $2,000,000 GBNEINI. AGGR6US1'f: S4,000,000 URN'1. AC IRIMA'1 B 1.1M1'I' APPLIES VER: PRODUC'18-COMPIOP AGO $4,000,000 EXX POLICY ❑ Plio. ❑ 10(1 L..J EEC"1' A MITONIOILIS LIABILITY 1607274 01/01/08 01/01/09 X ANYAUT° COMBINED SINGLE LIMIT S2,000,000 ALIAWNED AIJI'OS SCHEDULED nO'ro'e B(IDILY INJURY (rm r<no,q X )URI-DAUJO$ BODILYINIURY IN, l"U' U NON OWNER All I'US PROPERTY DAMAGE (Imr uaiAenp GARAGE: LIAGUATV All'f0 ONLY - HA ACCIDBNI' ANY AlITO OTHEREA ACC 8 AUTO ONLY '. uG A F:RCFNtiIWIRiIELLA LIABILITY 35490 01/01/0$ IiACH UCC(IRIiI+NCI: OOCCU0. O CLAIMS MADE AGGRFOATG 15,000,000 RUEDIRTIBLE X IIEI'IINTION $1,000,000 e WOI3IR:RS COMPENSATION AND X \VC STATU- OTH C GAIPLOVERS'LIAI3ILITY CA 'f llt'LIM TSI FAR FLEACIIACTIDENi' $2,000,000— ANYPItOPRII-TORII'AIffNCllll-Xl:('UTIV1: 5145043 01/01/08 01/01/09 c ORACRIUMI:MRIMEX(Y.DDED+ FI- 5145047 01/01/08 01/01/09 1.1. m5Rns0-r>a EMP1,ovEE $2, 000,000 ,d BL. WSRASR.POLICY LIMIT $2,000,00091 c Ifpes,Jcsail,cunJcr SPIiCIAI.PItOV1ElON$ bclo,l All Other StateS 1 OTIIF,II r 4 DESC'RIPDON Oil ORERAITONSR-OPAIIDNSNEIIIC'LGSII:RC'LUSIUNS ADDED 8Y 8NOORSF,MMV8PF,CIAL PROVISIONS Q Branch Location: AdeCCO Engineering & Technical, 4025 Automation way Ell Fort Collins, CO 80525. 21 CERTIRTCATE HOI.DER .• .EI..' T ION City of Fort Collins s. Attn: JaR1Ps B. O'Neill II DATE ENDEAE. EPDERIDE P:XPIR.A'1'ION 215 N. Mason St. 7111:R80f 111E TS90IN6 IN5(IRLIiESCRUIE)\VOJI VOR 101 MAT( 10 DAYSWRNrTNNO'(ICE TO I'fir. CSRi IFKATRIIOLDIiRNAMED'IOTHPL.rr, Fort Collins c0 80522 USA 8UTPAILURE JUDO SO SHALL IAi I'OSf: kOO111.IGAlIOa OR LIABILITY OP ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTTAHIES. AUNIOJU7.FD REPREMNYATR'I; ✓LtiRJy„yefnro+Jafn�iw ry ✓rrw ACOM) 25 1 -'-A1 ? RP (!0RV,0R" N O a e x Attachment to ACORD Certificate for Adecco Inc. The teals, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage aflbrded by the insum(s). This attachment does not contain all tonns, conditions, coverages or exclusions contained in the policy. INSURED Adecco Inc. 175 Broad Hot lma Road Melville NY 11747 USA ADDITIONAL POLICIES INSURER INSURER If a policy below does not include eel(ificatc 101171 for policy limits. to the corresoondine oolicv no INSn I: flt AUM, INSIU> T\'PE OF INSURANCP. D'NUAIUrn hULiCY H.SCIUPTION• POLICY POLICY EPFFAIL nA'I'6 fOucY EXPIRATION 0,11'1! LIMITS WORKERS COMVHNSATION D 5145046 Co,4+1,NNNVNYscrx 01/01/08 01/01/09 514SO45 ND,WA,WI,WV,IW 01/01/08 03./01/09 C 5145044 OR 01/01/08 01/01/09 Illifi('ItIP'nON OP OPIiItA'I IONSIIACATIONSNIiiilC'6fti/It%('LUSiONS AUUIiU ISY aND01tS1:MLNT/SPIiCIAa PItOV ISIONS Certificate No : 570030153920