HomeMy WebLinkAboutPROPERTY ROOM - INSURANCE CERTIFICATE (4)ACORDDATE
CERTIFICATE QF
LIABILITY
INSURANCE
(MMIDD/YY)
,,
08/29/2008
PRODUCER Serial # A18444
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
AON RISK SERVICES, INC. OF FLORIDA
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1001 BRICKELL BAY DRIVE, SUITE #1100
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
MIAMI, FL 33131-4937
COMPANIES AFFORDING COVERAGE
PHONE: 800.743-8130 FAX: 800-522-7514
COMPANY
NEW HAMPSHIRE INSURANCE COMPANY
A
INSURED -- -
COMPANY
ADP TOTALSOURCE, INC.
B
10200 SUNSET DRIVE
MIAMI, FL 33173
COMPANY
*ALTERNATE EMPLOYER:
C
NATIONAL RESEARCH CENTER INC.
_......._-..._ __ _... __... ______ _ ___.__...._ _.
COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT 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 B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS
SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MM/DDIYY) DATE(MMIDD/YY)
GENERAL
LIABILITY
GENERAL. AGGREGATE
$
COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OP AGO
$
I CLAIMS MADE OCCUR
PERSONAL 8 ADV INJURY
$
OWNER'S B CONTRACTOR'S PROT
EACH OCCURRENCE
$
FIRE DAMAGE (Anyone lire)
$
MEDEXP (Anyone person)
$
AUTOMOBILE
LIABILITY
ANYAUTO
COMBINEDSINGLE LIMIT
$
ALL OWNED AUTOS
$
SCHEDULED AUTOS
(Per person)URY
------
HIRED AUTOS
BODILY INJURY
§
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
i
�§
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT_
ANYAUTO
OTHER THAN AUTO ONLY
�$
EACH ACCIDENT
$
AGGREGATE
$
EXCESS LIABILITY
EACH OCCURRENCE
$
UMBRELLA FORM
AGGREGATE
$
OTHER THAN UMBRELLA FORM
g
WORKER'S COMPENSATION AND
WC 5881064 CO
07/01/2008
07/01/2009
We sTAru orH-
X TORY LIMITS ER
/j
EMPLOVERS'UA8ILITY
EL EACH ACCIDENT
$ 1,000,000
THE PROPRIETOW INCL
EL DISEASE -POLICY LIMIT
$ 1,000,000
PARTNERSXXECUTIVE
OFINCERS ARE: EXCL
EL DISEASE -EA EMPLOYEE
Is 1,000,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESISPECIAL ITEMS
ALL EMPLOYEES WORKING FOR THE ABOVE NAMED CLIENT
COMPANY, PAID UNDER ADP TOTAL SOURCE, INC'S PAYROLL, WILL BE COVERED UNDER
THE ABOVE STATED POLICY. *THE ABOVE NAMED CLIENT IS
AN ALTERNATE EMPLOYER UNDER THIS POLICY.
CERTIFICATE HOLDER
CANCELLATION'S
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF FORT COLLINS
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
ATTN: KELLYDIMARTINO
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
P. 0. BOX 580
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
FT. COLLINS, CO 80522
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
AON RISK SERVICES, INC. OF FLORIDA
ACORD 25-5 (1/@5)
0 ACORD'CORPORATION 1988