HomeMy WebLinkAboutADMINI STAFF, INC. - INSURANCE CERTIFICATEACORDm CERTIFICATE OF
LIABILITY INSURANCE
DATE
1
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PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF
INFORMATION
LOCATOR COMPANIES, PLC
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
BOUT FELIPE, SUITE 320
HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
xoosxON, oN, Tx T>osT
ALTERTHE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURERA ACE Ames Can Inpll.ptaoo Company
ADMINISIAPF, INC.
1.9001 CRESCENT SPRINGS DRIVE
INSURER B:
------
INSURER C.
+' SEE BELO41
INSURER D:
INSURER E:
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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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.
_ _
POLICY EFFECTIVE POLICYEXPIRATION
!
LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDMI DATE MMIDDIYY LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
COMMERCIAL GENERAL LIABILITY
_DAMAGE TO RENTED-------------""""'--
PREMISES {Ea occurence)
--"
$
CLAIMS MADE F—IOCCUR
MED EXP (Any one person)
$
PERSONAL&ADV INJURY
$
GENERAL AGGREGATE
S
GEN•L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMPIOPAGG
S
PRO-
POLICY LOG
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
.
ANY AUTO
(Ea accident)
S
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per person)
S
HIRED AUTOS
.........___ ___�
BODILY INJURY
$
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
--
AUTO ONLY ACCIDENT
-- '_
S
ANY AUTO
OTHER THAN EA ACC
—-
_
S
_-__---
AUTO ONLY:
AGG
1S
EXCESSIUMBRELLA LIABILITY
HOCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
S
DEDUCTIBLE
5
RETENTION $
$
A
WORKERS COMPENSATION AND
C45620141
10/01/2008
10/01/2009
X WC STATU- OTH
EMPLOYERS' LIABILITY
TGRY LIMIT$_ _ER_
ANY PROPRIETCAMPARTNEWEXECUTIVE
EL EACH ACCIDENT
S 11000, 000
OFFICERIMEMBER EXCLUDED?
E.L.1,000,000
DISEASE -EA EMPLOYEES
—
Es. under
Cdescribe
SPECIAL
SPECIAL PROVISIONS bolav
DISEASE
E.L. DISEASE-POLICV LIMIT
LIMIT
,00
$ 1, 000, 000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
* NAKOMA GROUP, LLC. ( 2181501 ) IS COVERED THROUGH BLANKET ALTERNATE EMPLOYERS ENDORSEMENT FOR ALL EMPLOYEES UNDER
CLIENT SERVICE AGREEMENT.
City of Port Collins
Purchasing Division
PO Eox 580
Fort Collins, CO 85022
USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVORTO MAIL 30 DAYS WRITTEN NOTICE TO
THE CERTIFICATE HOLDER NAMEOTOTHE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO
OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.