HomeMy WebLinkAboutVOLT INFORMATION SCIENCES INC - INSURANCE CERTIFICATE (2)DATE
AC d CERTIFICATE OF LIABILITY INSURANCE 04/01/ M/DD/YYYY)
04/01l2009
PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION
Marsh USA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1166 Avenue of the Americas HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
New York, NY 10036 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Attn: NewYork.certrequest@Marsh.com Fax: 212-948-0500
572750-CAS-GAW U-09-10 ADDTL
INSURED
VOLT INFORMATION SCIENCES, INC.
ATTN: GARY G. PENEBRE
560 LEXINGTON AVENUE
NEW YORK, NY 10022
rnvcoAccc
INSURERS AFFORDING COVERAGE
INSURER A: National Union Fire Insurance Company
INSURER B: Illinois National Ins Co
INSURER c: Commerce & Industry Ins. Co
INSURER D: New Hampshire Ins. Co.
INSURER E: St. Paul Fire & Marine Ins Co
NAIC #
19445
23817
23841
24767
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.
INS
LTR
'ADD'LY
O TYPE OF INSURANCE
-
POLICY NUMBER
POLICYEFFECTIVE
DATE
POLICY EXPI RATION
DATE D/YYYY)
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
090-73-05
03/31/2009
03/31/2010
EACH OCCURRENCE
1,000,000
DAMAGE T( RENTEDEa occurrence PREMISES
$ 250,000
CLAIMS MADE � OCCUR
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENERAL AGGREGATES LIMIT APPLIES PER
POLICY n JECT I LOCI
PRODUCTS -COMP/OP AG
$
A
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
090-74-95 AOS
( )
090-74-96(MA)
03/31/2009
03/31/2009
03/31/2010
03/31/2010
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
BODILY INJURY
$
HIRED AUTOS
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
$
AUTO ONLY: AGG
E
EXCESS / UMBRELLA LIABILITY
X OCCUR � CLAIMS MADE
QK09001890
03/31/2009
03/31/2010
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
DEDUCTIBLE
$
RETENTION $
B
WORKERS COMPENSATION AND
356-71-15 (AOS)
03/31/2009
03/31/2010
X I WC STATU- IOTH-
A
B
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
OFFICER/MEMBEREXCLUDED?
r 7N
356-71-16 (CA)
356-71-17 (FL)
356-71-18(OR)
03/31/2009
03/31/2009
03/31/2009
03/31/2010
03/31/2010
03/31/2010
E.L. EACH ACCIDENT
Is 1,000,000
E.L. DISEASE -EAEMPLOVE.$
1,000,000
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
C
(Mandatory in NH) If yes' describe under
SPECIAL PROVISIONS below
D
OTHER WC CONT.
356-71-19 (TX)
03/31/2009
03/31/2010
D
ND NY OH WA WI WV WY
356-71-20
03/31/2009
03/31/2010
SEE ABOVE FOR LIMITS
C
AZ CO MD NH SC
356-71-21
03/31/2009
03/31/2010
A I
AR DE GA ID MA MS MT NC VA
356-71-22
03/31/2009
03/31/2010
DESCRIPTION OF OPERATIO NS/LOCATIONSIVEHICL ES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
THE CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED UNDER THE GENERAL AND
AUTOMOBILE LIABILITY POLICIES WITH RESPECT TO SERVICES PERFORMED BY VOLT.
CERTIFICATE HOLDER Nvr _nn391A1A9_1R CONCFI LOTION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF FORT COLLINS
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
ATTN: JAMES B. O'NEIL
215 NORTH MASON STREET
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
FORT COLLINS, CO 80522
BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND
UPON THE INSURER, ITS AGENTS OR REPRESENTATIVE
f MS.
OR¢EDSAPI nC3ENTATNE
Dresa Allman
At,U cU ZO (zuua/UI) @ 1998-2009 ACORD CORPORATION. All Rights Reserved
The ACORD name and logo are registered marks of ACORD
IMPORTANT
If 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
This Certificate of Insurance 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..
Acord 25 (2009/01