HomeMy WebLinkAboutVOLT SERVICES GROUP - INSURANCE CERTIFICATE (3)CERTIFICATE OF LIABILITY INSURANCE page 1 of 1
03/2 / 012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. 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).
PRODUCER
CONTACT
NAME:
FAX
PHONE 888-467-2378
Ar No EXT: 877-945-7378 N
Willie of New York, Inc.
C/o 26 Century Blvd.(A/C
P. O. Box 305191
Nashville, TN 37230
EDMRE certificates@willis.com
INSURER(S)AFFORDING COVERAGE
NAICM
INSURERA: National Union Fire Insurance Company of
19445-002
INSURED
Volt Services Group
A Division of Volt Technical Resources
INSURERS: New Hampshire Insurance Company
23841-001
INSURER C: National Union Fire Insurance Co. of Pitt
19445-001
INSURER D: Illinois National Insurance Co.
23817-002
1065 Avenue of the Americas, 20th Floor
New York, NY 10018
INSURER E
INSURER P
I
COVERAGES CERTIFICATE NUMBER: 17592520 REVISION NUMBER:
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 BY 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.
INSR
T
TYpEOFINSURANCE
ND'
$UB
POLICYNUMBER
POLICY EFF
POLICY EXP
LIMITS
A
GENERALLIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
GL4406353
3/31/2012
3/31/2013
EACHOCCURRENCE
$ 1,000,000
OAMAGETO RENTED
PREMISES Eeoccurence
$ 250,000
MED EXP(My one person)
$ 10,000
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO M LOC
PRODUCTS-COMP/OP AGG
$
S
AUTOMOBILE LIABILITY
ANY AUTO
AOHSCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
H
I
COMBINED TINGLE LIMIT
(Ea accident)
IS
BODILY INJURY(Per person)
$
BODILY INJURV(Per accident)
S
! A
Per accident
S
i -
$
HUMBRELLA
LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACHOCCURRENCE
S
AGGREGATE
$
DED I IRETENTION $
$
B
-C
D
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y�
EXCLUDED?
fMantlatoryin NH)
ftlescribe antler
DESCRIPTIONOF OPERATIONS below
N/AOFFICER/MEMBER
-
WC033464491
WC033464492 -
WC033464493
�WC033464494
3/31/2012
3/31/2012
3/31/2012
3/31/2012
3/31/2013
3/31/2013
3/31/2013
3/31/2013
X
E.L. EACH ACCIDENT .- -
$. 1,000,000
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE -POLICY LIMIT
IS 1,000,000
B
wC
WC033464495
3/31/2012
3/31/2013
See above WC section
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required)
IiL.Ja I
City Of Fort Collins
Attn: Ed Bonnette
215 N. Mason, 2Nd Floor
Po Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Co11:3
ACORD 25 (2010/05)
72 Cert:
The ACORD name and logo are registered marics oT AL:UKL)
ACORD
rights reserved