HomeMy WebLinkAboutVOLT INFORMATION SCIENCES INC - INSURANCE CERTIFICATE (4)"� �® CERTIFICATE OF LIABILITY INSURANCE page 1 of 1
DATE
03/(31/2012
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, ANDTHE 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
Willie of New York, Inc.
c/o 26 Century Blvd.
P. 0. Box 305191
Nashville, TN 37230
CONTACT
NAME:
PHONE FAX
AIDN XT: 877-945-7378 A/C NO: 888-467-2378
A'6"[,AgE'ss certificates@willis.com
INSURER(S)AFFORDING COVERAGE
NAICs
INSURERA: National Union Fire Insurance Company of
19445-002
INSURED Volt Information Sciences, Inc.
INSURERS: National Union Fire Insurance Company of
19445-008
INSURERC: National Union Fire Insurance Co. of Pitt
19445-001
1065 Ave -of the Americas, 20th Floor
New York, NY 10018
INSURER D: Bt. Paul Fire and Marine Insurance Compare
24767-001
INSURER E: New Hampshire Insurance Company
23841-001
INSURER F: Illinois National Insurance -Co. -
23817-002
P
COVERAGES CERTIFICATE NUMBER: 17631645 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
TYPE OF INSURANCE
DD'
NSRE
SUB
VOID
POLICY NUMBER
POLICY IPOLICY
EXPLTR
LIMITS
A
GENERALLIABILITY
Y
GL4406353
3/31/2012
3/31/2013
EACHOCCURRENCE
$ 11000,000
DAMAGE
PREMISES (Ea occurence)
$ 250,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
MED EXP(Anyone person)
$ 10,000
PERSONAL$ ADV INJURY
S 11000,000
GENERALAGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS COMP/OPAGG
$
X I POLICY PROT LOC
E
AUTOMOBILE LIABILITY
AL4982705
3/31/2012
3/31/2013
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY(Per person)
$
C
ANYAUTO
AL4982706
3/31/2012
3/31/2013
AOSCHEDULED
AUT
AUUTOSS OS
N
BODILY INJURV(Per accident)
$
PR YE
Peraccitlent)
$
HIRED AUTOS NON -OWNED
AUTOS
D
X
UMBRELLA LIAS
X
OCCUR
ZUP-12T71007-12-NF
3/31/2012
3/31/2013
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 51000,000
EXCESS LIAB
CLAIMS -MADE
DEO RETENTION $
$
E
C
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY IN
ANY PROPRIETOR/PARTNER/EXECUTIVE Y�
OFFF (Mandatry In NH)R Fzcwoeov
f yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
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 UTOETIH-
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1�000, 000
E.L. DISEASE -POLICY LIMIT
is 1,000,000
E
WC
WC033464495
3/31/2012
3/31/2013
Bee above WC section
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required)
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.
I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City Of Fort Collins
Attn: James B. O'Neil
215 North Mason Street
Port Collins, CO 80522
Coll:3683653 Tp1:1416110 Cert:l'T631645 01988-201
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD