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HomeMy WebLinkAboutSNELLER ASSOCIATES INC - INSURANCE CERTIFICATE'� �® CERTIFICATE OF LIABILITY INSURANCE DAT06114/DIYYYY, O6/, 4/12 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 endorsements . PRODUCER Aou Risk Services. Inc of Ronda 1001 Bnckell Bay Drive, Suite#1100 Miami, FL 33131a937 CONTACT Aon Risk Services, Inc of Florida NAME: PHONE FAX INC. No, Ext : 800-743-8130 1 INC, No): 800-522-7514 EMAIL ADDRESS: ADP.COI.Center@Aon.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : New Hampshire Ins On 23841 INSURED ADP TotalSource FL XI, Inc. INSURER B : INSURER C 10200 Sunset Drive Miami, FL 33173 INSURER D: ALTERNATE EMPLOYER INSURER E neller Associates, Inc. 500 Grant Street, suite 1200 INSURER F enver, CO 80203 COVERAGES CERTIFICATE NUMBER: 454220 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. LIMITS SHOWN ARE AS REQUESTED. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR MD POLICY NUMBER POLICY EFF (MMIDDNYYY) POLICY EXP (MMIDD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F—IOCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ed occurrence $ MED EXP (Any oneperson) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GENL AGGREGATE LIMIT APPLIES PER: 17 POLICY PROJECT 71 LOC PRODUCTS - COMP/OP AGO $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS J COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Perperson) $ BODILY INJURY Peraccident $ PR TV DAM. E PER Per accident) $ $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE $ DEC I I RETENTION $ WORKERS COMPENSATION AND R PLO TCfR?ARTNE /E YIN IEXEGUTIVE ANY P ERIM ETORR EXCLUDED? OFFlCEWMEMBER EXCLUDED? (Mandatory in NH) If yon<, di, u.. undx, DESCRIPTION OF OPERATIONS below NIA WC 038087762 CO 7/1/2012 7/1/2013 WCSTATU- X TCRY LIMITS OTH- ER E.L. EACH ACCIDENT $ 2.000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000.000 E.L. DISEASE - POLICY LIMIT It 2,030,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) All worksite employees working for the above named client company, paid under ADP TOTALSOURCE, INC.'s payroll, are covered under the above stated pdicy. The above named dient is an alternate employer under this policy. CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: JIM HUME THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PURCHASING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. P. 0. BOX 580 FT. COLLINS, CO 80522 AUTHORIZED REPRESENTATIVE tfion 6RAk &cvlcea, 41ic o f(flo-tida ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD ACCWZY CERTIFICATE OF LIABILITY INSURANCE _DATE0611411,YYYY, 6/, 4/12 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 Ann Risk Services, Inc of Florida 1001 Brickell Bay Drive, Suite #1100 Miami, FL 33131-4937 CONTACT NAME: Ann Risk Services, Inc of Florida PHONE FAX A/C, No, Ext : 800-743-8130 AIC. No : 800-522-7514 EMAIL ADDRESS: ADP.Cal.Center@Acn.com INSURERS) AFFORDING COVERAGE NAIC N INSURER A: New Hampshire Ins Cc 23841 INSURED ADP TotalSource FL XI, Inc. INSURER B INSURER C 10200 Sunset Drive Miami, FL 33173 INSURER D ALTERNATE EMPLOYER INSURER E Sneller Associates, Inc. 1900 Grant Street, suite 1200 INSURER F : Denver, CO 80203 COVERAGES CERTIFICATE NUMBER: 454221 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. LIMITS SHOWN ARE AS REQUESTED. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR MD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP MMIDD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES his occurrence $ MED EXP (Any oneperson) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LI MIT APPLIES PER: POLICW PROJECT I PRODUCTS - COMP/OP AGO $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS k - COMBINED SINGLE LIMIT Ea accident) $ BODILY INJURY Perperson) $ BODILY INJURY Per accident) $ PROPERTY DAMAGE Peraccident $ $ UMBRELLA LAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEC I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If „s. aavuno —, . DESCRIPTION OF OPERATIONS below NIA WC 038087762 CO 7/1/2012 . . 7/l/2013 X WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 2,000,000 E. L. DISEASE EA EMPLOYFF $ 2,000.000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) All worksite employees working for the above named client company, paid under ADP TOTALSOURCE, INC's payroll, are covered under the above stated policy. The above named client Is an alternate employer under this policy. CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: JIM HUME THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PURCHASING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. R O. BOX 580 FT. COLLINS, CO 80522 AUTHORIZED REPRESENTATIVE p4orc �isk �e�vices, Qac o f �loxirla © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD