The URL can be used to link to this page

Home My WebLink About130882 LABOR READY - INSURANCE CERTIFICATE (3)ACORD,M CERTIFICATE OF LIABILITY INSURANCE7/I/2013 6/28//28/DAM2012DD 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 Lockton Companies, LLC Denver 8110 E Union Avenue Suite 700 Denver CO 80237 (303) 414-6000 O r� Q 1 VAS Q ✓ CONTACT NAME INC,No Bid): NC No E-MAIL ADDRESS, IN AFFORDING COVERAGENAIC A INSURERA: National Union Fire Ins Co Pittsburgh PA 19445 INSURED Labor Ready 1332617 (See Attached Named Insured Schedule) 1015 A Street PO Box 2910 Tacoma, INA 98401 1354-1150 INSURER B: New l-lam shire Insurance Company 23841 INSURER C : Insurance Company of the State of PA 19429 INSURER INSURER INSURER rnvFRAnFS TRI IR1 I)7 I r.FRTIFICATF NI IMRFR- 117'67i5 REVISION NUMRER: XXXXXXX 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 LTR TYPE OF INSURANCE ADDL INSR SUBR YMD POLICY NUMBER POLICY EFF IMMIDDAYNY1 POLICY EXP (MMIDDIYYYY)LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X I OCCUR X Ilost Liquor $1M Y N _I 4406477 7/12012 7/1/2013 EACH OCCURRENCE 1,000,000 PREMISES (ETO d RENTED ) $ 1 .000,000 MED EXP (My oneperson) XXXXXXX PERSONAL BADV IIJJURY $ 1'000"00 X SIR $IM GENERAL AGGREGATE $ 5,000.000 GENE AGGREGATE LIMIT APPLIES PER XI POLICY JECOT LOC PRODUCTS - COMPIOP AGG $ 3,000000 $ A A AUTOMOBILE LIABILITY ANY AUTO AUTUSMED SCHEDULED HIRED AUTOS AUTOS ED Y N 4982855-AOS 4982856-VA 7/1/2012 7/1/2012 7/1/2013 7/I/2013 COMBINED SING LE LIMIT Eaaccident $ 1,000.000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX Per ac.den DAMAGE $ XXXXXXX $XXXXXXX UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE NOF APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX DED RETENTION $ $ B B C WORKEAND RS COMPENSATION WORKERS COMPENSATION YIN ANY PROPRIETORIPARTNER/EXECUIrVE oFFICERIMEMBER ExCLUDE07 N❑ IMuneatory in NH) If es d,,fxrmuofer DESCRIPTION OF OPERATIONS CeFrx NIA N 061967959-AOS: 061967951-C 061967953-FL: 061967962-NIN 061967955-OR:061967960-MA 7/1/2012 7/1/2012 7/1/_012 7/1/2013 7/1/2013 7/1/2013 WC STATU- OTH- X TORYLIMITS FR E L. EACH ACCIDENT $ 1 000,000 EL. DISEASE EA EMPLOYEE 1.000,000 E L. DISFASEFOLICY LIMIT 1.000000 A Excess Work Comp N N 1192511-QSI 7/1/2012 7/1/2013 WC- Statutory: EL Limit$1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more apace is required) The above coverages apply only to Temporary Labor Ready employees dispatched to do work on behalf of the Certificate Holder. The City of Fort Collins, its officers- agents and employees are named as Additional Insured per written contract between Labor Ready and the City of Fort Collins as respects General and Auto Liability. 11736735 City of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Th. Arnan ..nme erfr4 Inr.n .re r.M.f.r.A r...rl.a . f Arnwn L All Hants reserved SCHEDULE OF NAMED INSUREDS Labor Ready Affiliates' States of Operation Please refer to the chart below to find the Labor Ready entity Named Insured for the state in which temporary workers are dispatched to work. Labor Ready Entity Labor Ready Northeast, Inc. Labor Ready Southeast, Inc. Labor Ready Mid -Atlantic, Inc. Labor Ready Central, Inc. Labor Ready Midwest, Inc. Labor Ready Northwest, Inc. Labor Ready Southwest, Inc. Labor Ready, Inc. Labor Ready Holdings, Inc. Spartan Staffing, LLC Spartan Staffing Puerto Rico, LLC PTPR, Inc. Job Rooster, Inc. Centerline Drivers, LLC Venue Ready, LLC PlaneTechs, LLC Drivers on Demand, LLC TrueBlue Enterprises, Inc. TrueBlue Inc. PAC States of Operation Connecticut, Maine, New Jersey, Delaware, Maryland, New York, District of Columbia, Massachusetts, Pennsylvania, Rhode Island, New Hampshire, Vermont Alabama, Kentucky, Louisiana, Georgia, Mississippi, Florida Indiana, Ohio, Virginia, North Carolina, South Carolina, West Virginia, Tennessee Arkansas, Missouri, Texas, Colorado New Mexico, Wyoming, Kansas, Oklahoma Illinois, Minnesota, South Dakota, Iowa, Nebraska, Wisconsin, Michigan, North Dakota Alaska, Montana, Oregon, Hawaii, Washington, Idaho Arizona, Utah, California, Nevada Miscellaneous Attachment : M 19451 Master ID: 1332617. Certificate ID: 1 ] 736735 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement, effective 12:01 A.M. 07/01/12 forms a part of Policy No. 4406477 Labor Ready Northeast, Inc.; Labor Ready Southeast, Inc.; Labor Ready Mid -Atlantic, Inc.; Labor Ready Central, Inc.; Labor Ready Midwest, Inc.; Labor Ready Northwest, Inc.; Labor Ready Southwest, Inc.; Spartan Staffing, LLC; Venue Ready, LLC; PlaneTechs, LLC; TransTechs; Project Trade Solutions, LLC; & Centerline Drivers, LLC and GL 4406478 CLP Resources, Inc. Issued to Spartan Staffing, LLC; CLP Resources, Inc.; Centerline Drivers, LLC; PlaneTechs, LLC; & Venue Ready, LLC By National Union Fire Insurance Company ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION II - WHO IS AN INSURED, is amended to include as an additional insured: Any person or organization to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability caused in whole or in part: A. by your acts or omission in the performance of your ongoing operations; or B. in connection with your premises owned by or rented to you. However, the insurance provided will not exceed the lesser of: • The coverage and/or limits of this policy, or • The coverage and/or limits required by said contract or agreement. Miscellaneous Attachment: M56029 Certificate ID : 11736735 ENDORSEMENT This endorsement, effective 12:01 A.M. 7/1/2012 forms a part of Policy No. 4982855 & 4982856 issued to Labor Ready Northeast, Inc.; Labor Ready Southeast, Inc.; Labor Ready Mid -Atlantic, Inc.; Labor Ready Central, Inc.; Labor Ready Midwest, Inc.; Labor Ready Northwest, Inc.; Labor Ready Southwest, Inc.; Spartan Staffing, LLC; CLP Resources, Inc.; Centerline Drivers, LLC; PlaneTechs, LLC; Project Trade Solutions, LLC & Venue Ready, LLC by National Union Fire Insurance Company of Pittsburgh, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modified insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: "Any person or organization for whom you are contractually bound to provide Additional Insured status but only to the extent of such person or organizations liability arising out of the use of a covered "auto". I. SECTION II - LIABILITY COVERAGE, A. Coverage, 1. - Who is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. 87950 (10/05) Miscellaneous Attachment : M103493 Certificate ID : 1 ] 736735