The URL can be used to link to this page

Home My WebLink About114084 EXPRESS EMPLOYMENT PROFESSIONALS - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 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: PHONE (A/C, No, Ext): FAX (A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ $ $ $ $ $ $ Express Services, Inc. Workers' Compensation Policy Schedule: Policies Periods: 10/1/12 ‐ 10/1/13 New Hampshire Insurance Company Policy No. WC043464654 NAIC # 23841 States Covered: AK, AR, CO, DC, DE, GA, HI, ID, MS, MT, NC, NH, NM, NV, OK, PA, RI, SD, TN, UT, VA, WV New Hampshire Insurance Company Policy No. WC043464655 NAIC # 23841 States Covered: AL, AZ, CT, IA, IL, IN, KS, KY, LA, MD, MI, MN, MO, NE, NJ, NY, OR, SC National Union Fire Insurance Company of Pittsburgh, PA Policy No. WC043464659 NAIC #19445 States Covered: MA, ND, OH, WA, WI, WY MONOPOLISTIC STATES (Employers Liability/Stop Gap Only) Insurance Company of the State of PA Policy No. WC043464656 NAIC # 19429 States Covered: CA Illinois National Insurance Company Policy No. WC043464657 NAIC # 23817 States Covered: FL New Hampshire Insurance Company Policy No. WC043464658 NAIC # 23841 States Covered: TX Illinois National Insurance Company Policy No. WC043464660 NAIC # 23817 States Covered: ME National Union Fire Insurance Company of Pittsburgh, PA Policy No. WC6636146 NAIC # 19445 States Covered: OH Excess Self Insured National Union Fire Insurance Company of Pittsburgh, PA Policy No. WC6636147 NAIC # 19445 States Covered: WA Excess Self Insured Miscellaneous Attachment : M480401 Master ID: 1352730, Certificate ID: 12499330 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ $ $ $ $ UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $ EACH OCCURRENCE AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION 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 ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD Lockton Companies, LLC-1 Kansas City 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 EXPRESS SERVICES, INC. DBA: EXPRESS EMPLOYMENT PROFESSIONALS 8516 NW EXPRESSWAY OKLAHOMA CITY, OK 73162 EXPSE01 10/1/2013 1352730 XX 1,000,000 XXXXXXX XXXXXXX XXXXXXX XXXXXXX X X 20,000,000 20,000,000 XXXXXXX X X X STAFFING SERVICE 5,000,000 1,000,000 10,000 5,000,000 5,000,000 5,000,000 CRIME/FIDELITY STAFFING E&O COVERAGE CRIME/FIDELITY: 5,000,000 E&O OCC/AGG: 5,000,000 N X 1,000,000 1,000,000 1,000,000 American Guarantee and Liab. Ins. Co. 26247 New Hampshire Insurance Company 23841 Zurich American Insurance Company 16535 B PRA5854213-00 10/1/2012 10/1/2013 B PRA5854213-00 10/1/2012 10/1/2013 B PRA5854213-00 10/1/2012 10/1/2013 C 5498877 10/1/2012 10/1/2013 A SEE ATTACHED POLICY #'S 10/1/2012 10/1/2013 See Attachment CITY OF FORT COLLINS ATTN: GERRY S. PAUL 215 NORTH MASON STREET FORT COLLINS CO 80521 12499330 12499330 8/8/2013 ALL INSURANCE CARRIERS SHOWN ON THIS CERTIFICATE HAVE AN A.M. BEST RATING OF A XV OR BETTER UNLESS OTHERWISE NOTED. LOCATION: 1016 - FORT COLLINS CO / TYPE OF COMPANY: MUNICIPALITY / JOB DESCRIPTION: GENERAL CLERICAL AND ADMINISTRATIVE SUPPORT POSITIONS. X NN NN NN N NN