HomeMy WebLinkAboutINSPERITY INC - INSURANCE CERTIFICATEACORO®
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/---)
09-it-2011
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. IUSUBROGATION 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 endamement(s).
PRODUCER —
ONTACT
AME:
NONE
AX
Lockton Companies, LLC
5847 San Felipe, Suite 320
An;
sas-Bzs-sass
AIC, No):
4Nn LI:
Houston, TX 77057
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIL
NSURERA: Ace American Insurance Co.
22667
INSURED
NSURER-B:
INSPERITY, INC. UGF
PAYMENT PROCESSING, INC.
NSURER-C:
NSURER-D:
19001 CRESCENT SPRINGS DRIVE
NSURER-E:
KINGWOOD, TX 77339
NSURER:
COVERAGES CERTIFICATE NUMBER: 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.
IN
ADDL
Wil
POLICY Err
POLICY EXP
S
R
INSR
MM/DDIYYYY)
MMIDDIYYYY)
LT
R
TYPE OF INSURANCE
POLICY NUMBER
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
DAMAGE TO RENTED
OMMERCIAL GENERAL LIABILITY
LAIMS
PREMISES(Ea orrunence)
ADE OCCUR
MED EXP(Anyone person)
$
PERSONAL& ADV INJURY
GENERAL AGGREGATE
ENLAGGREGATE LIMITAPPLIES PER:
PRO-
PRODUCTS — COMPIOP AGG
$
' OLICV JECT' LOC
PROFESSIONAL LIABILITY
$
COMBINED SINGLE LIMIT
AUTOMOBILE LIAIT BILY
NY AUTO
U. OWNED SCHEDULED
Ea..deni)
$
BODILY INJURY Per Person
$
CLOG AUTOS
IRED NON-0WNED
H
BODILY INJURY (Per amdent)
$
PROPERTY DAMAGE
UTOS AUTOS
Peracddent
$
MERELLA LIAB
%CESS LIAB
OCCUR
CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
ED I I RETENTION$
INDEXERS COMPENSATION
MC STATI}
OTH-
A
NO EMPLOYERS'' IJARILITV
C4]90]28]
10/01/2013
10101I2014
X
ORV LIMITS
R
ANY PROPRIETORIPARTNER/EXECUTIVE
M
FFICER/MEMBER EXCLUDED?
N/A
E.L. EACH ACCIDENT
$ 1,000,000
MANDATORY IN NH)
i yes, desmbe under
E.L. DISEASE — EA EMPLOYEE
$ 11000,000
DESCRIPTION OF OPERATIONS below
EL.DISEASE — POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES (Attach Atom 101, Additional remarks Scheduk, if more space is required)
BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS
CITY OF FORT COLLINS
ATTN: FINANCIAL SERVICES PURCHASING DIVISION
215 N MASON ST 2ND FL / PO BOX 580
FORT COLLINS, CO 80522
15 (2010/05) The ACORD name and logo are
Acctp: 1170703