HomeMy WebLinkAbout514019 VOLT MANAGEMENT CORP - INSURANCE CERTIFICATE (2)A� �® CERTIFICATE OF LIABILITY INSURANCE Page 1 of 1
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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
Willis of New York, Inc.
c/o 26 Century Blvd.
P. O. Box 305191
PHONE FAX
877-945-7378 888-467-2378
E-MAIL certificates@willia.com
Nashville, IN 37230
INSURER(S)AFFORDING COVERAGE
NAICM
INSURERA: National Union Fire Insurance Company of
19445-002
INSURED Volt amaat
N$n.I�A�l
2401 N.. Glassell St.'
t. Corp. 5t�1
INSURERS: NAW Hampshire Insurance Company
23841-001
INSURERC: National Union Pize Insurance Co. of Pitt
19945-001
Orangs, CA 92865
INSURERD: Illinois National Insurance Co.
23el7-002
NSURER E:
INSURER F:
rnVFRAr:FS CERTIFICATE NUMBER' 21394254 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OFINSURANCE
DD'
sm
SUB
ppUCY NUMBER
POLICY EFF
POLICY EXPjxL
LIMRS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE❑$ OCCUR
-mom
GL3823566
3/31/2014
3/31/2015
EACH OCCURRENCE
$ 1,000,000
PREMGETORENTED
$ 2SO,000
MED EXP (Any one pemon)
$ 10,000
PERSONAL B AOV INJURY
$ 1.000.000
GENERALAGGREGATE
$ 2.000.000
GENT AGGREGATE LIMIT APPLIES PER:
X I POLICY 7 PRO LOC
PRODUCTS-COMP/OP AGG
$ 4,000.000
$
AUTOMOBILE LIABILITYL
ANY AUTO
ALLOWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS NON -OWNED
AUTOS
COMBINED SINGE LIMIT
$
BODILY INJURY(Per person)
$
BODILY INJURY(PW aoddem)
$
AMAUE
Pera[ddsnt
$
UMBRELLAUAB
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACHOCCURRENCE
$
AGGREGATE
$
DED RETENTION $
$
B
B
C
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE FINTN/A
OFFICER/MEMSER EXCLUDED9
�M��da�r NH
ye0 s, do., u�r
DESCRIPTION OF OPERATIONS bebW
WCO260347SI
WCO26034752
WCO26034755
WCO26034756
3/31/2014
3/31/2014
3/31/2014
3/31/2014
3/31/2015
3/31/2015
3/31/2015
3/31/2015
X
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
B
Workers Compensation
WCO26034758
3/31/2014
3/31/2015
Sea above Workers Compensation
section
DESCRIPTION OF OPERATIONS/ LOCATIONS/VEHICLES (Mach Aeord 101, Addl1>nal Remarks Schedule, If more apace la raquImd)
Re: Proof of insurance to accompany a bid.
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.
City of Port Collins, CO
AUT10 R ENT
Attn: James B. O'Neill II
300 LaPorte Ave.
Port Collins, CO 80521
Coll:4376855 Tpl:1793031 Cert:21394254"8-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered mar of ACORD
"� �® CERTIFICATE OF LIABILITY INSURANCE
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page 1 of 1
03/(3 0 4
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 requ ire an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
CONTNAMEACT
Willie of New York, Inc.
c/o 26 Century Blvd.
PHONE FAX
- 877-945-7378 888-467-2378
Ap'pAF1'E'ss certificates®arillis.com
P. O. Box 305191
Nashville, 1N 37230
INSURER(SAFFOROING COVERAGE
NMC4
INSURERA National Union Fire Insurance Company of
19445-002
INSURED Volt Information Sciences, Inc.
uINSURERS: National Union Fire Insrance Company of
19443-008
INSURERC: National Onion Fire Insurance Co. of Pitt
19445-001
1065 Avenue of the Americas, 20th Floor
New York, NY 10018
INSURERD: Starr Indemnity and Liability Company
38318-001
INSURER E: New Hampshire Insurance Company
238{1-001
INSURERF: Illinois National Insurance Co.
23817-002
COVERAGES CERTIFICATE NUMBER: 21382955 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
TYPEOFINSURANCE
O'
mim
SUB
POLICY NUMBER
POLICY EFF
POLICYEXP1331.
3/31/2015
LIMITS
A
GENERALUABILITY
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
Y
GL3823566
3/31/2014
EACH OCCURRENCE
$ 2,000,000
DARMAGETORENTFcel
$ 250,000
MEDEXP( onsperso
$ 10,000
PERSONAL S ADV INJURY
$ 2,000,000
GENERALAGGREGATE
$ 2.000.000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY 7 PRO- LOC
PRODUCTS-COMP/OP AGG
$
$
B
C
AUTOMOBILE
LIABILITY
ANY AUTO
ALLOWNED SCHEDULED
AUTOS AUTOS
HIREDAUTOS E NON -OWNED
AUTOS
CA2248445
CA2248446
3/31/2014
3/31/2014
3/31/2015
3/31/2015
COMBINED SINGLE LIMIT
Ea scoiderlt
$ 2,000,000
E
BODILY INJURY(Per person)
$
BODILY INJURV(PerealtleM )
$
X
PROPERTY DAMAGE'
PW acciOenl
$
a
D
E
UMBRELLAMAB
EXCESS UAB
Ed
Occult1000010464
CLAIMS -MADE
3/31/2014
3/31/2015
EACHOCCURRENCE
a 5,000,000
AGGREGATE
$ 5 000 000
DED IRETENTIONS
$
g
E
C,
F
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y®
1OI FF^C Rryi NBER EXCLUDED?
Il yea, tleseNEe un e,
DESCRIPTION OF OPERATIONS below
N/A
WCO26034751
WCO26034752
WCO26034755
NCO26034756
3/31/2014
3/31/2014
3/31/2014
3/31/2014
3/31/2015
3/31/2015
3/31/2015
3/31/2015
R
EL EACHACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
S 1,000,000
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
8
Workers Compensation
WCO26034758
3/31/2014
3/31/2015
See above Workers Compensation
section
DESCRIPTION OF OPERATIONS/ LOCATIONS/VEHICLES (Attach Acortl 101, AOOhonal Remarks SchWule, It more space is rs9ulratl)
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.
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.
City
Of Fort Collins
AUTHORI DR BENTA
Attn:
James B. O'Neil
215 North Mason Street
Fort
Collins, CO 80522
Coll:4375863 Tpl:1792724 Cert:21382955 O 2010ACORDCORPORATION.Allrightsreserved.
ACORD 25 (2010/05) The ACORD name and logo are registered ma of ACORD