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Home My WebLink AboutADP TOTALSOURCE MI XXX INC - INSURANCE CERTIFICATE (2)A41CC11 i CERTIFICATE OF LIABILITY INSURANCE oAT06/3//14mn 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 endorsemen s . PRODUCER Aon Risk SeMces, Inc of Honda CONTACT NAME: Aon Risk Services, Inc of Florida NC No Ext: 800-743-8130 NC No:800-522-7514 1001 BnCkell say Onw, Suite #1100 Miami, FL M1314937 ADDRESS: ADP.COI.Center Aon.com INSURERS) AFFORDING COVERAGE NNC# INSURER A: New Hampshire Ins Co 23841 INSURED •' ADP TotalSource MI XXX, Inc. INSURER a: -- INSURER C : 10200 Sunset Ome Miami, FL 33173 INSURER D : ALTERNATE EMPLOYER Bshop-Brogden Associates, Inc. 333 W. Hampden Ave., Suite 10M INSURER E : INSURER F : Englewood, CO 80110 COVERAGES CERTIFICATE NUMBER: 833699 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. INS LTR TYPE OF INSURANCE ADDL INSR SUER WO POLICYNUMBER POLICY EFF (MMMOIYYYY) POLICY EXP (MMIDDIYYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Eauccvreme $ MED EXP Anyone erson $ PERSONAL A NOV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE 17 POLICY LIMIT APPLIES PER PROJECT F I LOC PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON-0W NED HIREDAUTOS AUTOS COMBINED SINGLE LIMIT Ea accident $ BODILYINJURY Per erson $ BODILY INJURY Peraccidcnt $ Peraccident $ UMBREULJ EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEC I I RETENTION$ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NHl It 'nb wrbr DEESCRISCRIPTION OF OPERATIONS hNow NIA WC 094179798 CO 7/1/2014 7/1/2015 WC STATU- OTH- X TORYLIMITS ER EL EACH ACCIDENT $ 2,000.000 EL DISEASE - EA EMPLOYEE $ 2,000,000 E.L DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) All wodcsne empbyeas working for me above named client company, pad under ADP TOTALSOURCE, INC.'a payroll, are covered under me abo a stated policy. The.cove named client is an alternate employer under this policy. CERTIFICATE HOLDER CANCELLATION City of Fort Collins - Purchasing P.O. Box 580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collim, CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4790n 0ie% (5etritcee, 4nc o f(f%titia Q91988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD