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HomeMy WebLinkAboutADP TOTALSOURCE I INC - INSURANCE CERTIFICATEA� CERTIFICATE OF LIABILITY INSURANCE DAT06/M3I14 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 entlorsement s . PRODUCER Aon Risk Services, Inc of Floods CONTACT NAME: Aon Risk Services, Inc of Florida 1001 Bdrkall Bay Doe, Suits #1100 Miami, FL 331314937 AIC No Exi: BOD-743-8130 aC No : 800-522-7514 ADDRESS: ADP.COI.Center Aon.com INSURER(S) AFFORDING COVERAGE NAIL# INSURER A : National Union Fire Ins Co of Pittsburgh 19445 INSURED ADP TotalSource I, Inc. INSURERS INSURER C : 102W Sunset Doe Miami, FL 33173 INSURER D : l/C/F PROPERTYBUREAU Com Inc. DBA Property Roan 5257 Buckeystmn Pike, Sute 475 INSURER E: INSURER F Frederick, MD 21704 CUVERAUE5 CERTIFICATE NUMBER: 792661 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. INSH LTR TYPE OF INSURANCE ADDL INSR SUER Wo POLICY NUMBER POLICY EFF MWDD POLICY EXP MM/D WN)(Y LIMITS GENERALUAINUTY COMMERCIALDAMAGE S-MAD GENERAL LIABILITY CLAIM$ -MADE OCCUR EACH OCCURRENCE $ TO RENTED PREMISES Es occurrence $ MED EXP (My am on $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE IS GEN'L AGGREGATE POLICY LIMIT APPLIES PER: PROJECT LOC PRODUCTS-COMP/OP AGG $ $ AUTOMOBILE H LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS Ea accident) $ BODILY INJURY Perperson) $ BODILY INJURY Peraccident $ Per accident $ $ UMBRELLA LIMB EXCESS UAB OCCUR CLAIMS -MADE — EACH OCCURRENCE $ AGGREGATE IS DEC RETENTION IS A WORKERS COMPENSATION ANDEMPLOYERS'UABIUry YIN MY PROPRIUORNARTNEWEXECUTME ❑ OFFICER/MEMBER EXCLUDED' small WrY ie NH) Irye., eeKdee war DESCRIPTION OF OPERATIONS below N/A WC 094182282 CA 7/1/2014 7/1/2015 X WC STATU- TORY LIMITS OER E.L. EACH ACCIDENT S 2.000,000 E.L. DISEASE - EA EMPLOYEE b 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AHach ACORD 101, Addltlonal Remarks Schedule, N more apace is required) Al woasae employees working for the stow named client company, paid under ADP TOTAL SOURCE, INC, payroll, am ca,ered under the abow stated policy. CERTIFICATE HOLDER CANCELLATION City of Fart Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 North Mason Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins, CO ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (7foa U--Dw:- k j6etvic", 4ac of 4f&tida ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05)✓ The ACORD name and logo are registered marks of ACORD ``� b® CERTIFICATE OF LIABILITY INSURANCE F ODATE(Mim3114 YI 6/13/14 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 endorsements . PRODUCER Aon Risk Services, Inc of Florida CONTACT NAME: Aon Risk Services, Inc Of Florida AX AIC No Est : 800-743-8130 AC No): 800-522-7514 1001 Bnckell Bay Drive, Suite 41100 i MiamFL 331314937 ADDRESS: ADP.COI.Center Aon.Com INSURERS) AFFORDING COVERAGE NAIC0 INSURER A : New Hampshire Ins Cc 23841 INSURED AOP TotalSource I, Inc. INSURER B INSURER C 10200 Sunset Dtiw Miami, FL W173 ALTERNATE EMPLOYER - INSURER D: INSURER E : National Research Center Inc 2955 Valmont Road, Suite 300 INSURER F : Boulder, CO 81 rf3VFRACCFS CERTIFICATE NUMBER: 810878 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 MD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (My one arson $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GENL AGGREGATE POLICY LIMIT APPLIES PER: PROJECT LOC PRODUCTS - COMPIOP AGO $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SiNCLrOVIIlli Ea acadent S BODILY INJURY Per non $ BODILY INJURY Per accident $ TrITUF171717DAMAGE Per accident $ UMBRELLA LIAR EXCESS LAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ OEC I I RETENTION 8 A WORKERS COMPENSATION AND EMPLOYERTLIABILITy YIN ANY PROPRIETORPARTNERAIDECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yas, descdea „mar DESCRIPTION OF OPERATIONS below NIA WC 094179798 CO 7/1/2014 7/1/2015 X WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 2,000.000 E.L. DISEASE -EA EMPLOYEE $ 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) All worlarte employees working for the above named client company, paid under ADP TOTALSOURCE, INC.'s payroll, are covered under the Prow stated policy. The above named client is an alternate employer under this policy. CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS City Hall West 300 Laporte Avenue Fort Collins, CO 80522 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 clil C046k cletviii One o f (flotida ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD