HomeMy WebLinkAboutADP TOTALSOURCE FL XI INC - INSURANCE CERTIFICATE®
�`� CERTIFICATE OF LIABILITY INSURANCE
DATE(MIUDDNYYY)
06/13/14
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(les) 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 SeNces, Inc of Florida
1001 Brickell Bay Drive, Suite A1100
Miami, FL 331314937
CONTACT qOn Risk Services,Inc of Florida
NAME:
AIC No Ext : 800-743-8130 1 INC,No): 800-522-7514
ADDRESS: ADP.COLCentef AOD.COm
INSURER(S) AFFORDING COVERAGE
NAIC9
INSURER A: Nave Hampshre Ins Go
23841
INSURED
INSURER e
C
ADP TotalSource FL XI, Inc.
102M Sunset Dimas
INSURER D
Miami, FL M173
ALTERNATE EMPLOYER
Sneller Associates. Inc.
INSURER E :
INSURER F:
. odnel/1rJ 1JI IMRFR-
1900 Grant Street suite BDO
Denver. CO 80200 —_
COVERAGES U arli urn m i c naar.rvr_,.. --
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.
ADDL SUBR POLICY NUMBEfl POUCY EFF PODCV EXP LIMITS
EOP INSURANCE INSR MD MWDDfYYYY MMIDDIYYYY
ILITY
IAL GENERAL LIABILITY
S-MADE OCCUR
NAGGREGATE
EACH OCCURRENCE
E
DgMAGE TO RENTED
PREMISES Ea occurrence
$
MEDEXP An one on
$
PERSONAL& ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS-COMPIOP AGO
ATE LIMIT APPLIES PER:
$
E
PROJECTLOCEa
LIABILITY
acadent
$
BODILY INJURY Par non
E
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON-0WNED
HIRED AUTOS AUTOS
BODILY INJURY Per accident
E
q
Per accident
$
8
EACH OCCURRENCE
E
UMBRELLA LIAB
EXCESS tia
OCCUR
CIAIMS-MADE
AGGREGATE
E
DEC RETENTIONE
WORKERSCOMPENSATION
WC STATU- OTH-
X TORY LIMITS ER
E.L. EACH ACCIDENT
E 2,000,000
A'
AND EMPLOYERT UABIUTY YIN
ANY PROPRIETORNARTNERIEXECUTNE
OFFICERIMEMBER EXOWDEOP
(Mandatory In NMI
Me.ae.onelwaM)
DESCRIPTION OF OPERATIONS belay
NIA
WC 094179798 CO
7/1/2014
7/1/201$
E. L. DISEASE - EA EMPLOYEE
$ Z000,000.
EL DISEASE -POLICY LIMIT 8 2,000!00011
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additlonal Remarks Schedule, If more space Is required)
All wi maize employees working for the abae named client company, pad under ADP TOTALSOURCE. INC's payroll, am coasted under the above stated Policy. The above named client is an e1mirm, e
employer under this policy.
r il-A 1 C r1 V LI Ii
CITY OF FORT COLLINS
ATTN: JIM HUME
PURCHASING DEPARTMENT
P. 0. BOX 580
FT. 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
�on �i�k $etveeea, 4nc o f � flotl�ia
reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD