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HomeMy WebLinkAbout172842 XEROX BUSINESS SERVICES LLC DBA AFFILIATED - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE DATos 2iaia �) 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(in) 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 Aon Risk Services Northeast, Inc. New York NY office CONTACT PHONE (g66) 283-2122 FAX g00-363-0105 lac. No. Exq: .L. No.: 199 water Street New York NY 10038-3551 USA E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURERA: AIG Specialty Insurance Company 26883 ss Services, LLC. dba ommer services INSURER B: INSURER C: EDk:g ell Ave. 204 USA INSURER D: SURER E: INS INSURER F: COVERAGES CERTIFICATE NUMBER: 570053623826 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 am as requested INSR LTR TYPE OF INSURANCE ADD[ INSD SUER VIVO POLICY NUMBER IMMJDDIYYYY) 1=100= LIMITS COMMERCIAL GENERAL WIBIUTY CLAIMS -MADE ❑OCCUR EACH OCCURRENCE PREMISES Ea o=mna MED UP (Any one person) PERSONAL & ADV INJURY GENL AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- LOG JECT OTHER: GENERAL AGGREGATE PRODUCTS -COMPIOP AGG AUTOMOBILE LIABIUTY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS NON-0WNED AUTOS COMBINED SINGLE LIMIT Ea amitlent BODILY INJURY ( Per person) BODILY INJURY(Peracciden0 PROPERTY DAMAGE Peramident IUMBRELLA LUB EXCESS LOUR OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED1RETENTION WORKERS COMPENSATION AND EMPLOYERS' LUBHLnY YIN ANY PROPRIETOR/ PARTNER I EXECUTIVE OFFICERIMEMBER EXCLUCED? ❑ (Mandatory In NN) u Yes desrnw under DESCRIPTION OF OPERATIONS teelow NIA PER OTH- STATUTE E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.L. DISEASE -POLICY LIMIT A E&O-PL-Primary 011818900 SIR applies per policy ter 05/26/2014 s & condi 05/26/2015 ions Aggregate S1010001000 DESCRIPTIONOFOPERATIONSILOCATIONSIVEHICLES(ADORD101,Addiemul ReaM sSchaduY,maybaMcMdIIn mspaceisrequired) Name in Contract: Buck Consultants, LLC RE: RFP #P999 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCHES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED N ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins AUTHORIZED REPRESENTATIVE 215 N. Mason Street, 2nd Floor Fort Collins, CO 80524 USA JQL c./ '*"Z fJ Ct ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD