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HomeMy WebLinkAbout152500 ROBERT HALF INTERNATIONAL DBA ACCOUNTEMPS - INSURANCE CERTIFICATESHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ PROPERTY DAMAGE $ BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? 2019-2020 RHI Workers Compensation Policy Numbers Policy# States Policy Entity Eff. Date Exp. Date Issuing Company Robert Half International Inc. and Protiviti Inc. RWD3001140-03 AOS: AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WV, WY RHI/ Protiviti 6/1/2019 6/1/2020 XL Insurance America, Inc. RWR3001141-03 WI RHI/ Protiviti 6/1/2019 6/1/2020 XL Insurance America, Inc. Protiviti Government Services, Inc. RWR3001142-03 AOS: AZ, CA, DC, MD, OK, TX, VA Prot. Govt. Svs. 6/1/2019 6/1/2020 XL Insurance America, Inc. Additional Insured - Scheduled Person Or Organization continued 80-02-2367 (Rev. 5-07) Endorsement 1 Liability Insurance Form Page 3579-66-87 SFO FEDERAL INSURANCE COMPANY JUNE 1, 2015 TO JUNE 1, 2016 JUNE 10, 2015 JUNE 1, 2015 ROBERT HALF INTERNATIONAL, INC This Endorsement applies to the following forms: Name of Company Endorsement Policy Number Effective Date Policy Period Date Issued Liability Insurance Insured GENERAL LIABILITY Who Is An Insured the following provision only: them Additional Insured - but they are insured you are Scheduled Person Or Organization by this policy. Is An Insured, However, the person or organization is an insured is added ; obligated pursuant to a with to shown or agreement to are insureds •if is or organizations the extent the person or organ Persons and then only contract in the Schedule provide Under Who ization . described in the Schedule; such insurance s only if as is afforded • for eement; and did not occur, in whole requires the person or • agr Additional Insured - Scheduled Person Or Organization last page 80-02-2367 (Rev. 5-07) Endorsement 2 Liability Insurance Form Page Liability Endorsement (continued) Conditions from insurance available to such Other Insurance – person Primary, Noncontributory case Insurance – Scheduled Person Or Organization this insurance is primary and we a contract or added to the th shown are obligated, pursuant to will not seek contribution or you Conditions, the following provision is agreement, afforded by If organization. with Schedule Schedule Under in the primary insurance such as is to condition provide titled this policy, then in such Other Insurance. e person or organization Persons or organizations that you are obligated, pursuant to a contract or agreement, to provide with such insurance as is afforded by this policy.  All other terms and conditions remain unchanged. Authorized Representative Reference Copy PERSONS OR ORGANIZATIONS THAT YOU ARE OBLIGATED, PURSUANT TO WRITTEN CONTRACT OR AGREEMENT BETWEEN YOU AND SUCH PERSON OR ORGANIZATION, TO PROVIDE WITH SUCH INSURANCE AS IS AFFORDED BY THIS POLICY; BUT THEY ARE INSUREDS ONLY IF AND TO THE MINIMUM EXTENT THAT SUCH CONTRACT OR AGREEMENT REQUIRES THE PERSON OR ORGANIZATION TO BE AFFORDED STATUS AS AN INSURED. HOWEVER, NO PERSON OR ORGANIZATION IS AN INSURED UNDER THIS PROVISION WHO IS MORE SPECIFICALLY DESCRIBED UNDER ANY OTHER PROVISION OF THE WHO IS INSURED SECTION OF THIS POLICY (REGARDLESS OF ANY LIMITATION APPLICABLE THERETO). act an insured •to loss, cost or expense for injury or status as to damages, or agreement or in part, before the of with respect that contract damage which this insurance applies. such ; execution the to the extent organization to be afforded ivities contract or • person is more specifically identified under this provision: of the No section organization is an insured that under any other provision Who or (regardless of any limitation applicable thereto). Is An Insured • expense for injury absence of , to which this insurance person would have in the or contr or agreement. This limitation does not apply cost or with act to any assumption of liability (of another applies, that the respect damage such contract or agreement. liability for damages organization in to the or organization) by them a person or , loss, Reference Copy JUNE 1, 2019 TO JUNE 1, 2020 JUNE 1, 2019 JUNE 1, 2019 (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER (MM/DD/YYYY) LIMITS POLICY EXP (MM/DD/YYYY) POLICY EFF LTR TYPE OF INSURANCE POLICY NUMBER INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $ $ OCCUR CLAIMS-MADE DED RETENTION $ PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $ EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 5/31/2019 Arthur J. Gallagher & Co. Insurance Brokers of CA, Inc. License #0726293 505 N. Brand Boulevard, Suite 600 Glendale CA 91203 Robert Half Certificates 818-539-1463 818-539-1801 roberthalf_certificates@ajg.com Federal Insurance Company 20281 ROBEHAL-03 XL Insurance America, Inc. 24554 Robert Half International Inc. including Accountemps 2613 Camino Ramon San Ramon CA 94583 508820588 A X 2,000,000 X 2,000,000 X Stop Gap Em.Liab 10,000 X in OH, WA, WY,ND 2,000,000 2,000,000 X Y 3579-66-87 6/1/2019 6/1/2020 2,000,000 Employer Liability 1,000,000 A 1,000,000 X 7323-32-17 6/1/2019 6/1/2020 Comp/Coll.Ded: 1,000/$1,000 A X X 7921-71-07 6/1/2019 6/1/2020 5,000,000 5,000,000 X 0 B X N See Attached Supplemental 6/1/2019 6/1/2020 1,000,000 1,000,000 1,000,000 Certificate Holder is deemed Additional Insured on the above referenced General Liability policy as required by written contract for liability arising out of the Named Insureds' acts or omissions. Please refer to attached Chubb General Liability form 80-02-2367 for scope of Additional Insured status. City of Fort Collins 215 N Mason St Fort Collins CO 80524-4402 USA