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HomeMy WebLinkAbout451613 EMPLOYERS EDGE LLC - INSURANCE CERTIFICATE (8),acoRv' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 05/20/2019 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 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). PRODUCER Doug Jones C/o Artex Risk Solutions, Inc. 8840 E. Chaparral Rd.; Suite 275 Scottsdale, AZ 85250 A/C No Ext): (480) 951-4177 ( �pr8 No): (480) 951-4266 E-MAIL nnnRFcs. SDL.BSD.Certificates@artexrisk.com INSURER A: American Zurich Insurance INSURED INSURER B : Oasis Acquisition. Inc.. a Paychex Company Alt. Emp: EMPLOYERS EDGE LLC 2054 Vista Parkway Suite 300 INSURER C : West Palm Beach, FL 33411 INSURER D : INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER:19FLO75782178 REVISION NUMBER: 40142 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. INSR LTR TYPE OF INSURANCE ADDLiSUBRI POLICY NUMBER POLICY EFF MMOD/YYYY POLICY EXP MM/DD/YYYY _ LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE j $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occu ence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY F I PRO- JECT 7 LOC PRODUCTS COMP/OP AGG $ $ OTHER- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB EACH OCCURRENCE $ HIOCCUR AGGREGATE $ EXCESS LIAR CLAIMS -MADE �— DED ' I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN N IANYPROPRIETOR!PARTNER/EXECUTIVE OFFICERWEMBEREXCLUDED? (Mandatory in NH) N/A WC 29-38-687-17 06/01/2019 06/01/2020 PER OT - X STATUTE I ER E.L. EACH ACCIDENT $ 1,000,000 — ------ — E.L. DISEASE - EA EMPLOYEE $ 1,000,000 describe under If or DESCRIPTION OF OPERATIONS below E.L. DISEASE POLICY LIMIT $ 1,000,000 Location Coverage Period: 06/01/2019 06/01/2020 Client# 6056-DENVER DESCRIPTION OF OPERATIONS ! LOCATIONS; VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Coverage is provided for EMPLOYERS EDGE LLC only those co -employees 5290 E YALE CIR STE 205 of, but not subcontractors DENVER, CO 80222 to: City of Fort Collins 215 N Mason Street Fort Collins, CO 80522 L;AIVLaLLA I IUN 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and Ioao are reaistered marks of ACORD 2• of 2 29394