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HomeMy WebLinkAboutTRINET HR III INC/PROPERTYROOM.COM INC - INSURANCE CERTIFICATET3-JL5 A� Rom® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 6/26/2019 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 Commercial Lines - (305) 443-4886 US[ Insurance Services LLC CONTACT Risk Management Department PHONE 8664438489 FAX 8008890021 A/C No Ext : A/C No): E-MAIL ADDRESS: Work.om p@CTrinet.com 2601 South Bayshore Drive, Suite 1600 INSURER(S) AFFORDING COVERAGE NAIC# Coconut Grove, FL 33133 INSURERA: Indemnity Insurance Company of North America 43575 INSURED INSURER B: TriNet HR III, Inc. INSURER C RE: Property Room.com, Inc. INSURERD: 9000 Town Center Parkway INSURER E : Bradenton, FL 34202 INSURER F : COVERAGES CERTIFICATE NUMBER: 14356127 REVISION NUMBER: See below 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 I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/..!YYYY POLICY EXP MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE $ DA A O RENT PREMISES Ea occurrence $ MEO EXP (Any one person) $ PERSONAL & ADV INJURY $ $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- JECT ❑ LOC OTHER: GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY E CEOa MaccBINED SINGLE LIMITident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB 1 OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBEREXCLUC C (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WLR C66084218 7/1/2019 7/1/2020 I ER X STATUTE EERH 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 / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers Compensation is limited to worksite employees of PropertyRoom.com, Inc. through a co -employment contract with TriNet HR III, Inc. tUANt,tLLA I IUN City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 North Mason St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins CO 80522 AUTHORIZED REPRESENTATIVE 4 - The ACORD name and logo are registered marks of ACORD © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) 111111111111111111111111111111111111111IN 11111111111 1111� 111111111111111111111 IIIII 'C YB03A26/000914/02/02/0/0/0/0'