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Home My WebLink AboutADP TOTALSOURCE CO XXI INC - INSURANCE CERTIFICATE (10)CERTIFICATE OF LIABILITY INSURANCE 1 _ O5/;5�20 CERTIFICATE DOES NOT BELOW. THIS CERTIFICA EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be I 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). YKVuuULK Am Risk Services, Inc of Florida Miaf Bdcke3131 Drive, Suite #1100 Miartri, FL 33131-0937 " NAME: AOn Risk Services, Inc Of Florida e r PHONE Exl : 800-743-8130 aC Noy 800-522-7514 _.. ADDRESS: ADP.COI.Center@Aon.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: New Hampshire Ins Co 23841 INSURED INSURER B. ADP TotalSource CO XXI, Inc. INSURER C : 10200 Sunset Drive Miami, FL 33173 ALTERNATE EMPLOYER INSURER D : INSURER E : - Enginuity Engineering Solutions LLC 10106 W San Juan Way, Suite 215 .. Littleton, CO 80127-6348 INSURER F : _ COVERAGES CERTIFICATEINUMBER: 2848920 REVISION NUMBER' THIS IS TO CERTIFY THAT THE POLICIES OF _.. _ WIINSURANCE LISTED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERMOR CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE ... _ EXCLUSIONS AND CONDRIONS OF SUCH POLICIES. LIMITS SHOWN .. BELOW HAVE BEEN ISSUED TO"THE-INSURED NAMED ABOVE FOR THE POLICY PERIOD CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, c AS MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS ::HO:AJIi AR..�+.;: R (-1L'F:STD ' INSR LTR TYPE OF INSURANCE ADDL MSR SUBR WVD I - - - POLICY NUMBER POLICY EFF MMIDDNYri POLICY EXP MMIDD.... _ LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP .oneperson) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F I PROJECT LOC OTHER GENERAL AGGREGATE. $ PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO OWNED - SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY - BI D ING Ea accident) $ BODILY. INJURY Perperson) $ - BODILY INJURY Per accident $ PROPERTY DAMAGE Per acddent $ $ UMBRELLA DAB EXCESS LAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ .AGGREGATE. _ $ DEC I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, dms Aloe uWer DESCRIPTION. OF OPERATIONS below N/A C 027115056 CO 7/1/2020 7/1/2021 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - FA EMPLOYEE $ 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 DESCRIPTION OF -OPERATIONS] LOCATIONS / VEHICLES (ACORD 101, Additional All worksite employees working for ENGINUITY ENGINEERING SOLUTIONS L SOLUTIONS LLC is an alternate employer under this policy. Remarks Schedule, may be attached If more space is required) , paid under ADP TOTALSOURCE, INC.'s payroll, are covered under the above stated policy. ENGINUITY ENGINEERING CERTIFICATE HOLDER I CANCELLATION City or Fart Collins Attn: Purchasing Department SHOULD ANY OF THE. ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins, CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 09. avoni+sk 'etvsce3, �t Rc a __ G{ ida U 195IS-ZU75 AGUKL) GUKPUKAI IUN. Ali rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD . 008754 90005826000 a 02 02 0 0000 0 000 1060975