HomeMy WebLinkAboutADP TOTALSOURCE - INSURANCE CERTIFICATELc - CERTIFICATE OF LIABILITY INSURANCE 1 ' 05/;5/2oTrr'
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DONT
ES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,. EXTEND OR ALTER THE, COVERAGE, AFFORDED_ BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CORACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER AND THE CERT►FICATE.HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the po►icy(les) 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 certifis.not cate doeconfer rights to ttie certificate holder In"lieuof such endorsements .
Aoo RisCER k Services, Inc of Florida NAMEACT Aon Risk Services, Inc of Florida Miami,
FL 3l_Bay Drive, Suite 91100 AICNNo EXt : 800-743.8130 aC No k 800.522.7514
EMAIL
Miami, FL 33131�937.
ADDRESS:. ADP.COI.Center Aon.com
INSURER(S)AFFORDING COVERAGENAIC#
INSURER A American. Home Assurance Co. 19380
INSURED INSURERS:
ADP TotalSouroe DE IV, Inca
10200 Sunset Drive INSURER C : -
Miami, FL 33173 - - -
UCIF _ INSURER D _
TruePoInl Solutions LLC - --
3262 Penryn Rd Unit 10D-B, INSURER E
Loomis, CA 95650 INSURER F.:
CAVFRAnPA Y:FRTIP11%ATPI NI it u1RFR; ookiooe orwi%unri Id11MCamo. -
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERMIOR
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE -FOR THE POLICY PERIOD "
CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOV0,; ARE AS REQUESTED
NSR
LTR
-
TYPE OF INSURANCE
ADDL
INSR
SUER
WVD
POLICY NUMBER
POLICY EFF
MM/DD
POLICY EXP
MMIDD
LIMBS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE F OCCUR
-
-
EACH OCCURRENCE
$
DAMAGE TO RENTED
PREMISES Ea occurrence
$
MEDEXP (Any oneperson)
$
PERSONAL B ADV INJURY.
$ -
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY 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
-
M IN SINGLE LIMIT
-
BODILY INJURY Per arson
$
-- -- -- --
BODILY INJURY Per accident
$
PROPERTY DAMAGE
Per accdent
$.
$
UMBRELLA LIAB
EXCESS LIAR
OCCUR
.CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEC .RETENTION$..
...
A
...DESCRIPTION
WORKERS COMPENSATION -.
AND EMPLOYERS• LIABILITY YIN
ANY PROPRIETOR/PARTNERIEXECUTIV ❑
OFFICERIMEMBER EXCLUDED?
(f yes, describe uMer Mandatory I NH)
I -
OF. OPERATIONS below
..
NIA
..
... - -
WC 027117495 CA
._ ....
7/1/2020
7/1/2021
X
PER _
STATUTE
OW
ER
.. _.
.... .
E.L. EACH ACCIDENT
$ 2,006,006
E.L. DISEASE- EA EMPLOYEE
-
$ 2,000,000
E.L. DISEASE - POLICY LIMIT
S 2.000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional
All worksite employees working for TRUEPOINT SOLUTIONS LLC, paid under ADP
Remarks Schedule, may be attached If more apace Is required)
TOTALSOURCE, INC's payroll, are covered under the above stated policy. - -
CANCELLATION
City of Fort Collins
215 North Mason
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Fort Collins, CO80522
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE -POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
U 18SS-2015 AGORO CORPORATION. All Tights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
011570 90005826500 5 02 02 0 0000 0 000
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