HomeMy WebLinkAboutTRINET HR III INC - INSURANCE CERTIFICATET3-UVU
C
OF LIABILITY INSURANCE.
6/15/2020
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 I_NSURER(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 riahts to the certificate holder in lieu of such endorsement(s).
PRODUCER
Commercial Lines - (305) 443-4886
US] Insurance Services LLC
WIN'' Risk Management Department
PHONE0. (866)443 8489 F N,; (800)889-0021
ADDRESS, Work.Comp@Trinet.com
2601 South Bayshore Drive, Suite 1600
INSURER(S) AFFORDING COVERAGE
NAILIf
Coconut Grove, FL 33133
INSURER A: Indemnity Insurance Company of North America
43575
INSURED
INSURER B :
TriNet HR III, Inc.
INSURER::
RE: Policy Confluence; Inc. DBA POLCO
INSURER D:.
9000 Town Center Parkway
INSURER E
Bradenton, FL 34202
„pep ,
COVERAGES CERTIFICATE NUMBER: 15057718 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 MAYBE ISSUED OR MAY. PERTAIN, INSURANCE
AFFORDED -BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS
N MTHE
SHOWAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTR
TYPE OF INSURANCE
ADDL
SUER
POUCY NUMBER
MWDDIYYYY EFF
MM1DDfrnY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
S
CLAIMS -MADE F OCCUR
DAMAGE TO RENTED
PREMISES Ea,occurrence
$
MED EXP (Any. one person)
$
PERSONAL B ADV INJURY
S
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
S
POLICY ❑ JEST 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)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTYDAMAGE
Per accident
$
$
UMBRELLA LU18
OCCUR
EACH OCCURRENCE
S
AGGREGATE
.S
EXCESS LUA3
CLAIMS -MADE
DED I I RETENTIONS
S
I
I
I
P`
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETORIPARTNERIEXECUTIVE YIN
MI OFFICEREMBEREXCLUDED? N
NIA
WLR�C67487254
07/01/2020
07/01/2021
X STATUTE OTRH-
E.L. EACH ACCIDENT
S 2.000,000
E.L. DISEASE - EA EMPLOYEE
S 2,000,600
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
-
E.L. DISEASE - POLICY LIMIT
-
I s 2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS? VEHICLES (ACORD 101, Additional
Workers' Compensation coverage is limited to worksite employees
Remarks Schedule, maybe attached R more space is required)
of Policy Confluence, Inc. DBA POLCO through a co -employment agreement with
TriNet HR III, Inc.
CITY OF FT COLLINS, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ITS OFFICERS, AGENTS AND EMPLOYEES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
- -. ACCORDANCE WITH THE POLICY PROVISIONS.
CITY HALL WEST, 300 LAPORTE AVE
FORT COLLINS CO 80521-2719 AUTHORIZED REPRESENTATIVE Mn
/n
The ACORD name and logo are registered marks of ACORD @ 1986.2615 ACORD CORPORATION. All rights reservei
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