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HomeMy WebLinkAboutVOLT INFORMATION SCIENCES INC - INSURANCE CERTIFICATE (6)A CERTIFICATE OF LIABILITY INSURANCE page 1 of 1 FDATE
03/130/20151
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 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).
Willis of New York, Inc.
c/o 26 Century Blvd.
P. O. Box 305191
Nashville, TN 37230
volt Information Sciences, Inc.
1065 Avenue of the Americas, 20th Floor
New York, NY 10018
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PHONE ... R77-q45-7378 IMP
FAX n,rn. 888-467-
INSURERA:National Union Fire Insurance Company of 19445-002
INSURERS: National Union Fire Insurance Co. of Pitt 19445-001
INSURERC:Nati0nal Union Fire Insurance Company of 19445-008
INSURERD:Starr Indemnity and Liability Company 38318-001
INSURERE: New Hampshire Insurance Company 23841-001
INSURERF: Illinois National Insurance Co. 23817-002
RFVISIl1N NI IRARPR-
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
TYPE OF INSURANCE
DDL
SUBan �J
POLICYNUMBER
POLICY EFF
POLICY EXP
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 8 OCCUR
y
I
GL9575059
I
3/31/2015
3/31/2016
EACH OCCURRENCE
$ 2,000,000
tt��ppl�,,,ttppFr;EE77Qpaocouranoe
PREMISES It
$ 250,000
MEDEXP(Anyoneperson)
$ 10,000
PERSONAL&ADV INJURY
$ 2,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICYPRO-
JECTLOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
8
PRODUCTS-COMP/OP AGG
$
$
B AUTOMOBILE LIABILITY
C X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
X HIREDAUTOS 8 UTOSWNED
CAS260794
CR5260793
3/31/2015
/31/2015
3/31/2016
3/31/2016
EOMscoldEeMSINGLELIMIT
$ 2,000,000
BODILY INJURY(Perperson)
$
$
—
$
BODILY INJURY(Per accident)
PROPERTYDAMAGPer accident E
D X UMBRELLA LIAR
—~ EXCESS LIAB
8
OCCUR
CLAIMS -MADE
1000010964
3/31/2015
3/31/2016
EACHOCCURRENCE
$ 5,000,000
El
AGGREGATE
$ 5,000,000
DED RETENTION$
$
E WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
E ANY PROPRIETOR/PARTNER/EXECUTIVEa
OFFICER/MEMBER EXCLUDED?
F' ((MandetoryInNMI
fI yes, describe under
B DESCRIPTIONOFOPERATIONS below
NIA
WCO21459984
WCO21459989
NCO21459986
NCO21459988
/31/2015
/31/2015
/31/2015
/31/2015
3/31/2016
3/31/2016
3/31/2016
3/31/2016
$
E.LEACH ACCIDENT
$ 1,000,000
E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
E workers Compensation
WCO21459990
31 2015
3/31/2016
See above workers Compensation
section
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additonal Remarks Schedule, maybe attached 8 more space is required)
City Of Fort Collins, its officers, agents and employees are included as Additional Insured under
the General and Automobile Liability policies with respect to services performed by Volt.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City Of Fort Collins AUTHORI DR ESENi
Attn: James B. O'Neil
215 North Nason Street
Fort Collins, CO 80522
Coll:4655882 Tpl:1936643 Cert:22993620 ® 88-2014ACORDCORPORATION.Allrightsreserved.
ACORD 25 (2014/01) The ACORD name and logo are registered mark of ACORD