Loading...
HomeMy WebLinkAboutXEROX BUSINESS SERVICES DBA AFFILIATED COMP - INSURANCE CERTIFICATEA CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D O5/27/2015015 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). PRODUCER AOn Rl sk Services Northeast, Inc. New York NY Office CONTACT NAME: (AICO.NNo. Ext): (866) 283-7122 (wc No.): 800-363-0105 E-MAIL ADDRESS: 199 water Street New York NY 10038-3551 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: AIG Specialty Insurance Company 26883 Xerox Business Services. LLC. dba INSURER B: Affiliated Computer Services 2828 N. Haskell Ave. INSURER C: INSURER D: Dallas TX 75204 USA INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570057801781 REVISION NUMBER: 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. Limits shown are as requested INR TR TYPE OF INSURANCE NSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE ❑ OCCUR DAMAGE T RENTED PREMISES Ea occurrence MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY ❑ JECT PRO ❑ LOC PRODUCTS - COMP/OP AGG OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY ( Per person) ANY AUTO BODILY INJURY (Per accident) ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAR HCLAIMS-MADE DED I RETENTION WORKERS COMPENSATION AND PER OTH- EMPLOYERS' LIABILITY Y / N STATUTE ER E.L. EACH ACCIDENT ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED9 ❑ N / A E.L. DISEASE -EA EMPLOYEE (Mandatory in NH) If yes, describe under DESCRIP. OF: OPERATIONS bebw . E.L. DISEASE -POLICY LIMIT A E&O-PL-Primary 013348971 05/26/2015 05/26/2016 Ea. Claim / Agg. $10,000,000 SIR applies per policy ter s & conditions DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Name in Contract: Buck Consultants, LLC RE: RFP #P999 CERTIFICATE HOLDER CANCELLATION 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 AUTHORIZED REPRESENTATIVE 215 N. Mason Street, 2nd Floor Fort Collins, CO 80524 USA �CQ� ,�ff��' �y �cJu tx�4 c//"r. d ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD