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HomeMy WebLinkAboutVOLT INFORMATION SCIENCES INC - INSURANCE CERTIFICATE (7)CERTIFICATE OF LIABILITY INSURANCE page 1 of 1 F�ATE 04/(O1/2016) 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 CONTACT NAME Willis of New York, Inc. c/o 26 Century Blvd. P. o. sox 305191 PHONE FAX 877-945-7378 888-467-2378 E-MAIL certificatesCwillis.com Nashville, TN 37230 INSURER(S)AFFORDINGOOVERAGE NAIC # INSURERA:National Union Fire Insurance Company of 19445-002 INSURED Volt Information Sciences, Inc. INSURERB:National Union Fire Insurance Company of 19445-008 INSURERC:Starr Indemnity and Liability Company 38318-001 1133 Avenue of the Americas 15th Floor New York, NY 10036 INSURERD:Illinois National Insurance Co. 23817-002 INSURERE. New Hampshire Insurance Company 123841-001 INSURERF: National Union Fire Insurance Co. of Pitt�19445-001 COVERAGES CERTIFICATE NUMBER: 24317481 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. INSR TYPE OF INSURANCE DDL SUB POLICY NUMBER POLICY EFF POLICY EXPITR LIMITS A X COMMERCIAL GENERAL LIABILITY Y GL3796573 3/31/2016 3/31/2017 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR ppqM R TWp�IENTED PREMISES(taoccurence) $ 250,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ $ OTHER: B AUTOMOBILE LIABILITY CA3434126 �3/31/2016 3/31/2017 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 BODILY INJURY(Perperson) $ X ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS X HIREDAUTOS X NON -OWNED AUTOS BODILY INJURY(Per accident) $ PROPERTYDAMAGE (Per accident) $ C X UMBRELLALIAB X OCCUR 1000011363 li3/31/2016 3/31/2017 EACH OCCURRENCE $ 51000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ D WORKERS COMPENSATION WC015519376 3/31/2016 3/31/2017 CITH X STATUTE rp E F E AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE� OFFICER/MEMBER EXCLUDED? ( ff escMandatoryin NH) ribe under yes, d. DESCRIPTION OF OPERATIONS below NSA WC015519373 WC015519375 WC015519377 3/31/2016 31 3 2016 / / 3/31/2016 3/31/2017 3i 3 2017 / / 3/31/2017 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EAEMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 E Workers Compensation WC015519379 3/31/2016 3/31/2017 See above Workers Compensation E WC015519374 3/31/2016 3/31/2017 section E WC015519380 3/31/2016 3/31/2017 E WC015519378 3/31/2016 3/31/2017 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additonal Remarks Schedule, may be attached if 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. 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 AUTHORI DR ESENT Attn: James B. O'Neil 215 North Mason Street Fort Collins, CO 80522 Coll:4877830 Tpl:2044662 Cert:24317481 © 88-2014ACORDCORPORATION.Allrightsreserved. ACORD 25 (2014/01) The ACORD name and logo are registered mark of ACORD