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HomeMy WebLinkAboutVOLT WORKFORCE SOLUTIONS - INSURANCE CERTIFICATEA �® CERTIFICATE OF LIABILITY INSURANCE page 1 of 1 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. 0. Box 305191 PHONE FAX • 877-945-7378 888-467-2378 E-MAIL certificates@willis.com Nashville, TN 37230 INSURER(S)AFFORDINGOOVERAGE NAIC # INSURERA:National union Fire Insurance Company of 19445-002 INSURED Volt Workforce Solutions INSURER B:New Hampshire insurance Company 23841-001 INSURERC:Illinois National Insurance Co. 23817-002 A Division of Volt Management Corp. 7300 West 110th St., Commerce Plaza, Ste. 140 INSURERD:National Union Fire Insurance Co. of Pitt 19445-001 INSURERE: Overland Park, KS 66210 INSURER F: COVERAGES CERTIFICATE NUMBER: 24314242 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 $ 1 000 000 pDAp,M�pp FFrrq�a{occEence PREMRES (t ) $ 250 000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY PRO- JECT LOC X PRODUCTS -COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY(Per person) $ ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON -OWNED HIREDAUTOS AUTOS PROPERTYDAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED (RETENTION$ $ B WORKERS COMPENSATION WC015519373 3/31/2016 3/31/2017 XOTH C D B AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE� OFFICER/MEMBER EXCLUDED? MandatoryinNH) ,Mandatory describe under DESCRIPTIONOFOPERATIONS below N/A WC015519376 WC015519375 WC015519377 3/31/2016 3/31/2016 3/31/2016 3/31/2017 3/31/2017 3/31/2017 E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE $ 11000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 B Workers Compensation WC015519379 3/31/2016 3/31/2017 See above Workers Compensation B WC015519374 3/31/2016 3/31/2017 section B WC015519380 3/31/2016 3/31/2017 B WC015519378 3/31/2016 3/31/2017 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additonal Remarks Schedule, maybe attached if more space is required) Re: Services Agreement effective November 1, 2012 The City of Fort Collins, its officers, agents and employees are included as Additional Insureds as respects to General Liability when required by written contract. 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 E Attn: Purchasing P.O Box 580 Fort Collins, CO 80522 Coll:4877830 Tpl:2045891 Cert:24314242 © 88-2014ACORDCORPORATION.Allrightsreserved. ACORD 25 (2014/01) The ACORD name and logo are registered mark of ACORD