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HomeMy WebLinkAboutPEOPLEREADY INC - INSURANCE CERTIFICATE (5)AC;UHVr CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DD/YYYY) 7/1/2018 1 6/27/2017 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 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton CompaniesNAME: 8110 E. Union Avenue Suite 700 Denver CO 80237 NTACT A/C No Ext : A/C No): E-MAIL ADDRE S: IN R AFFORDING COVERAGE NAIC x (303) 414-6000 INSURERA: National Union Fire Ins Co Pitts. PA 19445 INSURED PeopleReady, Inc. 1036748 1015 A. Street PO Box 2910 INSURER B : New Hampshire Insurance Company 23841 INSURER C : Insurance Company of the State of PA 19429 INSURER D : American Home Assurance Company 19380 Tacoma, WA 98401 -INSURER E : 48837-1999 INSURER F : COVERAGES CERTIFICATE NUMBER: 13028266 REVISION NUMBER: XXXXXXX 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 TR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR SIR $IM Y N 6938943 7/1/2017 7/1/2018 EACH OCCURRENCE 1,000,000 PREMISESa occurrence 1 000 000 X MED EXP (Any oneperson) XXXXXXX PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ]{ POLICY❑ JJECT LOC OTHER GENERAL AGGREGATE $ 5,000,000 PRODUCTS -COMP/OP AGG $ 3,000,000 $ A 4 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY AUTOS ONIRED LY Y N 2867455 2936057 2936058 7/1/2017 7/1/2017 7/1/2017 7/1/2018 7/1/2018 7/1/2018 EasBINEDtSINGLEUMIT $ 1,000000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX Peer a.,den DAMAGE $ XXXXXXX $XXXXXXX A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE N N 28189240 7/1/2017 7/1/2018 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I I RETENTION $ $ XXXXXXX XXXXXXXAND H C D WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY YIN OFFICER/MEMBEREXCLUDED?ECUTIVE a (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below N/A N 63724521, 63724533, 63724529 63724525,63724527,63724531 63724523 I 7/1/2017 7/1/2017 7/1/2017 7/1/2018 7/D2018 7/1/2018 PER OTH- X STATUTE ER eLEACHAccIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE 1000 000 E.L. DISEASE - POLICY LIMIT is 1000 000 A Excess Work Camp N IN 6583172-QSI 7/1/2017 7/1/2018 SIR $350,000 each accident DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The above coverages apply only to temporary employees dispatched to do work on behalf of the Named Insured. City of Fort Collins is named as Additional Insured if required by written contract between Labor Ready and City of Fort Collins as respects General and Auto Liability. CERTIFICATE HOLDER CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 13028266 AUTHORIZED REPRESENTATIVE City of Fort Collins PO Box 580 Fort Collins, CO 80522 r;✓C rl , c lal ACORD 25 (2016/03) ©1 8 201! ORPOICATION. All riahts reserved The ACORD name and logo are registered marks of ACORD SCHEDULE OF NAMED INSUREDS TrueBlue, Inc. Affiliates' Centerline Drivers, LLC CLP Resources, Inc. Labor Ready Inc. PeopleReady, Inc. PeopleReady Florida, Inc. PlaneTechs, LLC Project Trade Solutions, LLC Spartan Staffing, LLC Spartan Staffing Puerto Rico, LLC TrueBlue, Inc. TrueBlue Enterprises, Inc. TrueBlue Energy and Industrial Services, LLC TransTechs Venue Ready, LLC Job Rooster, Inc. Miscellaneous Attachment: M19451 Master ID: 1036748, Certificate 1D: 13028266 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement, effective 12:01 A.M. 07/01/17 forms a part of Policy No. 6938943 By National Union Fire Insurance Company ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION II - WHO IS AN INSURED, is amended to include as an additional insured: Any person or organization to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability caused in whole or in part: A. by your acts or omission in the performance of your ongoing operations; or B. in connection with your premises owned by or rented to you. However, the insurance provided will not exceed the lesser of: • The coverage and/or limits of this policy, or • The coverage and/or limits required by said contract or agreement. Miscellaneous Attachment: M56029 Certificate ID : 13028266