HomeMy WebLinkAbout131163 ADECCO INC - INSURANCE CERTIFICATE (3)ACOR" CERTIFICATE OF LIABILITY INSURANCE ��. DATE (MM/DD/YYYY) 04/02/2018 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 Marsh USA, Inc. 1166 Avenue of the Americas CONTACT _NAME: PHONE FAX (A/C No. Ext): _ _____ - ___— _ — A/C No): E-MAIL ADDRESS: New York, NY 10036 Attn: Adecco.certs@Marsh.com Fax: 212-948-0018 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: AXA Insurance Company 33022 370044-ALL-ALL-18-19 NO INSUREDAdecco, Inc. & its subsidiaries 10151 Deelwood Park Blvd. INSURER B : National Union Fire Insurance Co Of Pittsburgh 19445 INSURER C : Insurance Company of the State of Pennsylvania 19429 INSURER D : New Hampshire Insurance Company 23841 Building 200, Suite 400 Jacksonville, FL 32256 INSURER E : American Home Assurance Company 19380 INSURER F : Hartford Fire Insurance Company 19682 COVERAGES CERTIFICATE NUMBER: NYC-009477490-16 REVISION NUMBER: 1 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDYYYY POLICY EFF LICY EXP MM /DD YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY PCS002071(18) 01/01/2018 01/01/2019 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE Cl OCCUR PRE-INAMMISES SES�Ea�orccur ence $ 2,000,000 X MED EXP (Any one person) $ 5,000 CONTRACTUAL LIABILITY PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY [_ X ] PE& FX] LOC PRODUCTS - COMP/OP AGG $ 4,000,000 $ OTHER B AUTOMOBILE LIABILITY 7093432 (MA) 01/01/2018 01/01/2019 COMBINED SINGLE LIMIT ca accident $ 2,000,000 BODILY INJURY (Per person) $ B X ANY AUTO 7093433 (FL) 01/01/2018 01/01/2019 B AOWNE ONLY SCHEDULED AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 7093434 (AOS) 01/01/2018 01/01/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB X OCCUR XS002072(18) 01/01/2018 01/01/2019 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $10 000 $ D E C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 014122426 (AOS) 014122427 (CA) 014122430 FL ( ) 01I01/2018 01/01/2018 01/01/2019 01/01/2019 01/01/2019 X PER OTH- STATUTE ER E.LEACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below F E&O / PROFESSIONAL LIABILITY 10 HH 032657918 01/01/201. "'0'12019 EA. CLAIMIAGG(SIR $500,000 $5M/$5M (INCLUDING NETWORK SECURITY) PRIVACY EVENT EXPENSE EA. CLAIMIAGG (SIR $250,00 $5MI$5M DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Branch Location: Adecco Engineering & Technical, 300 E, Boardwalk, Fort Collins, CO 80525. laK I lr[L A I C YIVLUtK liHrvliCLLH I IVIY City of Fort Collins Attw Ed Bonnette 215 N. Mason St. Fort Collins, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Jason Clarke ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD