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HomeMy WebLinkAbout131163 ADECCO INC - INSURANCE CERTIFICATE (4)ACC?RU® oC" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 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 WC No. Ext): /C, No) _. E-MAIL ADDRESS:______ New York, NY 10036 Attn: Adecco.certs@Marsh.com Fax: 212-948-0018 INSURER(S) AFFORDING COVERAGE NAIC p INSURER A: AXA Insurance Company 33022 370044-ALL-ALL-18-19 NO _ INSURED Adecco, Inc. &its subsidiaries 10151 Deerwood 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 CnVFRAnFR CERTIFICATE NUMBER: NYC-009477491-16 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 VVITH 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. INSRPOLICY LTR I TYPE OF INSURANCE INSD WVD SUER POLICY NUMBER EFF MM DD/YYYY POLICY 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 � OCCUR TED PREMISES Ea occurrence) $ 2,000,000 CONTRACTUAL LIABILITY X MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000A00 POLICY PE0 � NLOC $ OTHER B AUTOMOBILE LIABILITY 7093432 (MA) 01/01/2018 01/01/2019 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 BODILY INJURY (Per person) $ B X ANY AUTO 7093433 (FL) 01/01/2018 01/01/2019 B OWNEDONLY _ SCHEDULED AUTOSAUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 7093434 (ADS) 01/01/2018 01/01/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB X OCCUR XS002072(18) 01/01/2018 01/0112019 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I X I 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 ( ) 01/01/2018 01/01/2018 01/0112019 01/01/2019 01/01/2019 X PER OTH- STATUTE ER E.L. EACH 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 01/01/2018 01101/2019 EA. CLAIM/AGG(SIR $500,000 $5MI$5M (INCLUDING NETWORK SECURITY) PRIVACY EVENT EXPENSE EA. CLAIMIAGG (SIR $250,00 $5M/$5M DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Branch Location: Adecco Engineering & Technical, 4025 Automation Way F1, Fort Collins, CO 80525. GERIIFIGAIE HULDEK t1AI4I+C1_LAIIVIY City of Fort Collins Attn: Ed Bonnette 215 N. Mason St. Fort Collins, CO 80522 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 CORPORA I IUN. All ngnts reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD