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HomeMy WebLinkAbout131163 ADECCO INC - INSURANCE CERTIFICATE (5)DATE (MM/DDNYYY) AIR" CERTIFICATE OF LIABILITY INSURANCE 0410212018 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 CONTACT Marsh USA, Inc. NAME: PHONE FAX 1166 Avenue of the Americas IAIQ NQ, €xt1; ______ _ __ _ A/c No): New York, NY 10036 E-MAIL Attn: Adecco.certs@Marsh.com Fax: 212-948-0018 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC # 370044-ALL-ALL-18-19 INSURED Adecco, Inc. & its subsidiaries 10151 Deerwood Park Blvd. Building 200, Suite 400 Jacksonville, FL 32256 CnVFRAnFS 2 CFRTIFICATF NtIMRFR INSURER A: AXA Insurance Company 33022 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 INSURER E : American Home Assurance Company 19380 INSURER F : Hartford Fire Insurance Company19682 NYC-009477489-16 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 TYPE OF INSURANCE ADDL UBR POLICY NUMBER MM DD/YYYY MMPOLICY EFF L ICY EXP LTR DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY PCS002071(18) 01/01/2018 01/01/2019 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE U OCCUR DAMAGE To RETED PREMISES Ea occurrence) $ 2,000,000 X CONTRACTUAL LIABILITY MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRO - - X PRO- POLICY X LOC N PRODUCTS - COMP/OP AGG $ 4,000,000 $ 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 OOU E ONLY SCHEDULED AUTOS 7093434 (AOS) 01/01/2018 01/01/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 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 I X I RETENTION $10,000 $ D E C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNERlEXECUTIVE OFFICER/MEMBER EXCLUDED? NJ (Mandatory in NH) NIA 014122426(AOS) 014122427 (GA) 014122430 FL ( ) 01/01/2018 01/01/2018 01/01/2019 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 01/01/2019 EA. CLAIM/AGG(SIR $500,000 $51VV$5M (INCLUDING NETWORK SECURITY) PRIVACY EVENT EXPENSE EA. CLAIMIAGG (SIR $250,00 $5M1$5M DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Branch Location: Adecco Staffing, 3711 JFK Parkway, Suite 305, Fort Collins, CO 80525. CERTIFICATE HOLDER City of Fort Collins Attn: 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