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HomeMy WebLinkAbout131163 ADECCO INC - INSURANCE CERTIFICATE (6)L CERTIFICATE OF LIABILITY INSURANCE DATE /2018 /VYYY) L __.= oa/o212018 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: 1166 Avenue of the Americas PHONE FAX 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 NO INSURER A: AXA Insurance Company 33022 INSURED Adecco, Inc. &its subsidiaries INSURER B :National Union Fire Insurance Co Of Pittsburgh 19445 10151 Deerwood Park Blvd. INSURER C : Insurance Company of the State of Pennsylvania 19429 Building 200, Suite 400 INSURER D : New Hampshire Insurance Company 23841 Jacksonville, FL 32256 25 INSURER E : American Home Assurance Company 19380 INSURER F : Hartford Fire Insurance Company 19682 COVERAGES CFRTIFICATF NIIMRFP- NYC-nnQdQd19Q_1R 09=%1ICInK1 KII IMn=0- 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 POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR PCS002071(18) 01/01/2018 01/01/2019 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 2,000,000 X MED EXP (Any one person) $ 5,000 CONTRACTUAL LIABILITY PERSONAL & ADV INJURY $ 2,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY ] PE� LJ LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 $ OTHER. B B AUTOMOBILE LIABILITY ANY AUTO X 7093432 (MA) 7093433 (FL) 01/01/2018 01/0it2018 01/0112019 01/01/2019 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 X BODILY INJURY (Per person) $ B OWNED A OS ONLY SCHEDULED AUTOS 7093434 (AOS) 01/01/2018 01/01/2019 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ X UMBRELLA LAB X JOCCUR XS002072(18) 01/01/2018 01/01/2019 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 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) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 014122426(AOS) 014122427 (CA) 014122430 (FL) 01101/2018 01/0112018 0110112 119 01/01/2019 01/01/2019 X I 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 F E&O / PROFESSIONAL LIABILITY 10 HH 032657918 01/01/2018 01/01/2019 EA. CLAIMIAGG(SIR $500,000 10,000,000 (INCLUDING NETWORK SECURITY) PRIVACY EVENT EXPENSE EA. CLAIM/AGG (SIR $250,00 $5M $15M DESCRIPTION OF OPERATIONS / LOCATIONS I 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. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Attn:Ed.Bonnene 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 9)1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD