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Home My WebLink About552492 ANYTIME LABOR DBA LABORMAX STAFFING - INSURANCE CERTIFICATE (3)ACOR1j' CERTIFICATE OF LIABILITY INSURANCE 66._� 3/1/2019 DATE(MM/DD/YYYY) 2/23/2017 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). Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816)960-9000 CONTTPRODUCER NAME: T HONE A/C, No, Ext : (AIC, No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Everest National Insurance Company 10120 INSURED ANYTIME LABOR - COLORADO LLC 1349554 dba: LaborMAX Staffing 971 PREMIER DRIVE INSURER B : XL Specialty Insurance Company 37885 INSURER C INSURER D : KEARNEY MO 64060 INSURER E INSURER F : COVERAGES ANYLA01 CERTIFICATE NUMBER: 13413831 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERALLIABILITY Y N 91ML.000142-181 3/1/2018 3/1/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREMISESOEa occur ence 1,000,000 MED EXP (Any oneperson) 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY❑ PE � LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000 000 OTHER $ A AUTOMOBILE LIABILITY Y Nl 91 ML000142-181 3/1/2018 3/1/2019 COMBINED SINGLE LIMIT Ea accident s 1,000,000 BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident $ XXXXXXX X AUTOS ONLY X AUUTOS ONLDY Peer accidenDAMAGE $ XXXXXXX $ XXXXXXX A X UMBRELLA LIAB X OCCUR N N 91CU000143-181 3/1/2018 3/1/2019 EACH OCCURRENCE $ 5,000000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DEC) I I RETENTION $ $ XXXXXXX B AND YERS'LIAILIT AND EMPLOYERS' LIABILITY y / N ANY OFF ICER/MEMBER EXCLUDED? PROPRIETORIPARTNER/EXECUTIVE FN I (Myandatory in NH) if DESCRIPTION OF OPERATIONS below N / A N RWD3000731-03 3/1/2018 3/1/2019 X STATUTE OER E.L. EACH ACCIDENT $ j ,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE -POLICY LIMIT 1,000,000 A CRIME (EMPLOYEE DISHONESTY INCL. N N 91CR000014-181 3/1/2018 3/1/2019 $1,000,000PER OCC $10.000 DED THIRD PARTY THEFT DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF FORT COLLINS IS AN ADDITIONAL INSURED WITH RESPECT TO THE GENERAL LIABILITY AND AUTO LIABILITY COVERAGES, ONLY AS REQUIRED BY CONTRACT, SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. CERTIFICATE HOLDER CANCELLATION 13413831 City of Fort Collins Traffic Operations 626 Linden Street Fort Collins CO 80524 ACORD 25 (20161031 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 .- ',t 147 0)108-2015 ACORD CORPORATION- All rights rpsprvpd The ACORD name and logo are registered marks of ACORD