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HomeMy WebLinkAbout126171 VOLT SERVICES GROUP - INSURANCE CERTIFICATE (2)A �® CERTIFICATE OF LIABILITY INSURANCE page 1 of 1 F�ATE 03124/2017) 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). PRODUCER CONTACT Willis of New York, Inc. c/o 26 Century Blvd. P. O. Box 305191 PHONE FAX EXT)- 877-945-7378 888-467-2378 E-MAIL certificates@willis.com Nashville, TN 37230 INSURER(S)AFFORDINGOOVERAGE NAIC # INSURERA:National Union Fire Insurance Company of 19445-002 INSURED INSURER B: National Union Fire Insurance Company of 19445-008 Volt Workforce Solutions A Division of Volt Management Corp. INSURERC:New Hampshire Insurance Company 23841-001 INSURERD:�erican Home Assurance Company 19380-001 2401 N Glassell Street Orange, CA 92865 INSURERE:Illinois National Insurance Co. 23817-002 INSURER F: COVERAGES CERTIFICATE NUMBER: 25303772 REVISION NUMBER: 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 DDL sn SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR Y GL3630051 3/31/2017 3/31/2018 EACH OCCURRENCE $ 1,000,000 ppRMR�ETTQQtppENTED aoccurence) $ 250,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY JET F71 LOC $ PRODUCTS-COMP/OPAGG $ $ OTHER: B AUTOMOBILE LIABILITY Y CA1921917 3/31/2017 3/31/2018 CON BINEDSINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY(Per person) $ X ANYAUTO BODILY INJURY(Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE (Peraccident) $ _ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED RETENTION $ $ C D E C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE� OFFICER/MEMBER EXCLUDED? ((Mandatory in NH) ff yes, describe under DESCRIPTION OF OPERATIONS below NSA WCO23102487 WCO23102489 WCO23102490 WCO23102491 �3/31/2017 3/31/2017 3/31/2017 3/31/2017 3/31/2018 3/31/2018 3/31/2018 3/31/2018 X E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 C workers Compensation WCO23102492 3/31/2017 3/31/2018 See above Work Comp C WCO23102494 3/31/2017 3/31/2018 section C WCO23102493 3/31/2017 3/31/2018 C WCO23102488 3/31/2017 3/31/2018 DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Service Agreement dated November 3, 2014. The City, its officers, agents and employees are included as Additional Insureds as respects to General Liability and Auto Liability, when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI D R ESENT City of Fort Collins 300 LaPorte Avenue Fort Collins, CO 80521 Coll:5052014 Tpl:2132974 Cert:25303772 © 88-2015ACORDCORPORATION.Allrightsreserved. ACORD 25 (2016/03) The ACORD name and logo are registered mark of ACORD