HomeMy WebLinkAboutInsurance Certificate: ADP TotalSource I
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 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
NAME:
PHONE
fNC No. ExO:
E-MAIL
ADDRESS:
PRODUCER
CUSTOMER 10 #: 10762287
r-""\
ACORD.
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CERTIFICATE OF LIABILITY INSURANCE
Aon Risk Services, Inc of Florida .-
Aon Risk Services, Inc of Florlda
1001 Brickell Bay Drive, Suite #1100
Miami, FL 33131-4937
800-743-8130
I FAX
(AIC.No),
ADP.COI.Center@Aon.com
INSURER(S) AFFORDING COVERAGE
INSURED
AD? TolalSource l. Inc.
10200 Sunset Drive
Miami, FL 33173
ALTERNATE EMPLOYER
National Research Center Inc
3005 30th Street,
Boulder, CO 80301
INSURER A: New Hampshire Ins Co
INSURER B:
INSURER C:
INSURER D:
INSURER E:
INSURER F:
COVERAGES
CERTIFICATE NUMBER: 345698
REVISION NUMBER;
DATE (MM/DDIYY)
06/10/11
800-522-751
NAlC #
23841
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. LIMITS SHOWN I\RE AS REQUESTED.
INSR
COR
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDI'l'YYV) DATE (MM/DDI'l'YYV)
ADDL SUBR
INSR wvo
TYPE OF INSURANCE
POLICY NUMBER
GENERAL LIABILITY
o COMMERCIAL GENERAL LIABILITY
o CLAIMS MADE 0 OCCUR
.
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Anyone person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMPIOP AGG
GEN'L AGGREGATE LIMIT APPLlES PER
D POLICY D PROJECT D LOC
AUTOMOBILE LIABIliTY
D ANY AUTO
D ALL OWNED AUTOS
D SCHEDULED AUTOS
D HIRED AUTOS
D NON OWNED AUTOS
COMBINED SINGLE LIMIT
(Eaaccident)
BODilY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
EACH OCCURRENCE
AGGREGm-e
o UMBRI:LLA LIAS OCCUR
D EXCESS LIAS CLAlMS~AOE
o DEDUCTIBLE
o RETENTION $
LIMITS
$
$ ,
$
$
$
$
$
$
$
$
$
$
$
$
$
$ 2,000,000
$ 2,000,000
$ 2,000,000
A WORKERS' COMPENSATION AND WC 012437064 CO 07/01/11 07/01f12 X I we STATU. I I OTHER
EMPLOYERS' liABIliTY TORY LIMITS
~;IC~::~~EET~~~';:06~~~XECUTlVE N/A E.L EACH ACC1DENT
(MandalorylnNH) ~ El D1SEASE-EAEMPlOYEE
Ityosdescnbeunder
. OESC","'O' 0> 0"""'0", ,.bw ( E L DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS I '''''ATI I tH'CL~ :~~'Ch~C~RL 1111 "" Sch.dol., ,f mo,,,p'" " """"d)
All worllslte employees 'NOrkmg for the above lU.I n\ company paid under ADP TOTA ~INC 's payroll are covered under the above stated polley The above named client is an alternate
employer under this policy. -.
CERTIFICATE HOLDER
City of Ashland
20 East Main Street
Ashland, OR 97520
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFDRE THE EXPIRATION DATE
THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE W(TH THE POLICY PROVISIONS,
AUTHORIZED REPRESENTATIVE
dlol1 d{.i!.I< 8e'CI'ice!>. Ql1c of cFlo'Cida
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