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HomeMy WebLinkAboutCertificate of Insurance - AirportDATE A` )RbF CERTIFICATE OF LIABILITY INSURANCE /21/2MIODmYYI 10/21/2016 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). PRODUCERN ACT NAME Marsh Sponsored Programs HONE FAX .800-338-1391 No 868-621-3173 a division of Marsh USA Inc. EMAIL PO Box 14404 ADDRFSSacecclientrequest@marsh.com Des Moines IA 50306 INSURERISI AFFORDING COVERAGE NAIC At INSURED Infrastructure Engineers, Inc. 12596W. Bayaud Avenue Lakewood, CO 80228-2000 COVFRAGFS CFRTIFICATF Nt1MRFR- RFVISION NUMRER- 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 TYPEOF INSURANCE ADDLSUBR POLICY NUMBER POUCYEFF MD MI POUCYEXP MMIDDl LIMITS A GENERAL LIABILITY Y 84SBWBS5307 11/01/2016 11/01/2017 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL UABU`FY CLAIMSMADE IOCCUR Prof. Liab. Excl. DAMAGE'rORME1D PREMISES (Ea o¢urrenca 81,000,000___ MED EXP (Any one person) 510,000 PERSONAL S ADV INJURY $2,000,000 X Val. Papers $250k GENERALAGGREGATE $2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $2,000,000 POLICY FX1P LOC $ B AUTOMOBILE LIABILITY Y 84UEGRF5137 11/01/2016 11/01/2017 COMBINED SINGLE LIMIT E ... card) S11000,000 BODILY INJURY (Par parson) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par acemant) $ PROPERTY DAMAGE $ racdderrt NONAWNED HIRED AUTOS AUTOS $ A XUMBRELLA LIAR X OCCUR Y 64SBWBS5307 11/01/2016 11/01/2017 EACH OCCURRENCE $8,000,000 AGGREGATE _ $6,000,000 EX UAB MS -MADE OEC X RETENTION SIO 0,00 S WORK ERSCOMPPRSATION ANDEMPLOYERSLIABILITY YIN WC STATU- OTH- TORY LIMITS ER ANY PROPRIETORIPARTNER/ ECUDVEEL EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? F-1 NIA (MmmMo7m'NHJ— -- - — - — - E.L DISEASE-. EA EMPLOYEE _ It yes, describe under DESCRIPTION OF OPERATIONS below E.LDISEASE.PCUCYLIMT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 707, Additional Remarks Schedule. N more space Is required) RE: City of Sebastian Continuing Engineering Services; IEI 4121B9FL00.00 - When required by written contract: City of Sebastian is included as additional insured for above coverages. City of Sebastian Attn: Jean Tarbell 1225 Main Street SebastiaD, FL 32958 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 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD OP ID: JMC AC"M6 ' �.� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 06125/13 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 800 - 338 -1391 ACEC /MARSH 888 - 621 -3173 701 Market St., Ste. 1100 St. Louis, MO 63101 Kevin P. Woolley CONTACT NAME: PHONE FAX A/C No Ext : AIC No): E -MAIL ADDRESS: PRODUCER INFRAEN CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Infrastructure Engineers, Inc. INSURER A: Hartford Accident & Indemnity EACH OCCURRENCE Infrastructure Investment Group, LLC 1460 John B. White Sr.,Ste. 1C INSURERB: $ 1,000,000 INSURERC: X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F7X OCCUR Spartanburg, SC 29306 INSURER D: 11/01/13 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 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 DD R POLICY NUMBER MM DDIIYYYY MMIDDfYYYY LIMITS 1225 Main Street GENERAL LIABILITY �_ Gt. EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F7X OCCUR 84SBWBS5307 11/01/12 11/01/13 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,00 PROFESSIONAL LIAB EXCL GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY X PRO- LOC $ A AUTOMOBILE X LIABILITY ANY AUTO 84UEGRF5137 11/01/12 11/01/13 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ X NON -OWNED AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 8,000,00 AGGREGATE $ 8,000,000 A EXCESS LIAR CLAIMS -MADE 84SBWBS5307 11101/12 11/01/13 DEDUCTIBLE $ X $ RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? r N/A WC STATU- OTH- T RY L MITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: City of Sebastian Continuing Engineering Services; IEI #12189FL00.00 - When required by written contract: City of Sebastian is included as additional insured for above coverages. CERTIFICATE HOLDER CANCELLATION CITYOF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Sebastian Attn: Jean Tarbell AUTHORIZED REPRESENTATIVE 1225 Main Street Sebastian, FL 32958 �_ Gt. © 1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD A' ( CERTIFICATE CERTIFICATE CAF LIABILITY INSURANCE 6/25/2013Y) 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 certlficate 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 International Special Risks, Inc. 50 Salem Street Building B, 3rd Floor Lynnfield MA 01940 CONTACT Divin Cont NAME; Assoc . 9 PHONE (781)295 -0270 AX (781) 246-7830 A60RE INSURERS AFFORDING COVERAGE NAIL0 INSURERA:Commerce and IndustrV Insurance 19910 INSURED Infrastructure Engineers Inc. Infrastructure Underwater Inc. 2121 Old Hickory Tree Rd. St. Cloud FL 34772 INSURER B:Ll4 dI s of London INSURERC: INSURERD: INSURER E: $ INSU ERF: COMMERCIAL GENERAL LIABILITY COVERAGES CERTIFICATE NUMBER:Blanket 12 -13 RFVIRInN NIIMRFR- 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 AIIDLSU13R POLICY NUMBER POLICY EFF MM D fYYYY) POLICY EXP (MMJDDNWYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAM GE 0 - PREMISES Ea a oc occurn=nce $ MED EXP (Any one person) $ GLAIMS -MADE EJ OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ MIL AGGREGATE LIMIT APPLIES PER PRODUCTS -GO MPIOP AGG $ POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGER LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULEb AUTOS AUTOS BODILY INJURY Per accident $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X I WC STATU- J OTH- E.L. EACH ACCIDENT $ 110001000 ANY PROPRIETORIPARTNERJEXECUTIVE OFFICEWMEMBER EXCLUDED? ❑ (Mandatory In NH) H yes, describe under DESCRIPTION OF OPERATION below N I A 586 ^79 -32 Includes USL &H Coverage /9/2012 /9/2013 E.L. DISEASE - EA EMPLOYE $ 1 000 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Maritime Employers PG004690B 9/9/2012 /9/2013 any one eccldent1disease $1,000,000 Coverage (Jones Act) DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) 30 day notice of cancellation except 10 days for non payment of premium. Project: City of Sebastian Continuing Engineering Services IEI# 12189FL00.00 CERTIFICATE HOLDER rANrFLLATIPIN ACORD 25 J201 0105) INS025 poiom).oi (9 ) 1988 -2010 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Sebastian ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Jean Tarbell AUTHORIZED REPRESENTATIVE 1225 Main ,Street Sebastian, FL 32958 Steve Macquarrie /JAMI ACORD 25 J201 0105) INS025 poiom).oi (9 ) 1988 -2010 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD INFRA -1 OP ID: DO CERTIFICATE OF LIABILITY INSURANCE COVERAGES CERTIFICATE NUMBER: 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 DATE 06 /26 /2013Y) 06/25/2013 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 Phone: 321-445 -1117 Jackson, Collinsworth & Fax: 321 -445 -1076 Johnson Insurance Agency, LLC. 2208 Hillcrest Street Orlando, FL 32803 Mark E. Jackson CONTACT NAME: Donna Casenove HONE 321 -445 -1860 FAX (PAC. No Ext : A /C, .):321-446-1076 ADDRESS: Certs@jcj- insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: U-S. Specialty Ins. Co. LIMITS INSURED Infrastructure Engineers, Inc. 1460 John B. White Sr Bivd. #1C Spartanburg, SC 29306 INSURER B: INSURER C: INSURER D: INSURER E: $ INSURER F: $ COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE Attn: Jean Tarbell ACCORDANCE WITH THE POLICY PROVISIONS. POLICY NUMBER POLICY MMIDD/YYYY MM /DDfYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ �6 RENTED PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN TORY LIMITS I ER E.L. EACH ACCIDENT $ ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liab USS1223380 10/17/2012 10/17/2013 Aggregate 2,000,00 Retro Date 1/30/94 Per Claim 2,000,00 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) REF: City of Sebastian Continuing Engineering Services. IEI #12189FLOO.00 CERTIFICATE HOLDER CANCELLATION CITYSEB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Sebastian ty THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Jean Tarbell ACCORDANCE WITH THE POLICY PROVISIONS. 1226 Main Street AUTHORIZED REPRESENTATIVE Sebastian, FL 32958 _D� 01988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD '4� �® CERTIFICATE OF LIABILITY INSURANCE DATE 9/2/2016 ) 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(les) 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 KeenanSuggs 1330 Lady Street Columbia SC 29201 CONTACT Michelle GOOdNin NAME: PNONE (803)799-5533UVC, Nol.(803)771-0166 E"PAIL .mgoodefin@keenansuggs.com INSURERS AFFORDING COVERAGE NAIC 9 INSURER A:Travelers Property Casualty Co 25674 INSURED Infrastructure Consulting 6 Engineering PLLC 1021 Briargate Circle Columbia SC 29210 INSURERB:PhoeniX Insurance Co 25623 INSURERc-Arch Insurance Co 11150 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2016-2017 toaster 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 LTR TYPEOFWSURANCE ADDLISU13R INSR MID POLICY NUMBER POLICY EFF MM POLICY EXP MMIDwl LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X 6302G750322 9/6/2016 9/6/2017 PREMISES occurrent $ 100,000 MED EXP one person) 3 5,000 PERSONAL 8 ADV INJURY $ 1,000,0001 GENERAL AGGREGATE 2,000GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO,000POLICY X JFcTPRO LOC AUT MOBILE LIABILITY ks:'0001 COMBINEjSINGLE UNIT 000ANYAUTO102G762787 BODILY INJURY(Perperscn) BALLOWNEDSCHEDULEDAUTOSAUr05BODILY /6/2016 /6/2017 INJURY (Per aceidm0HIREDAUTOSAUTOSNON-OWNED PeOPERTacciden DAMAGE Underinsred matonsl 11000,00 X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 A EXCESS LIAR CLAIMS -MADE X 10,00 DED RETENTION$ $ UPSBBSN464 9/6/2016 9/6/2017 * WORKERS COMPENSATION ANDEMPLOVERS'LIABILITY YIN ANY PROPRIETORIPARTNER,EXECUTIVE� OFFICERWEMBER EXCLUDED? (Mandatory In NH) NIA B2G779721 9/6/2016 9/6/2017 WC STAT-F-OTH- X IMITS ER E.L EACH ACCIDENT $ 500,000 E.L DISEASE - EA EMPLOYE $ 500 000 Ifyes. aescnhe,nder DESCRIPTION OF OPERATIONS below -- - - — _. ___-__ _ _ __ E.L DISEASE -POLICY LIMIT $ 500,000 C Professional Liability AAEP0005600 9/6/2016 9/6/2017 Limit Each Claim $5,000,000 A Leased/Rented Equipment 6302G750322 9/6/2016 9/6/2017 L'mft $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AHaeh ACORD 101, Additional Renarics Schedule, if more space is nquind) iPR\BiiP14Ji:� City of Sebastian, FL Attn: Joseph Griffin 1225 Main Street Sebastian, FL 32958 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 Foy/MDB I — ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(2oio06).01 The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS CERTIFICATE HOLDER IS SHOWN AS ADDITIONAL INSURED REGARDING THE GENERAL LIABILITY AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. COVERAGE IS PRIMARY AND NON-CONTRIBUTORY AS STATED IN POLICY ENDORSEMENT FORM AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. 45 DAY CANCELLATION CLAUSE BEING ENDORSED ON EACH POLICY FOR THIS CERTIFICATE HOLDER AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. I OFREMARK COPYRIGHT 2000, AMS SERVICES INC. I