HomeMy WebLinkAboutCertificate of InsuranceACORO® CERTIFICATE OF LIABILITY INSURANCE ogre lYwTxNrnn
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TNITRTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLE .THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATWELY 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), AUTHONU ED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the cerliRute holder is an ADDITIONAL INSURED, Na p,Ilcy(les) must have ADDITIONAL INSURED provisions or be endomed.
It SUBROGATION IS WAIVED, subject to the terms and conditions of Ne policy, ceriale policies may require an endorsement A statement on
p)Js cerDRcate does not confer rights to the certillcate holder in lieu of such endorsemen4s).
Pdd ckR CVxe°CT Melba Loveless
Atlas Insurance Group a Rink Strategies Company I VMIE \ (954) 6532830 iuC.xa:
3250 N 29th Ave
ADDRESSIhbvelasa®a11as4nsurance mm
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H011,vood FL 33020 FISVRERA: COvugton perla y o
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M. Land Services LLC W.M.
PO Box 385 ..R. D.
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Roseland FL 0952 Nw. F:
RMSION
COVERAGES
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SHCEAFFOY HAVE SEEN
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AIMS.
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,CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EMeaTIR DATE THEREOF, NOTICE WILL BE DEIWERED IN
Cuy of Sebaslan AttOROAMCEYAM T!F Pol1CY RIOVISIONS.
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Sebe l.en
O 198842815 ACORD CORPORATION. All Iighb reserved.
ACORD 25 (2016103) The ACOR D name and logo a re registered marks of ACORD
MICCO-1 OP ID: IR
Al6ft u CERTIFICATE OF LIABILITY INSURANCE
DA08122TE 12 6
08/2212016
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 policytes) 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
Atlass-Merritt Island
26 Oleander Street
Cocoa, FL 32922
Russell Jamieson
NNE:CT Kendra Franklin
PHONE
A1C No E :954525-0582 Alc No: 954525-0586
AOORRESS: kfranklin atlassinsurance.com
INSURERS) AFFORDING COVERAGE NAIL /
INSURER A: COVI ngtonS ecia Ity Ins. Co. 13027
INSURERS: Progressive Insurance 10193
INSURED Micco Land Services LLC
PO Box 365
INSURER C:
Roseland, FL 32957
02/11/2016
INSURER D
INSURER E
PREMISESIEaoicwreor- 50,00
CCIVFR GG FR
WSURERF:
KtV101UN NUMBLK:
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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
INS RSM
LTR
A
TYPE OF WSURANCE
GENERAL LIABILITYEACHOCOJRREIP:E
I
POLICY NUMBER
MMA)DIYYYY
MMIODIYYYY
LIMITS
FXCOMMERCIAL
FV-1
VBA 36260800
02/11/2016
02/11/2017
1,000,00AIMSMEDE
PREMISESIEaoicwreor- 50,00
MEDE:P IAnY one p -,;en) c 5,00
PER' ONAL"AGVIMP. ? 1,000,000
C-E4rL AGGRE AFP -1 PER
PRO.
POLICI 0 JE -T L0'
OTHEF
iEIJER AL AGGREGATE 9 2,D0o,00
PP:'DU'=TS-_CWPPOP AGS S 1,000,000
B
AUTOMOBILE LIABILITY
ANY AVTO
ALL �iwPlEri X SCHEDULED
AUTOS AUTOS
HIRED AUTOS NON -OWNED
AUTOS
03145275-1
05/3012016
05/30/2017
C iMCI IED SINGLE LIMIT -
Ea ac:mem p'
BODILY INJURY (Per person) ? 100,00
SODIL! INJURY (Per a udenq ? 300,00
PRracu�i:n DALtaGE ; $O,oO
❑MBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE 5
AGGREGATE S
GED RETEIJTIONI
WORNERS COMPENSATION
S
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIET! ,RIPARTNEREIECUTIVE
OF FICERIMEMBER EXCLUDED?
(Mandatory In NH)
NIA
L H-
STATUTE ER
EL EACH ACCIDENT ?
EL DISEASE - EA EMPLOYEE ?
If Yes, des<nte,,nds
DESCPIPTI,)IJOFGFERATICNSb-Ion
EL Cd =EASE - POLICI LIMIT 5
DESCRIPTION OF OPERATIONS I LOCATIONS IVEHCLES (ACORD 101, Adtlleoml Remarks Schedule, may be attached R more space is required)
CFRTIFICGTF Hnt nCo
City of Sebastian Bldg. Dept.
Fax # 772-589-2566
1225 Main St.
Sebastian, FL 32958
Arnen ee
CITYSEB
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
l
1988-2014
w-1— „a„re, unu luau are reglsrerea marks Or ACORD
reserved.