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HomeMy WebLinkAboutCertificate of InsuranceA� O® CERTIFICATE OF LIABILITY INSURANCE DATE IMM/20/ 17 os/zz/zo17 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). PRODUCERNTA T NAME: HIscox Inc.PHONE 978,344.4200 uc No: 520 Madison Avenue, 32nd Floor q ortEss: contactus@)nsurancebee.com INSURERS AFFORDING COVERAGE NAIC6 New York, NY 10022 INSURERA: Hiscox Insurance Company Inc. 10200 MED EXP (My ono person) $ 5.000 INSURED Nash Janitorial Service INSURER B: GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ jECT LOC OTHER: GENERALAGGREGATE $ 1,000,000 INSURER C: D: 141 San Luis Street S wINSURER Palm Bay FL INSURER E: INSURER F: 32908 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 IN$UMNCE DDLS POUCYNUMBER POLICY EFF MMIDDM'YY) POLICY EXP IMMIDONYYYI LIMITS A X COMMERCIALGENERAL LABILITY CLAIMS -MADE FXIOCCUR Y N 33326226 -GL 05/22/201705/22/2018 EACH OCCURRENCE $ 1,000,000 PREMISES Me occunence S 100,000 MED EXP (My ono person) $ 5.000 PERSONAL B ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ jECT LOC OTHER: GENERALAGGREGATE $ 1,000,000 PRODUCTS-COMPX)PAGG $ S/T Gen. Agg AUTOMOBILELUIBILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINtldED SINGLE LIMIT $ Ee eeaM BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S PROPERTYDAMAGE $ de Per eo9M UMBRELLALIAB EXCESS UAB OCCUR CWMSMADE EACH OCCURRENCE $ AGGREGATE S DEO I I RETENTION$ WORXERSCOMPENSATION AND EMPLOYERS' LIABILITY YIN MYPROPRIETORIPARTNEREXECUTNE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) (lyes, describe under DESCRIPTION OF OPERATIONS below NIA PER OTH. STATUTE ER EL. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddiSonat Remerb Schedule, maybe attached Hmom apace N required) City of Sebastian is noted as an additional insured as required by written contract. City of Sebastian 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 ©1988-2014 ACORD CORPORATION. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD A� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDNYYY) 6/20/2016 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 CONTACT NAM Customer Service Department PRONE (800) 920-4125 FAAXX o. (800)920-4107 Gaslamp Insurance Services ADDRESS:certificates@premieragencyservices.com 6/2/2016 INSURER(S) AFFORDING COVERAGE NAIC# 3234 Grey Hawk Ct. INSURER A:Pref erred Contractors Ins Co. 12497 Carlsbad CA 92010 INSURED INSURER B: INSURER C : Nash Janitorial Service INSURER D: 2 8 0 9B Jadewood Ct INSURER E: INSURER F: Austin TX 78748 COVERAGES CERTIFICATE NUMBER:GL 16-17 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. ILTR TYPE OF INSURANCE ADD UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X PCICS016-PCAS67414 6/2/2016 6/2/2017 EACH OCCURRENCE $ 11000,000 PREMMISES (EaENTED occccurrrrence) $ 50,000 MED EXP (Any one person) $ 51000 GEWL AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT LOC OTHER: PERSONAL & ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 11000,000 PRODUCTS - COMP/OP AGG $ 11000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNEDSCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED Ea accident SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ P�accident) UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATIONPTA AND EMPLOYERS' LIABILITY Y 1 N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N ! A OTH- E ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addldonal Remarks Schedule, may be attached If more space Is required) Certificate Holder is named as Additional Insured per the attached Endorsement. *Additional Insured status is subject to all policy terms, exclusions and conditions* City of Sebastian 1225 Main Street Sebastian, FL 32958 ACORD 25 (2014101) INS025 (201401) TION 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 Dave Pike/JON ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD