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HomeMy WebLinkAboutCertificate of Insurance85/12/19 15:12:85 1-855-893-4357 -> The Hartford Page 084 A Rte' CERTIFICATE OF LIABILITY INSURANCE ( o5iivza 9 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 SUBROGATIONIS 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 endorsament(s). PRODUCER CONTACT NORTHEAST AGENCIES INC/PHS HAIII PHONE (866) 467-8730 FAX (888) 443-6112 01214608 (AIC, No. Ext): (AfC, No): The Hartford Business Service Center 3600 Wiseman Blvd C MNL San Antonio, TX 78265 ADDRESS: 03URMS) AFFORDING COVERAGE NAtC7! INSURED HECTOR R HURTADO DIBIA BUENA VISTA LAWN SERVICE 155 CHALOUPE TER SEBASTIAN FL 32958.6253 INSURER A: The Twin City Fire Insurance Company 29459 INSURER 9: 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 INDICAT'ED.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 OP INSURANCE ADOL SUBR POLICY NUMBER POLICY eFF POLICY EXP I LIMITS ,-(.TR IAML M" IMMIDOIYYYYI IV"' COMMERCIAL GENERAL UABILITY = CLAIMS MADCa OCCUR CENL ACC4tEGArC LI WT APPLIES PER POLICYa F T 0 LOC OTHER: AUTOMOBILE LIABILITY ANY AUTO ALL ONNED �! SCHEDULED AUTO$ ALTOS HIRED — NON.OMEO AUTOS AUTOS _ UMBRELLA LIAO OCCUR EXCESSUAB rLAlm MA4 OE 7Eq InerwriON $ W' .RKERB COMPENSATKTN AND EMPLOYERS' LIABILITY ANY YIN A PnCPRIETCQPARTNDLEXECUT`VC r N OFIRCEW+ W*R F.XCLUOEO? L (Mandatory is NN) If yes, dewme uadel nP.T.111111nN OF QPFRATICNS palOw EACH OC,CURRF.NCF DAMAGE TO RENTF0 PRmtsrs M2 crl MEO EXP (Any om oomw ) PERSONAL s MV 1N.AIRY GENERAL AGGRMATE PRCDIJGTS. COMMOP ACO vOMEINEV VNOW LIMIT Ma —r d—n BODILY INJIJRY (Pet W--") DOULY INJURY 01" acedew) PWOPIzK 1 T UAMAUt: (Pet swdettl) EACHOCCURRENCE IAGGREC306 X IPERI IOTH. STAIUTF FR EL EACH A=utNr Ot WEC ZX5210 06110!2019 06/10/2020 EL DISEASE -eA EN.PLCYEE E.L. 01817ASE • POLICY LIMIT $100,000 $100.000 $500.000 CEWMPTIONOPOPeRATIONSrLOCA77ONS/V�NCLES(ACORD 101,Addi OUIRONISHIS3CntJule. maybe aesohtddMott spadefytegUired) Those usual to the Insureds Operations, CERTIFICATE HOLDER CANCELLATION City of Sebastian SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Attn: Jean TaTboll BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 1225 MAIN ST IN ACCORDANCE WITH THE POLICY PROVISIONS. SEBASTIAN FL 32958 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) oK' 42114-1 0 1009-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC RU CERTIFICATE OF LIABILITY INSURANCE DaTf:If/NND/YYYY) 5/13/2017 THIS CERTIFICATEIS 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 15 WANED, 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 endorsemen s . PROpume NORTHEAST AGENCIES INC/PHS 214608 P:(866) 467-8730 F: (888) 443-6112 301 WOODS PARR DRIVE CLINTON NY 13323 eourAcr NAIVE: PHCtl (,vc.m.E.N (866) 467-8730 wc.N.): (888) 443-6112 nOD�REss. INSUREP(SAFFORDING COVERAGE NAICN INSUREPA: Twin City Fire Ins Inn te) HECTOR R HURTADO D/B/A BUENA VISTA LAWN SERVICE 155 CHALOUPE TER SEBASTIAN FL 32958 INSURER D: INSUR01C: INSURERD: INSUIEPE: 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. MR UPEDFLVSt RANGE .4001 nR PDLLCTNUIWL POLILT'LFF POLLLTR.YP Lisa" COMMERCIALGENERA-UABILfrY EACH OCCURRENCE s CLAIMS -MADE OCCUR ❑ DAMAGETORENTED PREMISES(Ea ocrurmnce) MED EXP (Any one Person) PERSONAL &ADV INJURY GEN'L AGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE POLICY JET ❑ LOC PRODUCTS-COMP/OP AGG $ $ OTHER AUTOMOBILELUIBEITY COMBINED SINGLE LIMIT _ (Ea accident) BODILY INJURY (Per parson) g ANY AUTO OWNED F SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (PeraceBerd)y PROPERTY DAMAGE s (Per acdderd) HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 5 UMBRELLALWB OCCUR EACH OCCURRENCE 5 MESSLUUI CLAIMS- DE AGGREGATE D PE ofl5 $ WdRQ!ab'CwPPFlVSaTroN NVDEVKpIFBS1GSDLr ANY PROPRIETOMPARTNERIE%ECUTIVEY/N X PER OTH- STAME ER E.L. EACH ACCIDENT 5100, 000 A OFFICERIMEMBER EXCLUDED? (Maodalory m NN) ❑ IYA OS HEC ZX5210 06/10/2017 06/10/2018 E.L. DISEASE- EA EMPLOYEE 5100, 000 E.L. DISEASE -POLICY UNIT '500, 000 It yes. descrNe under DESCRIPTION OF OPERATIONS below DESCRN+OOAI OF OP TWNS/LOCATMS/VENICIRD 101, Addiflonai Remarks Schedule, may be attached U more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED City of Sebastian BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Jean Tarbell A� REPRESFDIrAnVE 1225 MAIN ST SEBASTIAN, FL 32958 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD