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Home My WebLink AboutCertificate of Insurance'4CC?R a CERTIFICATE OF LIABILITY INSURANCE DA01/25/2017) 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 CONNAME CT David Maxwell Layline Risk Management Partners 3700 Koppers Street Ste. 510 247-0550 FgIC No: MRda(v4i10) d.maxwell la lineriskm .cm INSURER(S) AFFORDING COVERAGE NAICN INSURER A: HISCOX Baltimore MD 21227 INSURED INSURER a: ROCKHILL INSURANCE COMPANY INSURER c: ASSOCIATED INDUSTRIES INS. CO., INC. Mulligan's Acquisition, LLC INSURER D: 1038 SE Ocean Blvd. INSURER E: Suite D INSURER F: Stuart FL 34996 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. ILTR TYPE OF INSURANCEADDLSUSR POLICY NUMBER POLICY EFF MMIOD POLICY EXP WMADDAnIM LIMITS X COMMERCIALGENERALLIABWTY CLAIMS -MADE 1XI OCCUR EACH OCCURRENCE S 1,000,000 PREMISES Ea occumencel S 100,000 MEDEXP(Anyone Parson) S 5,000 PERSONAL &ADV INJURY S 1,000,000 A X MPL1856945.17 01/31/2017 01/31/2018 GENERALAGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JET [X] LOC PRODUCTS-COMPIOP AEG S 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea a¢itlent BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS _ PROPERTY DAMAGE $ Per accitlenl _ S X UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 2,000,000 B EXCESS UAB CLAIM9-MADE X FF015766-01 01/31/2017 01/31/2018 AGGREGATE S 2,000,000 DED I I RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y C �ICERIMEMSER EXCLUDEPROPRIETORIPARTNED ECUTIVE ]YN (Mandatory in NH) NIA AWC1060857 01/31/2017 01/31/2018 PEROTH- STATUTE ER E.L. EACH ACCIDENT $ 1.000,000 E.L. DISEASE -EA EMPLOYEE S 1,000,000 Ir yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 Liquor Liability Per Occurence $1,000,000 A MPL1856945.17 01/31/2017 01131/2018 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddKional Remarks Schedule, may be attached Hmom apace is required) 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. 1225 Main Street AUTHORIZED REPRESENTATIVE Sebastian Fl- ACORD L ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD