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HomeMy WebLinkAbout2024 - 2025 Certificate of InsuranceE (MMDNYYY) A� o® CERTIFICATE OF LIABILITY INSURANCE I OAT4110/2024 04110I2024 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 have ADDITIONAL INSURED provisions or 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 )feu of such endomement(s). PRODUCER I CONTACT Brittany Gautney NAME: Stahl & Associates Insurance Inc. PHONE (863) 688-5495 FAX (863) 688-4344 r C. No. Eat): INC. No): 91 Lake Morton Drive ADDRESS: certificateslakeland@stahlinsurance.com P O Box 3608 I INSURER(S) AFFORDING COVERAGE NAIL p Lakeland FL 33802 INSURERA: Southern Owners Insurance Co 10190 INSURED INSURER B: FFVA Mutual Insurance CO 10385 Guardian Community Resource Management Inc I INSURER C: United States Liability Ins Co 25895 3020 Bruton Rd I INSURER D: I INSURER E : Plant City FL 33565 I INSURER F: COVERAGES CERTIFICATE NUMBER: 24-25 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 AuuL suety POUCYEFF POLICY UP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER IMMIDD/YYYYI IMMIDO/YWYI LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE g OCCUR t�XXCU nlracWA Coverage Included 72261676 G�E IN'LAGGREGATE LIMIT APPLIES PER POLICY °EC LOC — OTHER AUTOMOBILE LIABILITY ANYAUTO A OWNED SCHEDULED 72261676 AUTOS ONLY AUTOS xHIRED HW NO AUTOS ONLY AUTOSS ONLY ONLY X UMBRELLA LIAS OCCUR A EXCESS LIAB CLAIMS -MADE 4657373401 DED X RETENTION S 10,000 WOO(ERS OMfI NSATION AND EMPLOYERS' LIABILITY YIN B ANY PROPRIETORIPARTNERIEXECUTIVE NIA WC84000183642024A OFFICERIMEM8ER EXCLUDED' (Mandatory In NH) If vas, descri re under I EACH OCCURRENCE UAMAGE r0 RENTED PREMISES (Ea omemaricm MED EXP (Any one Person) 05/03/2024 05/03/2025 I PERSONAL a ADV INJURY GENERALAGGREGATE PRODUCTS-COMPIOPAGG COMBINED SINGLE LIMIT (Ea acodentl BODILY INJURY IPer person) 05/03/2024 05/03/2025 I BODILY INJURY(Per ac Nma PROPERTY DAMAGE IPersoodentl EACH OCCURRENCE 05/03/2024 05/03/2025 AGGREGATE I XI PER I I ERH 01/02/2024 01/02/2025 E.L. EACHACCIDENT E.L. DISEASE -EA EMPLOYEE DESCRIPTION OF OPERATIONS NJ. I E.L. DISEASE - POLICY LIMIT -- _ - - -- - ---------.--_ _ Professional Liability E&O - - Annual Aggregate — -- C SP7014974P 04/13/2024 04/13/2025 Each Claim i Deductibel DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more span is required) CERTIFICATE HOLDER CANCELLATION $ 1,000,000 E 300,000 E 10,000 $ 1,000,000 E 2,000,000 E 2,000,000 s g 1,000,000 S S E E S 2.000,000 E 2,000,000 E I E 1,000,000 E 1,000,000 E 1,000,000 $2,000,000 _ I - $1,000,000 $1,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Sebastian -Sebastian Entitlement CDBG Admin ACCORDANCE WITH THE POLICY PROVISIONS. 1225 Main Street AUTHORIZED REPRESENTATIVE �f Sebastian FL 32958 R%Q 4¢ , 15" I J�P(fC/[�[� iir ir4LW�4 ©1988.2015ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ACC)R 0® CERTIFICATE OF LIABILITY INSURANCE I DATE(MMIDD/YYYY) D4/10/2024 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 have ADDITIONAL INSURED provisions or 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 I CONTACT Brittany Gautney NAME: Stahl 8 Associates Insurance Inc. I PHONE (863) 688-5495 FAX Exile rA/C.1 (863) 688-4344 /AID. No. 91 Lake Morton Drive I ADo ESS: certificeteslakeland@stahlinsurance.com P O BOX 3608 I INSURER(S) AFFORDING COVERAGE Lakeland FL 33802 INSURERA Southern Owners Insurance Cc INSURED Guardian Community Resource Management Inc 3020 Bruton Rd INSURERS: FFVA Mutual Insurance Co INSURER C: United States Liability Ins CO INSURER D: INSURER E: NAIL k 10190 10385 25895 Plant City FL 33565 I INSURER F: COVERAGES CERTIFICATE NUMBER: 24-25 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH PO.ICIES. LIM"TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ITR TYPE OF INSURANCE DIED aWYO POUCYNUMBER (MVUK MIUDDY/YYYYI IMMNDY/YYYYVI LIMITS I X COMMERCIAL GENERALUABILITY EACH OCCURRENCE S 1,000,000 CLAIMS -MADE © OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) S 300,000 Contractual Liability MED EXP(Any one careen) S 10.000 A u XCU Coverage Included 72261676 05/03/2024 05/03/2025 I PERSONAL SADV INJURY $ 1,000,000 GEN'L AGGREGATE LIM IT APPLIES PER I GENERALAGGREGATE $ 2,000,000 RO- POLICY Pi LOC I PRODUCTS-COMPIOP AGG S 2,000,000 OTHER'. S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea actident) $ 1,000,000 _ ANVAUTO I BODILY INJURY (Par parson) S A OWNED �( SCHEDULED 72261676 05/03/2024 05/03/2025 BODILY INJURY IPar acadanll AUTOS ONLY AUTOS HIRED x NON-0WNEO P mY GAMA E $ III^yNIII AUTOS ONLY AUTOS ONLY 'ParecrJdentl E X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000000 A EXCESS LIAR HCLAIMS-MADE 4657373401 05/03/2024 05/03/2025 AGGREGATE g 2,000,000 DED �XI RETENTION 3 10,000 $ WORKERS COMPENSATION XI PER I OTH AND EMPLOYERS' LIABILITY N YIN PROPRIETOR ER/EXECl1TIVE STATUTE ER 1.000.000 B ANY MN NIA WC84000183842024A 01/02/2024 01/02/2025 EL. EACH ACCIDENT $ ER EXCLUOEO? EXCLUDED 1,000000 (MandatoryIn (Mandatory In NH) EL. DISEASE-E4EMPLOYEE g If ves describe under DESCRIPTION OF OPERATIONS below EL. DISEASE -POLICY LIMIT $ 1,000,000 --- - -- - — — --.-- --.— _ Aggregate $2,000,000 Professional Liability E80 _Annual C SP1014974P 04/13/2024 04/13/2025 Each Claim $1,000,000 Deductibel $1,000 DESCRIPTION OF OPERATIONS LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mom space Is requlredl CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Sebastian -Sebastian Entitlement CDBG Housing Rehab ACCORDANCE WITH THE POLICY PROVISIONS. 1225 Main Street AUTHORIZED REPRESENTATIVE AA Sebastian FL 32958 Rok rf Z. SAW �d I (WGW A LG(�Z�G ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD kA �cr 40 Iff