Loading...
HomeMy WebLinkAboutCertificate of InsuranceA� ® CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/ODYWY) 9/3/2024 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 AWA Insurance Agency 13700 Six Mile Cypress Pkwy Suite# 1 Ft.Myers FL 33912 INSURED JM Underground Utilities LLC 59 S Oak St Fellsmere FL 32948 INSURER F: 43389 COVERAGES CERTIFICATE NUMBER: 1565728568 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 ADDL POLICY EFF POLICY EXP LTR TYPE OF INSURANCE iNAn m POLICYNUMBER I sUDD/YYYYJI MAI YEXP LIMITS e X COMMERCIALGENERAL LIABILITY 01002181501 12/13/2023 12/13/2024 EACH OCCURRENCE $1,000,000 CLAIMS -MADE � OCCUR d $100,000 I GEML AGGREGATE UMITAPPUESPER RPOLICY � J� LOC OTHER C AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEOULED AUTOS ONLY AUTO X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY B X UMBRELLA LIAR Xd OCCUR EXCESS LIAB CLAIMS -MADE DEO I I RETENTIONS A YYORIO:RS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNERIEXECUrIVE OF FIDE WMEMBEREXCLUDED? 0 1 Intend Marine 64-279311-00 01002749010 12403 NIA EIM065856306 MED EXP GENERALAC PRODUCTS- 1/20/2024 I 1/20/2025 COMBINED SINGLE LIMIT I $1.000,000 Me accident) BODILY INJURY(Perpensw) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE $ (Per auitlant) 12/21/2023 12/13/2024 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 �$ 12/12/2023 2272024 12/12/2024 I EL DISEASE -POLICY LIMIT I $1,000.000 2/272025 Sdtedulad Equipment ( 334,496 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) 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 ACCORDANCE WITH THE POLICY PROVISIONS. Procurement/Contracts Manager 1225 Main Street AUTHORIZqO\REPRESENTATIVE Sebastian FL 32958 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD