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HomeMy WebLinkAboutCertificate of InsuranceA� CERTIFICATE OF LIABILITY INSURANCE OnrE104/20/rvyr) Accle: 3058928 I 09/04/2024 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 endomement(s). PRODUCER AON RISK SERVICES SOUTH, INC 3550 LENOX ROAD NORTHEAST, SUITE 1700 ATLANTA, GA 30326 INSURED Heavy Civil Inc 8230 210th Street S Boca Raton, FL 33433 844-398-0470 _ INSURER(S) AFFORDING COVERAGE NAICa INSURERA: Indemnity Insurance Comoanv Of North America 43575 INSURER F : I 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. I�TR TYPE OF INSURANCE ADOL SUER POLICY EFF POLICY E%P fNsa Wvn POLICY NUMBER IMMIDD/YYYYI fMMIDDM'YYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE Is CLAIMS -MADE OCCUR DAMA ET RENIEU .Mm$$ _ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT LOC PRODUCTS-COMP/OPAGG I $ OTHER: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS ANON -OWNED UTOS UMBRELLA LIAB CCUR EXCESS LI IAB COLAIMS-MADE DED RETENTION$ WORKERS COMONSATION AND EMPLOYERS' LIABILITY YIN OFFICEANY MEMBERIPARTNDED? UTIVE ❑ NIA C57196725 03/24/2024 12131/2024 A OFFICERIMEMBER EXCLUDED. (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below I$ COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY(Par person) $ BODILY INJURY(Per awl4ent) $ PROPERTY DAMAGE Par PERTRTnil $ I$ EACHOCCURRENCE $ AGGREGATE $ $ X PER OTH- STATUTEER _ $ 1,000,00) DE E.L. EACH ACCINT E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE -POLICY LIMIT I $ 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 10I, Additional Remarks Schedule, maybe attached If more space Is required) HOLDER City of Sebastian 1225 Main Street Sebastian FL 32958 ACORD 25 (2016/03) CANCELLATION 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 r ©1988.2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD HEAVCIV-01 .d►llw o CERTIFICATE OF LIABILITY INSURANCE DATE 91312024 (MMIDDIYYYY) 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 endor @megt(s). PRODUCER License # 958967 CRUTACT assle Stewart HUB International Limited PHONE FAX 5600 New King, Ste. 210 INC, No, Ext): (248) 602-4286 (AIC, No): Troy, MI 48098 JDoNFss: cassies@jlains.com INSURERtS) AFFORDING COVERAGE NAICP .INSURER A: Admiral Insurance Company 24856 INSURED INSURER B:Ohio Security Insurance Company 24082 Heavy Civil, Inc. INSURER C:StarstoneNational Insurance Company 25496 8230 210th Street S INSURER D : Boca Raton, FL 33433 -- - INSURERE: 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, _EXCLUSION_ S AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUO l I R TYPE OF INSURANCE INAn .Ua l POLICY NUMBER POLICY EFF POLICY EXP UMMmnMW"� r. umnrwwt LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE �$ 1,000,000 culMs-MADE � OCCUR CA00005364201 _ RENTED 612712024 6/2712025 °REMISES�Ea 300,000 LK oa $ NED EXP( Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GEM. AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE- I $ 2,000,000 _ jl POLICYJECT I_ J LoC PRODUCTS - COMPIOP AGG$ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY IIBKS58347963 COMBINED SINGLE LIMIT len0.—Pe, - - $ (EaacANY 1,000,000 AUTO 312612024 3126/2025 BODILY BODILY INJURY (—'er person) $ OWNED SCHEDULED OWNS ONLY AU��TµryO.ppSWULNEEDp BODILY INJUpRgYMLPer accident), $ X AUTOS X AUTOS ONLY ONLY (Perrac6dent)-AGE $ $ C X UMBRELLA LIAB X_ OCCUR EACH OCCURRENCE $ 1,000,000 Excess LIAB CLAIMS -MADE US058347963 3126/2024 3128I2025 _AGGREGATE- _- $ 1,000,000 DED X I RETENTION$ O $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PatoryROPREIIETggO��RRqJPARTNER/EXECUTNE YIN IManUERIMi NN) EXCLUDED. N/A If yes, descnbe umber DESCRIPTION OF OPERATIONS below PER ISTATUTE I EORH E.L EACH ACCIDENT I_$ E.L DISEASE - EA EMPLOYEE $ E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is requlmd) City of Sebastian is listed as additional Insured as respects to general liability as required by written contract. Job Name: Concrete Services Job Number: 24-17-ITB Job Address: Various locations Sebastian, FL CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Sebastian THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1225 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Sebastian, FL 32958 AUUTTHHO'REZyEnDrrRREPRESENTATIVE �'~` r' ACORD 25 (2016103) 01988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD