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HomeMy WebLinkAboutUnderwater Engineering Services COI exp 2026N / A $ $PER VESSEL, CSL (Ea occurrence)REMOVAL OF WRECK $ $ EA OCCURRENCE TOWERS (Ea occ), CSL COLLISION (Ea occ), CSL EA OCCURRENCE TOWERS (Ea occurrence) COLLISION (Ea occurrence) INSURED VALUE PER SCHEDULE ON FILE Page 1 of 2 $ $ $ ANY ONE ACCIDENT ANY ONE PERSON IN REM ENDORSEMENT DEATH ON THE HIGH SEAS EMPSINCLUDES JONES ACT CREW ALTERNATE EMPLOYER MARITIME EMPLOYERS LIABILITY NON-OPA / NON-CERCLA CERCLA OPA 90 POLLUTION LIABILITY PER CLUB RULES $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ IN REM TOWERS LIABILITY COLLISION LIABILITY JONES ACT INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : INSURER(S) AFFORDING COVERAGE NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: CUSTOMER ID #:PRODUCER PRODUCER (A/C, No, Ext):PHONE INSURED SHOULD ANY OF THE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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. SUBR WVD ADDL INSD 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. REMOVAL OF WRECK CREW LIABILITY PROTECTION AND INDEMNITY LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR HULL AND MACHINERY COLLISION LIABILITY TOWERS LIABILITY CERTIFICATE OF MARINE / ENERGY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 31 (2016/03) © 2012-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD 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). 12/30/2025 Arthur J.Gallagher Risk Management Services,LLC PO Box 100 Plattenville LA 70393 Danielle Formeller 225-278-5642 Danielle_Formeller@ajg.com UNDEENG-01 License#:0D69293 Underwater Engineering Services,Inc. 3306 Enterprise Rd. Fort Pierce FL 34982-8433 Accredited Surety and Casualty Company,Inc 26379 Berkley Casualty Company 15911 Pacific Insurance Company,Limited 10046 Transguard Insurance Company of America 28886 Samsung Fire &Marine Insurance Co LTD 689303134 E XSMCZ19040AAA12/31/2025 12/31/2026 E X X Y Y SMCZ19040AAA 12/31/2025 12/31/2026 X 1,000,000 A C X X V-22064-25 21 OH 0609171-25 12/31/2025 12/31/2025 12/31/2026 12/31/2026 5,000,000 Professional Poll.1,000,000 C D Professional 21 OH 0609171-25 IMP4004297 00Leased&Rented Equip 12/31/2025 12/31/2025 12/31/2026 12/31/2026 Per Claim 1,000,000 Any one item 25,000 Max occurrence 500,000 City of Sebastian Public Works,1225 Main Street Sebastian FL 32958 STATUTE PER OTHER: E.L. DISEASE (Ea employee) $ UMBRELLA N / A AS DETAILED IN THE DESCRIPTION OF OPERATIONSAS PER ATTACHED SCHEDULEVESSEL(S): $ $ CSL, ANY ONE OCCURRENCE (100% interest) Page 2 of 2 AGGREGATE $ $ VALUES AS SCHEDULED VALUES AS SCHEDULED VALUES AS SCHEDULED VALUES AS SCHEDULED $ $ (100% interest)ANY ONE OCCURRENCE $ $ $ $ $ $ $ $ AGGREGATE EACH OCCURRENCE $ $ $ $ $ AGGREGATE EACH OCCURRENCE OF OPERATIONS below EROTH-COMPENSATION ACT $ $ $ $ $ $ E.L. DISEASE - ANN AGG E.L. (Each accident) CONTROL OF WELL / OPERATORS EXTRA EXPENSE $ $ $ $ $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE (Ea employee) E.L. (Each accident) EROTH- STATUTE PER $ $ $ $ (Per accident) (Ea accident) PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT SHORE ON- SHORE OFF-CCC NAMED WINDSTORM CONTRACTORS EQUIPMENT OIL & GAS PROPERTY ONSHORE OIL AND GAS PROPERTY PIPELINES PLATFORMS OFFSHORE OIL AND GAS PROPERTY CARE, CUSTODY AND CONTROL (CCC) ENERGY BUMBERSHOOT UMBRELLA / EXCESS LIAB / BUMBERSHOOT NON-OWNED AIRCRAFT PASSENGER LIABILITY OWNED AIRCRAFT AIRCRAFT LIABILITY If yes, describe under DESCRIPTION MARITIME EMPLOYERS LIABILITY OCSL ACT ALTERNATE EMPLOYER U.S. LONGSHORE & HARBOR WORKERS MARITIME EMPLOYERS LIABILITY USL&H ENDORSEMENT OCSL ACT ALTERNATE EMPLOYER PRODUCTS-COMP / OP AGG GENERAL AGGREGATE PERSONAL & ADV INJURY MED EXP (Any one person) MARINE GENERAL LIABILITY PREMISES (Ea occurrence) DAMAGE TO RENTED EACH OCCURRENCE $ $ $ $ $ $ CERTIFICATE NUMBER:COVERAGES N / A SUBR WVD ADDL INSD AUTOS ONLY AUTOS AUTOS ONLY NON-OWNED SCHEDULED OWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS (ACORD 101, Additional Remarks Schedule, may be attached, if more space is required) CLAIMS MADE EXCESS OCCUR DED RETENTION $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC ACORD 31 (2016/03) HIRED AUTOS ONLY 689303134 E X X X Contractual Liab X S&A Pollution X Y Y SMCZ19040AAA 12/31/2025 12/31/2026 1,000,000 25,000 5,000 1,000,000 2,000,000 1,000,000 B X N X X X Y KRM327779225 12/31/2025 12/31/2026 1,000,000 1,000,000 1,000,000 Maritime Employers Li 1,000,000 E X Y Y SMCZ19040ABA 12/31/2025 12/31/2026 4,000,000 4,000,000 *Excess Auto Liability 3,000,000 Excess Liability follows form over Marine General Liability,Employers Liability,Auto Liability,P&I,and Pollution. Project #:COM2300038.00 Complete Certificate Holder:City of Sebastian council members,officers,employees and agents.Certificate Holder is Additional Insured with Waiver of Subrogation as required by written contract,with respects to Marine General Liability,Protection & Indemnity,and Excess Liability.Waiver of Subrogation is provided with respects to Workers Compensation as required by written contract.