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HomeMy WebLinkAboutCertificate of InsuranceINIEUILt1WYtTt1 ACORO CERTIFICATE OF LIABILITY INSURANCE si.nizo�s THIS THIS OERIIR DOE IS ISSUEi) AS A MATER OF INF-0R'dAMEN ONLY AND CONFERS NO RIGHTS UPON THE CER MCA HOMER THIS GLATR GOES NOT INSURANCE OR NEGATIVELY AMEND, EXTEND ET EEN TEE COVERAGE AEFOIi0E0 BY THE PoUCIREPREES EELOW. THIS LFRIIRCAT OF IN5SIRANCE DOES NOT CONSIILCE A CONRNOT BETWEEN Ti'c ISSUING INSUFER(E), pLTEOPo2EDREPFEEEMATIVE OR PRODUCERAND THE CERTIFICATE HOMER IMPORTANi:H drewhficea4W der isan AOOITONdLINSUfEO, tl»pdicy(Iesl Itus Have ADDITON.WNSURED prOYldasor beeltlasd. HSU6%DGACIONISYUNED SJyjectb lhs¢nTa arltl wdiSClscf Ihs Pdiry,cer3in PdiciasrtoYregulreansManelrem.ASatr.Terton :^is cer6Eca's dcesxtc0ltar right b h wr.'flcah id �Fiau et ach xtlmenenMa7. mmcs HmE GEICO { 0,e MOO E3'JF_.'✓Qd I a�tk. ESI. �-�•SD�'9i�i I fu ual.I FeYctloE•Jr9 va Let] I Emil RlCON4IIZ@G9C0.COM 111 A2tlran: I.vSJ'ncyS4'FOiRG C]YERAGS NNL {� INSIfE.RP IX,"TL3L2 'v:PL��2 2N6D?A[(L=COPIPT.VY 2EOfi3 rN`yJpy IINSIREiY E. I IIwaB E { SERF CERIIRCACE NUM , REVISION NUMPER T.;5 15-J r' S m' i TSE IAICIE$ G,,j OR tNLEU`T.S 3El.ON M4E FE31 R OTHER THE INSIF WmN FE A C TO WHICH RLLGERPM TEWY ED. f,.—ev.'r,T5rz•: w•4 �.v FEx1F_.vdt{ T5A1F LQJDRICN iM' CLMIb.LT OR OTHER CIS SUBJR T TO i THE TO WHICH LUSS LERfIFlLATENAY NS C; FvJAms ?E l 1 of l 'E i FEI)U EY THE F) CFS CES�PoSF➢ HERON IS SI�ECT i0 N1 THE i EPo.IS. FXCLt1SCN5uD LCeDOKAE 6 S.rUrJIICIB J.IIT59+.""Y,T.'.K'llv+:u 3EYlR*JULE'19y PA!CCLA151$ VSRpCE I xRJ I V/t9 PXYMIMS �Lvl 4y1FmY J2 WRI $ 1 I � M�IM,a,�H�l $ � J EawY Ru.� $ N1TCN'SLE Dai,-� 1 I II—��v�sues tca (YaL ry n4f1 i w-tea.=rrars arz.�us hem. pE:LA1Pt�CNOEOFERtTXHISILIX'_IiWNS•VEIIKLiS ;YARD tOT AEGReIu; RemaMZ SCnmule. may0eattachmll moreapa¢IsrtpulreEl CERMCAMc HOMER CANCELLATON SYWLO AW OF THE NeWE DESCIE® RLCIES FE eeHCP I E BEFORE THE DA TCN DATE THERE . HW7Ce .T W 15E13 IN fLCOpN10EVlITH THE PCUCY PRLNSW }'..m-, 9EAc5F-.T , ¢ Tsae¢mxoRD colsoRAnorl. aI dgltme®r..a. AC0�35Rgt90.)4 The AOORD name and logo are(gg6T,erM marks 0l ACORD cacNo sHlaE uxrt 5 IE..m.aa s't. :._. ar_; 2020 alxl N:I.R ONII . 5 103.00 9WlY tL4T'I%✓vCanv S 3N.003 mc.'ERr 0vA"� w. s..n 6 50,00 S etiH xnRImAE S Lvwm. c 5 5 Pi ory —VSSas g S EL Ct3A`£RYYL� I$ CERMCAMc HOMER CANCELLATON SYWLO AW OF THE NeWE DESCIE® RLCIES FE eeHCP I E BEFORE THE DA TCN DATE THERE . HW7Ce .T W 15E13 IN fLCOpN10EVlITH THE PCUCY PRLNSW }'..m-, 9EAc5F-.T , ¢ Tsae¢mxoRD colsoRAnorl. aI dgltme®r..a. AC0�35Rgt90.)4 The AOORD name and logo are(gg6T,erM marks 0l ACORD MOBLIIE-01 SGRUBB ,acoRO CERTIFICATE OF LIABILITY INSURANCE DAT ^/YY) s/28/20z61zo1s 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(les) 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 CONTACT NAME: Plastricige Insurance Agency 2100 N. Dixie Highway Boca Raton, FL 33431 PHONE (561 395-1433 F'ix ( ) c o Ea : ac No : 561 395-4755 E MAIL bocadocs lastrid e.com ADDRESS: @P g INSURER(S) AFFORDING COVERAGE NAICR 0912612016 INSURER A: Scottsdale Insurance Company 41297 EACH OCCURRENCE $ 1,000,00 INSURED INSURERS INSURER C MOBLEY II ENTERPRISE LLC INSURER D: 815 Brevard Avenue Cocoa, FL 32922 INSURER E: INSURER F: PRODUCTS - COMPIOP AGG $ 2,000,00 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. INSR LTR rypE OF 0 Sebastian, FL 32958 POLICY NUMBER POLICY EFF MM)DDrYN`YY POLI YUP MMIDOIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CWMS-MADE OCCUR BINDER 0912612016 0912612017 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occunence $ 100,00 MED EXP (Any one person) $ 5,00 GENL PERSONAL B ADV INJURY $ 1,000,00 AGGREGATE LIMIT APPLIES PER POLICY JECT D LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMPIOP AGG $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE E Pei -accident E UMBRELLA UAB EXCESSLIAB OCCUR CIAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENDON$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORJPARTNERIEUECUTIVE ❑NIA OFFICER,MEMBER EXCLUDED? (Mandatary In NH) H yas, describe under DESCRIPTION OF OPERATIONS below PER STATUTE ER EL EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYE $ El. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Operations: Lawn Care, Janitotial and Mobile Detailing CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014101) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Sebastian 1225 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Sebastian, FL 32958 AUTHORIZED REPRESENTATIVE ACORD 25 (2014101) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MOBLIIE-01 SGRUBB s�cofzo CERTIFICATE OF LIABILITY INSURANCE DAT1YYY) 91/2812028/2016 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 endomement(s). PRODUCER CONTACT NAME: Plastridga Insurance Agency 2100 N. Dixia Highway Boca Raton, FL 33431 PHONE FAX a Eat:(561) 395-1433 Arc Na: (561) 395.4755 AIL ADoRess: bocadocs@plastridge.com INSURERIS) AFFORDING COVERAGE NAIC9 09126/2017 INSURER A: Scottsdale Insurance Company 41297 PREMISES Eaocwrrence $ 100,00 INSURED INSURERS: INSURER C: MOBLEY 11 ENTERPRISE LLC D: Scottsdale Insurance Company 815 Brevard AvenuewsuRER Cocoa, FL 32922 INSURER E: 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE N D D POLICY NUMBER POLICY EFF MWDDNYYYI POLICY EXP (MWDDrNYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR BINDER 0912612016 09126/2017 EACH OCCURRENCE $ 1,000,00 PREMISES Eaocwrrence $ 100,00 MED EXP (My one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GENL AGGREGATE LIMIT APPLIES PER POLICY 0 JERT F-1 LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGO $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ PROPERTYDAMAGE $ Per accitlem UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION$ $ D WORK ERS COMPENSATION AND EMPLOYERS' LIABILITYYIN ANY PROPRIETORIPARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) Ora.descdbeuntler DCRIPTION OF OPERATIONS below NIA BINDER 09/26/2016 09/26/2017 STAME ER E.L. EACH ACCIDENT $ 1'000'00 E.L DISEASE -EA EMPLOYE $ 1'000'000 EL DISEASE - POLICY LIMB $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule. maybe attached Rmore apace Ia re1lulreE) Operations: Lawn Care, Janitotial and Mobile Detailing CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014101) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci of Sebastian City 1225 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Sebastian, FL 32958 AUTHORIZED REPRESENTATIVE ACORD 25 (2014101) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD