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HomeMy WebLinkAbout2019TIMOR -1 OP ID: TJ ACO CERTIFICATE OF LIABILITY INSURANCE I DATE(WWDDMYY) `i 06/20/2019 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. t IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of tho policy, corlaln policies may require an andorsement. A statement on this cortificate does not confer rights to the Certificate holder In )leu of such endorsemen s . PRODUCER 772-286-4334 C �CT Tani a obson Stuart Insurance, Inc. vx E 772-286-4334 IFA- 7f286.9389 3070 S W Mapp Arc, Nq, Ex : lac. Neo Palm City, FL 34990 A. j acD bson s Ua nsurance.ne Rick Halcomb, CIC, ARM IN VREa4 AFFD0.dHO COVERAGE NAlta WSURFR A: Everest Denali Ins Cc 16044 R. National Union Flre Insurance 19445 JJ??sUcc Fpev,Rp4s'eB CI1ont WI Inc Ns AFA Markel American 28932 V560 gld.`hxWLH3wA62 ' �e 106 IxsuRER c: INsuR Re: Vou. 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 )NSR TYPE OF INSURANCE I.L8 POIN.Y NUMBEarMu,nDYn F IYLDMLYNA,E YRPI Ymi3 EACH OLCURREW9 Iz 1,000,000 oA TSflE�TEv t00,000 A X COMMEHCIALGENERALWS1URY Mom I s P R 4Awlxum cwusMAce ❑X OCCUR X F30LOO172191 06/06/2019 06106/2020 PRODUCTS - COuPpPAOG X Contractual Late f ,CaEDSINGLE OMIT X nc CU GODLY INJURY IPe prawn/ S "l GENL AGGREGATE UMIIT AFPUES PER, PIF�'EiN�dNe4""'"GE" f I F CYO m ❑LCC 31000,000 EACH ocwRRENCE orv- pGGREWTE S 3.000,000 A AVi0110&IE LYWUT' %ANY euro FlICA00143191 06)0612019 06/0612020 Agm�0�5DCrILY ACDNJ�/.N��Dpp X AlnO5 ONLY X AUTOS PVI.Y X PIP 610000 B I ICCCLQi .C..1P. X ESLEss Lua LwMSwALE 5065882716 0610612019 06/08/2020 DED I I RETEMIONS I EACH OLCURREW9 Iz 1,000,000 oA TSflE�TEv t00,000 5,000 Mom I s P R 4Awlxum 1,000,000 NE ADORE TE 2,000,000 PRODUCTS - COuPpPAOG f 2'DDD'DDD f ,CaEDSINGLE OMIT f 1,000,0001 GODLY INJURY IPe prawn/ S "l ]I PIF�'EiN�dNe4""'"GE" f I It 1 31000,000 EACH ocwRRENCE pGGREWTE S 3.000,000 t WORMERS COMPENSATION c1aT,ur rtc fRµ AANNDEYPILE,YAIaOVLY8ft= Y�INTI Ii MgyFµna4En_ �FRIMEULUDFO) IJ XIA EL EACH ALLIOEEY0.0YEglI3 1 DEYAIPtION o� O TIONS M>v eL D5FASF-cou"uurt is C Contmctors Equip IMKLM31MD051334 06106/2019 06186/2020 Rented 50,000 1% DED, MIN 61000 Equipment 61000 detl DESLRIPiIDH DFOPEMTDN31LDc.a1 VEA=5 JACORD IDL, AtltlXlwul RF,nM1F U.d.. ns,. omeNW N mon Fwu N nq..d) -City of Sebastian Is additional insured with respect to general liability for ongoing and completed Operations When required by Written contract. CERTIFICATE HOLDER City of Sebastian 1225 Main Street Sebastian, FL 32958 ACORD 25 (2016103) CITSE4 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AMOR.. NEP.S1%rrADVE 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORb CERTIFICATE OF LIABILITY INSURANCE `/ DATE (MM DD YYYY) 9/2 612 01 7 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 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). PRODUCERSUNZ Insurance Solutions, LLC ID: (Essential) c/o Essential HR, Inc. dba First Star HR 4455 LBJ Freeway, Suite 1080 Dallas, TX 75244 CONTEA:C Jennifer Haulier PHONEF 972-404-0295 A AX c Net E MAIL ADDRESS: lennifer.hauAer@flrststarhr.com INSURER(S) AFFORDING COVERAGE Nmcff INSURERA: SUNZ Insurance Company 34762 INSURED Essential HR Inc., Essential HR II, Inc. dba FirstStar HR INSURER a: INSURERC: CLAIMS -MADE ❑ OCCUR 4455 LBJ Freeway INSURER D: INSURERE: Suite 1080 Dallas TX 75244 INSURER F: COVERAGES CERTIFICATE NUMBER: 38008815 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. IIN,TR TYPE OF INSURANCE ADD n POLICYNOMBER MMIODIIYYVY POLI LIMITS AUTHORO:ED REPRESENTATIVE Glen.] Distefano I COMMERMALGENERAL LIABILITY EACH OCCURRENCE $ PMAGET R PREMISES aomewce $ CLAIMS -MADE ❑ OCCUR MEDEXP("ono On) $ PERSONALS AOV INJURY $ GEN- AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ AGO $ POLICY JPERCT 1-1LOCPRODUCTS-COMPfOP $ OTHER AUTOMOBRELIABILITY (Es a=16DISINOLELIMIT $ BODILY INJURY (Per pemonj $ ANYAUTO SOMLY IWURY (Paracddenq $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-0WNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE $ IF" dcddsA) S UMSRELLALIABOCCUR EACH OCCURRENCE $ AGGREGATE $ FXCE95 LIAB CIpIMS-MADE DED RETENTION$ $ A WORKERS COMPENSATION WCPE0000018405 10/1/2017 10/1/2018 oTH- 1 srpTurE I ANDEMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNERIFXECUTNE WCPE0000018404 10/1%1016 10/1/2017 EL EACH ACCIDENT S 1,000,090 E.L. DISEASE -EA EMPLOYEE $ 1.000.000 OFFICERIMEMBEREXCLUDEDi ❑ (Mandatary in NH) NIA E.L. DISEASE - POLICY LIMB $ 1,009,000 Ilyas, tlesrnDe muter DESCRIPDON OF OPERATIONS bsksy DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addllional Remarks Schedule, may be attached if mem apace Is required) Coverage provided for all leased employees but not subcontractors of: Timothy Rase Conbacling, Inc. 1360 SW OLD DIXIE HWY SUITE 106 Effective dale: 10/112013 CERTIFICATE HOLDER CANCELLATION 62200099 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 AUTHORO:ED REPRESENTATIVE Glen.] Distefano I C-)19HB=1U15 AGOKU LLJKPUKA I W N. AU nghis reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 38009815 1 seeenciaT mt lm: Pao 104 tusTeR CPJIT I Nate is lmccheva 1 9/26/201/ 6:16:09 Pa (Cdr) I verge I or L