HomeMy WebLinkAboutCertificate of InsuranceCWTRA-1 OP ID: EW
,a►coiro CERTIFICATE OF LIABILITY INSURANCE
°A
o711n 712 7201177
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: R 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 Ileu of such endorsement(s).
PRODUCER
The J. Morey CompanyPHONE
License#:0655907
CONTACT
NAME:
A)
Ns Eq: 714-562-5910 Np: 714-562-5747
,JAK:
ADDRESS:
P. O. Box 1420
Anaheim, CA 92815
Elko Wakal
INSURERS) AFFORDING COVERAGE NAICf
INSURERA: Ohio Security Ins. Co.
INSURED CWT Engineering, LLC
INSURER B: Continental Casualty Company
4637 Paladin Circle
Vero Beach, FL 32967
INSURERC:
CLAIMS -MADE O OCCUR
X
INSURERD:
INSURER E
07114/2017
INSURER F :
PREMISESEe oc'w me $ 300,00
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
TYPE OF INSURANCE
1225 Main Street
POLICY NUMBER
MIDD1YYYY)
I (MMIDDNYYVI
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $ 1,000,00
CLAIMS -MADE O OCCUR
X
BKS58139235
07114/2017
07/14/2018
PREMISESEe oc'w me $ 300,00
MED EXP (Arty one person) $ 15,00
PERSONAL a ADV INJURY $ 1,000,00
GENL AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE $ 2,000,00
X POLICY 0 JECOT 7 LOC
PRODUCTS - COMP/OP AGG $ 2,000,00
$
OTHER,
AUTOMOBILE LMBLLnY
Ea COMBINED IP LIMIT$
BODILY INJURY (Psr person) $
ANY AUTO
ALL OVO ED SCHEDULED
AUTOS AUTOS
BODILY INJURY IPer scadNY) $
PROPERTY DAMAGE
PerecadsM) $
W�OED AUTOS OSWNED
HIRED
$
UMBRELLA LUIS
OCCUR
EACH OCCURRENCE $
AGGREGATE $
EXCESS LUIS
CLAIMSMADE
GED I I RETENTION $
$
WAND EMPLOYERS' LUV3ILORKERS COMPENSATION
RY YIN
ANY PROPRETORPARTNEREXECUrIVE ❑
OFFulator
NIA
STATlf1E ER
-
EL EACHACCIDENT $
In NH)
iMMldMeryM NH)
E DISEASE EA EMPLOY $
It y'Ss, deecnbe under
DESCRIPTION OF OPERATIONS below
E.L DISEASE POLICY LIMIT $
B
Professional Llab
H591911757
07/142017
07H4/2018
Per Claim 1,000,00
Aggregate 1,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addlurud Remarks Schedule, may be washed Cmem epees Is rec ulroe)
Certificate holder is added as additional insured perform f1CG00010413.
Nate: Only the authorized representative can Issue or modify this
Certificate of Insurance which is effective on the date shown.
CERTIFICATE HOLDER CANCELLATION
CITSE03
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Sebastian
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
1225 Main Street
Sebastian, FL 32958
AUTHORRED REPRESENTATIVE
ACORD 25 (2014/01)
O 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD