HomeMy WebLinkAboutCertificate of InsuranceClient#: 1053893 AMERIINF3
ACORD- CERTIFICATE OF LIABILITY INSURANCE °" 1(12019 rr
2113/2019
THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE OLDER.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 cart'I)icats holder is an ADDITIONAL INSURED, the pollcy(les) most 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 any rights to me certificate holder in lieu of such endomemenl(s).
PRODUCER CnmACT -
USI Insurance Services, LLCoI; 813 321.7500FAX
2502 N Rocky Point Drive ' - OUR. Na).
Suite 400 ADDREs6:
Tampa, FL 33607 INSURERS) AFFORDING COVEMOE nuts
INSURERA:TNeeelndan rc-SAn,da 125666
American Infrastructure Development Inc
3810 Northdale Blvd.
Suite 170
Tampa, FL 33624
INSURER 9: TMi.nlnYqu,ycgnwM
INSURER C: inM.n GwWymesv.yCwnpuy
INSURERO: xiepwiYry LaumuumPnY
INSURER.:
I 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAV HAVE BEEN REDUCED BY PUD CLAIMS.
IN. <pL'S aP' POLIO EFF P°YCI EIY
LTIi TYPE OF mSUMXCE Fou"'NUMBER MMIC°IWVYI MMNC MNRS
A X ommo RCULGENERALURBRITY NX X 6802H430278 091101201809/10/201A EACH OCCURRENCE $1.000.000
cwMSAwOE ❑X OCCUR �'raeE,u"TE,,.ew $1,000000
MED EXP w,v ane oano,N1 $10.000
PERSONAL a ADV INJURY $1.000.000
GENLAGGRFQAm IMITFPPUEGPER: GENERN-AGGREGATE 52.000.000
POLICY PRO' El LOC PRODUCTS COMP/OP AAO $2.000.000
5
A
AmOMOSILEUABILIrY X
X
6802H430278
3911012018091101201
$
PRROPEDAMAGE
$
N AUTO
EACH OCCURRENCE
$4000 000
AGGREGATE
OWNED
BCXEOUfEO
X PER OTH-
El EACH ACCIDENT E7.6DD.DDD
E.L DISEASE - EA EMPLOYEE $1.000.000
EL. DISEASE -FOUCY UMT 1$1.000.000
$5,000,000 per Claim
AITOpS ONLY
gUTOG
X
AUTOS
X
ONLY
pUTO90NFY I
B
XI
UMBRELLA ME g occuR XIX
CUP9E591416
09/10/2016
08M0/201
n
EXCESS LIAB CLAIMS -MODE
_
DEDXI REIENTIONS10090
I
C
,/I
WOPNERSCOMPENsgnoN
X
UB9J214328
31/0612019
01/06/202
AND EMPLOYERS' LUJENRO I' Y/N
p4Y PROPRIETORNARTNER,FNECUTNE
OFFICEWMEMBERE%CLU°E°] ❑ N/A
IMYYeeenaaerteY In NH)
NESC�nImWx Ueda
D Fe.nnN.A lw,„r
D
Professional
DPR9931792
109/10/2018
09/10/201
Liability
IEd.ecFEDtlINGLE UMIi-
S1,000.00O
BOOILYINJURY(Perpemuu)
a
BODILY INJURY(P—rccmu)
$
PRROPEDAMAGE
$
tPer account)S
EACH OCCURRENCE
$4000 000
AGGREGATE
1402!000 000
a
X PER OTH-
El EACH ACCIDENT E7.6DD.DDD
E.L DISEASE - EA EMPLOYEE $1.000.000
EL. DISEASE -FOUCY UMT 1$1.000.000
$5,000,000 per Claim
$5,000,000 Annl Aggr.
DESCRIPTION OF OPERAMONSI LOGTONS I WHICLES (ACORD 101. A0dIBO0al RemaM Schedule, My be ahachel If mm apart h,pul,M)
Professional Liability coverage is written on a claims -made basis.
RE: Agreement #RFQ 18-11, APF 5/23 project
The Gemmel Liability and Automobile Liability policies include an automatic Additional Insured
endorsement that provides Additional Insured status to the Certificate Holder, only when there is a
written contract that requires such status, and only with regard to work performed on behalf of the named
(See Attached Descriptions)
CERTIFICATE HOLDER CANCELLATION
City Of Sebastian SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
1225 Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
Sebastian, FL 32958
AUTHORED REPRESESTATNE
0-3LP /1'L 06-W.. A01-
0 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (201 SAYS) 1 of 2 The ACORD name and logo are registered marks of ACORD
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