HomeMy WebLinkAbout2024 WCDateCERTIFICATE OF LIABILITY INSURANCE 3/4/2024
Plymouth Insurance AgencyProducer:This Certificate is issued as a matter of information only and confers no
rights upon the Certificate Holder. This Certificate does not amend, extend
or alter the coverage afforded by the policies below.2739 U.S. Highway 19 N.
Holiday, FL 34691
(727) 938-5562 Insurers Affording Coverage NAIC #
Insurer A: Lion Insurance Company 11075Insured:South East Personnel Leasing, Inc. & Subsidiaries Insurer B:2739 U.S. Highway 19 N.Insurer C:Holiday, FL 34691 Insurer D:
Insurer E:
Coverages
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. Aggregate
limits shown may have been reduced by paid claims.
Policy Effective
Date (MM/DD/YY)
Policy Expiration
Date(MM/DD/YY)INSR
LTR
ADDL
INSRD LimitsType of Insurance Policy Number
GENERAL LIABILITY Each Occurrence $
Commercial General Liability Damage to rented premises (EA
occurrence)Claims Made Occur $
Med Exp $
Personal Adv Injury $
General aggregate limit applies per:
General Aggregate $
Policy Project LOC
Products - Comp/Op Agg $
AUTOMOBILE LIABILITY Combined Single Limit
(EA Accident)$
Any Auto
Bodily Injury
All Owned Autos
(Per Person)$
Scheduled Autos
Bodily InjuryHired Autos
(Per Accident)$Non-Owned Autos
Property Damage
(Per Accident)$
EXCESS/UMBRELLA LIABILITY Each Occurrence
Occur Claims Made Aggregate
Deductible
A Workers Compensation and
Employers' Liability
X WC Statu-
tory Limits
OTH-
ERWC 71949 01/01/2024 01/01/2025
E.L. Each Accident $1,000,000Any proprietor/partner/executive officer/member
excluded?NO E.L. Disease - Ea Employee $1,000,000
If Yes, describe under special provisions below.E.L. Disease - Policy Limits $1,000,000
Other Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616
Descriptions of Operations/Locations/Vehicles/Exclusions added by Endorsement/Special Provisions: Client ID:31-66-012
Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company":
Conlon Landscaping, Inc.
Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s)
Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity.
A list of the active employee(s) leased to the Client Company can be obtained by emailing a request to certificates@lioninsurancecompany.com
, while working in: FL.
Project Name:
ISSUE 02-14-22 (PH). REISSUE 02-28-22 (BP). REISSUE 06-21-23 (TD). REISSUE 03-04-24 (PH)
Begin Date:6/11/2007
CERTIFICATE HOLDER CANCELLATION
Should any of the above described policies be cancelled before the expiration date thereof, the issuing
insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to
do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives.
CITY OF SEBASTIAN
1225 MAIN ST
SEBASTIAN, FL 32958