The URL can be used to link to this page

COI Expires 10/01/2018Page 1 of 2 AC RV CERTIFICATE OF LIABILITY INSURANCE �09/29/200117 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 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 a . PRODUCER NA PHONE 1-877-945-7378 .1-888-467-2378 Willis of Massachusetts, Inc. c/o 26 Century Blvd Box 305191 certificateo@willis.com IL ADDRESSP.O. INSURE S AFFORDING COVERAGE NAICi Nashville, TN 372305191 USA INSURER A: ACE American Insurance Company 22667 INSURED Unilirst Corporation and its Subsidiariaa 68 Sonspin Road Wilmington, MA 018871086 INSURER B• Indemnity Insurance Company of North Ameri 43575 INSURER C: Agri General Insurance Company 42757 INSURER D- ACE Fire Underwriters Insurance Company 20702 INSURER E INSURER F : VERAGES CERTIFICATE NUMBER: W3 CO VERAGES CERTIFICATE NUMBER: W3 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. am IY EPF POLIO LIMITS LTR TYPE OF INSURANCE POLICY NUMBER X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 1,000,000 DAMAGETuRFNiEU CLAIMS -MADE � OCCUR PREMISES Ea occurre $ 1,000,000 A MED EXP (An one person)$ 5,000 Y Y HDOG2787146A 10/01/2017 10/0//2018 1,000,000 PERSONAL 8 AOV INJURY $ GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY Ea X LOCLJ $ OTHER: AUTOMOBILE LIABILITY a IN $ 2,000,000 ANY AUTO BODILY INJURY (Per person) $ * OWNEDI F 1SCHEDULED Y Y ISAS09063675 10/01/2017 10/01/2018 BODILYINJRTYURY(DAIWPeraccident) $ AUTOS ONLY AUTOS HIRED NON -OWNED PPROP PGE $ AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X S TATUT R AND EMPLOYERS' LIABILITY B ANYPROPRIETOR/PARTNER/EXECUTIVE - N E.L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED7 No N/A Y WLRC64619329 (ADS) 10/01/2017 10/01/2018 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 11000,000 If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ A Workers Compensation and Y WLRC64619317 (AZ, CA) 10/01/2017 10/01/2018 EL Each Accident $1,000,000 Employers Liability EL Disease - Limits $1,000,000 Per Statute EL Disease - Each Em $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace is required) Certificate Holder is an Additional Insured for General Liability and Auto Liability as their interest may appear if required by written contract but only with respect to liability arising out of operations of the Named Insured. It in understood and agreed that the Company waives its right of subrogation against the Additional Insured which may arise by reason of a payment of claim under all the policies, if required by written co ra iCANa,;G, s permitted by SEE ATTACHED PP 4*9 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissioners AUTHORIZED REPRESENTATIVE Attn: Alice Steryou /� 3583 South Roosevelt Boulevard QuL. %%ji1' 2Vtj2 �— ILey West,,FL 33040 off 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) `L a ACORD name and logo are registered marks of ACORD SR ID: 15136989 BATCH: 462292 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissioners AUTHORIZED REPRESENTATIVE Attn: Alice Steryou /� 3583 South Roosevelt Boulevard QuL. %%ji1' 2Vtj2 �— ILey West,,FL 33040 off 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) `L a ACORD name and logo are registered marks of ACORD SR ID: 15136989 BATCH: 462292 ACO H AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 2 Of 2 AGENCY NAMED INSURED UniFirst Corporation and its Subsidiaries Willie of Massachusetts, Inc. 68 Jonspin Road Wilmington, NA 018871086 POLICY NUMBER See Page 1 CARRIER NAIC CODE 1 EFFECTIVE DATE: See Page 1 See Page 1 See Page 1 A00111VINAL Kt:MAMRS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance law. Division/Location: 921 lAdditional Insured: Monroe County Hoard of County Commissioners INSURER AFFORDING COVERAGE: ACE American Insurance Company NAIC#: 22667 POLICY NUMBER: WCUC64619354 (MA, ME, OR) EFF DATE: 10/01/2017 EXP DATE: 10/01/2018 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Workers Compensation and EL Each Accident $1,000,000 Employers Liability EL Disease - Limits $1,000,000 Per Statute EL Disease - Each Emp $1,000,000 INSURER AFFORDING COVERAGE: Agri General Insurance Company NAIC#: 42757 POLICY NUMBER. WLRC64619330 (TN) EFF DATES 10/01/2017 EXP DATE: 10/01/2018 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Workers Compensation and EL Each Accident $1,000,000 Employers Liability EL Disease - Limits $1,000,000 Per Statute EL Disease - Each Emp $1,000,000 INSURER AFFORDING COVERAGE: ACE Fire Underwriters Insurance Company NAIC#: 20702 POLICY NUMBER: SCFC64619342 (WI) EFF DATE: 10/01/2017 EXP DATE: 10/01/2018 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Workers Compensation and EL Each Accident $1,000,000 Employers Liability EL Disease - Limits $1,000,000 Per Statute EL Disease - Each Rmp $1,000,000 4ORD 101 (2008/01) LUVB H�.VRU a.Vnrvnr►: w��. nn „y„aa ....... The ACORD name and logo are registered marks of ACORD SR ID: 15136989 SAacK: 462292 cBRT- W3851719