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HomeMy WebLinkAboutCertificates of Insuarnce STOCMAI-01 CRYANA ,�►coRc�° CERTIFICATE OF LIABILITY INSURANCE DATE 10/29/202 YY) �•---'' 10/29/2020 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(s). PRODUCER CONTACT Amy Cryan Insurance Office of America PHONE FAX 2056 Vista Parkway,Suite 350 (A/C,No,Ext):(561)472-0597 (A/C,No): West Palm Beach,FL 33411 ADDRESS:Amy.Cryan@ioausa.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Old Republic Insurance Company 24147 INSURED INSURER B:Lloyd's Stockton Maintenance Group INSURER C:Zurich American Insurance Company 16535 1975 Sansbury Way,Suite 116 INSURER D: West Palm Beach,FL 33411 INSURER E INSURER 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR IN SD WVD MM DD YYYY MM DD Y A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR MWZY 315879 20 10/31/2020 3/1/2021 DAMAGE TO RENTED 500,000 X PREMISES Ea occurrence $ Approved Ri k ; nag ment MEDEXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑X PECOT- LOG PRODUCTS-COMP/OP AGG $ 2,000,000 2-5-2021 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO X MWTB 315880 20 10/31/2020 3/1/2021 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident) ccident $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE SCX1024520 10/31/2020 3/1/2021 AGGREGATE $ 5,000,000 DIED RETENTION$ $ A WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN MWC 315878 20 10/31/2020 3/1/2021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Crime MPL746085500 10/31/2020 10/31/2021 Per Occurrence 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) If required by written contract,the following apply in favor of:Certificate Holder General Liability—Additional Insured On-going(CG 2010 04/13)and Completed Operations(CG 2037 04/13),Primary&Non-Contributory(CG 2001),Waiver of Subrogation(CG 2404) Auto Liability—Additional Insured(CA2001),Primary and Non-Contributory(PCA048)and Waiver of Subrogation(CA0444) Workers Compensation-Waiver of Subrogation(WC000313) Umbrella liability is follow form to General Liability,Auto Liability and Employers Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Monroe County Board of County Commissioners 1100 Simonton Street IKey West,EL 33040 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD +I. C.3 D �' �},� � .,I - ala - )� - 1 1 ' 1•-)„ � � r v " i _ D.1 �F[ �7. .,D . . 4�-..,.✓� IvJ l (i _. s—y s_'A U' !�� .j (!�'!./7;,�:7 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO ZIGI I-f S UPON THE CERTIFICA rE H0:_D =R. 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 BETVVEEN 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(s). PRODUCER 561-868-9010 Insurance Office of America 2056 Vista Pkw y., Suite 350 West Palm Beach, FL 33411 NAME CT Jaclyn Dillon PHONE 561-868-9010 FAX (A/C, No, Ext): (A/C, No): E-MAIL jaclyn.dillon@ioausa.com ADDRESS: Rick Heyman INSURER(5) AFFORDING COVERAGE NAICr:_ INSURERA:The Hanover Insurance Company 2_2292 INSURED Stockton Maintenance Group INSURER B :The Hanover American Ins. Co. 36064 1975 Sansbury Way Suite 116 & 110 INSURER C: Federal Insurance Company 20281 INSURERD:Associated Industries of MA 33758 West Palm Beach, FL 33411 INSURER E : INSURER F : e'n1/PPArAPC CERTIFICATE MI IMRFR• RP\/ICIn KI NI IMRFR• 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 TYPE OF INSURANCE DDL UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X ZZD07954601 10/31/2017 10/31/2018 DAMAGE TO RENTED PREMI ES Ea occurrence 300,000 $ MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY zn LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILY INJURY Perperson) $ X ANY AUTO X AZJ D079574001 10/31/2017 10/31/2018 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE Per accident $ X AUTOS ONLY X AUOTOS ONEY A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE UHJ D07956001 10/31/2017 10/31/2018 DED I I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A AWC1093575 10/31/2017 10131/2018 X PERI OTH- TUIE I ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 — -If-yes,-describe under — — DESCRIPTION OF OPERATIONS below -- - --- — ---- — E.L. DISEASE - POLICY LIMIT 1 000;000 $ C Crime 8208-7046 10/31/2017 10/31/2018 Fidelity 5,000'000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) r BAY PR E Y GEWNT �,. 0I^ c, Endorsement. Umbrella follows form. WAIVE VA�p ES� ,P /Z (- 4lii CC, ter' MONROE1 Monroe County Board of County Commissioners 1100 Simonton Street Key West,,FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ORIZED REPRESENTATIVE ���_1_ 1�— ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD STOCK-2 OP ID: JC '44ccR" CERTIFICATE OF LIABILITY INSURANCE `-� ATE(M6120 r16 10/2/206 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 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 endorsements . PRODUCER SLATON INSURANCE P.O. Box 220637 West Palm Beach, FL 33422 Richard Neyman, Jr. CONTACT NAME: Jaclyn Dillon PHONE MCC, No, Ext : 561-683-8383 a/c No): 561-684-5995 ADDRESS: jdillon@slatonriskservices.com INSURERS AFFORDING COVERAGE NAIC N INSURER A: Hanover American Ins. CO. 36064 INSURED Stockton Maintenance Group INSURER B : Hanover Ins. Co. 22292 1975 Sansbury Way Suite 116 S 110 West Palm Beach, FL 33411 INSURER C: Brid efield Employers Ins.Co. 10701 INSURER D : Federal Insurance Company 20281 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION Nl1MBFR- 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. I �TR TYPE OF INSURANCE U POLICY NUMBER EFF MM/ DPOLICY/YYYY EXP Me °u DY/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000. CLAIMS -MADE X OCCUR X ZZJ D079646 00 10/31/2016 10/31/2017 PREM E T RENTED PREMISES Ea occurrence 10O 0O � $ MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY PRO- JECT D LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident)$ 1,000,00 X BODILY INJURY (Per person) $ A ANY AUTO X AZJ D079674 00 10/31/2016 10/31/2017 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 6,000,00 B EXCESS LIAB CLAIMS -MADE UHJ D079560 00 10/31/2016 10/31/2017 DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 830-64874 10/31/2016 10/31/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE a 500,00 E.L. DISEASE - POLICY LIMIT $ 500,00 D Crime 8208-7046 10/31/2016 10/31/2017 Fidelity 5,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Monroe County Board of County Commissioners are an additional insured if required by written contract per the terms of form CGL 088 amd as respects Auto Liability as per Blanket Additional Insured r 4AAFPRE AG MEM Endorsement. Umbrella follows form. �0faL',w�!A YES ,, _ C(4 te_ MONROE1 Monroe County Board of County Commissioners 1100 Simonton Street Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD