COI Expires 01/01/2019CERTIFICATE OF LIABILITY INSURANCE
Date
1/4/2018
Producer: Plymouth Insurance Agency
This Certificate is issued as a matter of information only and confers no
2739 U.S. Highway 19 N.
Holiday, FL 34691
rights upon the Certificate Holder. This Certificate does not amend, extend
or alter the coverage afforded by the policies below.
1
Insurers Affording Coverage
NAIC #
(727) 938-5562
Insured: South East Personnel Leasing, Inc. & Subsidiaries
Insurer A: Lion Insurance Company
11075
InsurerB:
2739 U.S. Highway 19 N.
Holiday, FL 34691
InsurerC:
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.
INSR
LTR
ADDL
INSRD
Type of Insurance
Policy Number
Policy Effective
Date
Policy Expiration
Date
Limits
(MM/DD/YY)
(MM/DD/YY)
GENERAL LIABILITY
Each occurrence
Commercial General Liability
Claims Made ❑ Occur
Damage to rented premises (EA
occurrence)
Mad Exp
Personal Adv Injury
General aggregate limit applies per:
General Aggregate
Policy ❑ Project ❑ LOC
Products - Comp/Op Agg
AUTOMOBILE LIABILITY
Combined Single Limit
Any Auto
(EA Accident)
Bodily Injury
All Owned Autos
Scheduled Autos
(Per Person)
Bodily Injury
Hired Autos
Non -Owned Aulos
(Per Accident)
Property Damage
(Per Accident)
EXCESS/UMBRELLA LIABILITY
Each Occurrence
Occur ❑ Claims Made
Aggregate
Deductible
A
Workers Compensation and
WC 71949
01/01/2018
01/01/2019
X
WC Statu-
OTH-
Employers' Liability
to Limits
ER
E.L. Each Accident
$1,000,000
Any proprietor/partner/executive officer/member
E.L. Disease - Ea Employee
$1,000,000
excluded? NO
If Yes, describe under special provisions below.
E.L. Disease -Policy Limits
$1,000,000
Other
ILion 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: 84-67-118
Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company":
Florida Fence Corp.
Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s), while working in: FL.
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 faxing a request to (727) 937-2138 or by calling (727) 938-5562.
Project Name: MCSO FENCE REPLACEMENT
t
ISSUE 06-26-17 (KR) / REISSUE 01-04-18 (SD)
MENT
1�
DATE
WAIVER A en -Bate 5 23 2012
CERTIFICATE HOLDER
CANCELLATION J
MONROE COUNTY
Should any of the above described policies be cancelled before the expiration date thereof, the issuing
BOARD OF COUNTY COMMISSIONERS
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.
1100 SIMONTON STREET
KEY WEST, FL 33040�_--