Certificates of InsuranceCERTIFICATE OF LIABILITY INSURANCE 12/12/2017
Producer Plymouth Insurance Agency This Certificate is issued as a matter of information only and confers nit
2739 U.S. Highway 19 N. rights upon the Certificate Holder. This Certificate does not amend,
g y extend or alter the coverage afforded by the policies below.
Holiday, FL 34691
727 938 -5562 Insurers Affording Coverage NAIC #
Insured South East Personnel Leasing, Inc.& Subsidiaries Insurer A: Lion Insurance Company 11075
2739 U.S. Highway 19 N. Insurer B:
Holiday, FL 34691 Insurer C:
Coverages
The policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement, tern 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 /DDNY)
(MM /DDNY)
GENERAL LIABILITY
Each Occurrence
$
Commercial General Liability
Claims Made 11 Occur
Damage to rented premises (EA
occurrence)
$
Mod Exp
$
Personal Adv Injury
$
General aggregate limit applies per:
Policy ❑ Project ❑ LOC
General Aggregate
$
fi
Products - Comp /Op Agg
$
A UTOMOBILE LIABILITY
Any Auto
All Owned Autos
,AI E*1M
WAI R
EId LN
Combined Single Limit
(EA Accident)
$
Bodily Injury
(Per Person)
$
Scheduled Autos
Hired Autos
9cdi,y .ntury
Non -Owned Autos
(Per Accident)
$
Property Damage
(Per Accident)
$
EXCESS /UMBRELLA LIABILITY
Each Occurrence
Aggregate
Occur ❑ Claims Made
Deductible
A
Workers Compensation and
Employers' Liability
Any proprietor /partner /executive officer /member
excluded? NO
If Yes, describe under special provisions below.
WC 71949
01/01/2018
01/01/2019
X
WC Statu-
I tory Limits
OTH-
ER
E. L. Each Accident
$ 1,000,0
E.L. Disease - Ea Employee
$1,00o,0
I E.L. Disease -Policy Limits 1 $1, 000 , 0
Other Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616
Descriptions of Operations /LocationsNehicies /Exclusions added by Endorsement/Special Provisions: Client ID: 91-67 -888
Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company ":
Brownie Companies, LLC
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:
ISSUE 11 -06 -17 (KLR)
MONROE COUNTY BOARD OF Should any of the above described policies be cancelled before the expiration date thereof, the
C ( y issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the
COUNTY COMMISSIONERS left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its
1100 SIMONTON STREET ' �I a'/l (� a ants or representatives.
---- -- - - -- _ - -- - C /I e- _7_
CERTIFICATE OF LIABILITY INSURANCE 12I12120
4ucer: Plymouth Insurance Agency This certificate Is IssimA as a matter of Information only and confers
2739 U.S. Highway 19 N. ��d �� a � afforded t Use pis oliciete s bellow.
not amend,
Holiday, FL 34691
17017► 0ast_s8;a' Insurers Affording Coverage NAIC
uredt South East Personnel Leasing, Inc.& SubsidiariesLlnsumrA. IJon Insurarllte Company 1107
2739 U.S. Highway 19 N. Holi FL 34691
rerages
olicies of Insurance listed below have been issued to Me Insured nama l above for the policy period indicated. Notwithstanding any requiremanL term or condition of any contract or other
xnl with rasped to which itch certificate may be Issued or may pe"n, the Insurance afforded by the policies described herein is subject to ap the terms, exclusions, and conditions of sud
is. Aggregate llama shorn may ham been reduced by paid claims.
ADDL
INSRD
Type of Insurance
yP
Poll Number
Policy
Palicy Date
PolicyExpirationLimits
(MMIDDIYY)
(MMIDDIYY)
ENERAL
LIABILITY
Each Occurrence
Commercial General Liability
Claims Made11 Occur
Damage to ranted premises (EA
occurrence)
Mud �
Personal Adv Injury
eneral
aggregate limit applies per.
Polley LOS
General Aggregate
Products - Gomp*p Ag®
U TOMOBILE LIABILITY
Any Auto
All Owned Autos
By
WOA
.
Combined Single Limit
(EA Accident)
Bodity Injury
(Per Parson)
Scheduled Autos
Hired Autos"�
lrsJerry
Non -Owned Autos
(Per AaJdentj
Property Damage
(Per Accident)
E XCESSIUMBRELLA LIABILITY
Each OccurPence
Aggregate
Occur claims Merle
Deductible
Workers Compensation and
Employers° Liability
WC 71949
01/0112018
01/01/2019
x WC sistu-
iory Limits
OTH-
ER
E.L. End td rat
Any proprietor/partner/executive otlicerlmember
excluded? NO
If Yes, under special provisions below_
isease - Ea E
UND100
E.L. D - Poiiry LimNs
Other Lion Insurance Comanx Is A.M. Best Comeanj rated A (Excellent). AMB # 125]
.criptions of OperaUonslLoeationstVehicieslExclusions added by Endorsement/Special Provisions: Client ID: 91-67-M
erage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Comparr
Brownie Companies, LLC
erage only applies to injuries Incurred by South East Personnel Leasing, Inc. & Subsidiaries active employees), while working In: FL
erage does not apply to statubory employee(s) or Independent contactor(s) of the Client Company or any other entity.
It 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) 938-556
Jett Name:
UE 11-06-17 (KLR)
e -. e11 .e..,
s r!, sTON RE
Should any of the above described Wicea be CofKAORKS before me a)PMWn oars UNIRKH. Ha
Waning Inswer wtli endeavor to MR 3D days written notice to the carUllcate tender name to it
left but tenure to do an shall Release no obligruenor HaNfity of any k1nd upon the Insurer, its