Loading...
Certificates of Insurance IRorid,aLawyem Maduai 541 E. Mitchell Hammock Road Oviedo, Florida 32765 n IN S U R A, IN c E C 0 M P A, IN Y Phone: 800-633-6458 Fax: 800-781-2010 www.flmic.com Lawyers Professional Liability Policy This is a Claims Made and Reported Policy. Please read it carefully. *T Declarations BY : 4 Policy Number: 110231 DST -10 2°- " x yw.. Item 1. Named Insured: Fogarty Mueller Harris, PLLC Mailing Address: 501 E. Kennedy Boulevard, Suite 1030 Tampa, FL 33602 Item 2. Policy Period: From 08/01/2024 to 08/01/2025 at 12:01 A.M. Standard Time at Your Address Shown Above Item 3. Limit of Liability: $1,000,000 Per Claim $1,000,000 Total Limit Item 4. Deductible: $10,000 Annual Aggregate Item 5. Policy Premium: $10,197.00 Annual Premium $101.97 Florida Insurance Guaranty Association Emergency Assessment(1°o) $10,298.97 Total Amount Item 6. Forms and Endorsements Attached at Policy Issuance: FLPL-101 (R.10/01/2018) FLPL-200BR (R.06/01/2023) FLPL-103 (R.08/01/2011) FLPL-111 (R.06/01/2024) FLPL e-JDT" (R.01/01/2024) The Policy is not valid until signed by Our authorized representative. August 05, 2024 PIf ° Date Issued Authorize epresen ative FLPL-100 (R.08101/2011) Page 1 of 1 70T E(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 9/30/2021 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 C. Michael NAME: Halfast Risk Avoidance Managers, Inc. a/Co"N Ext: (727)381-1400 a/c "o:(727)381-1700 P.O. Box 55038 E-MAIL michael@yourPLspecialist.com ADDRESS: @y ecialist.com p Saint Petersburg, FL 33732-5038 ihlINSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Greenwich Insurance Company INSURED Fogarty Mueller Harris, PLLC INSURERB: Coalition Insurance Solutions, Inc./SwissRe/Arch/Argo 110 E. Madison Street INSURER C7 Suite 202 INSURER D7 Tampa, FL 33602 INSURERE: 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 EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MWDD/YYY MWDD/YYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAM CLAIMS-MADE 1:1OCCUR PREM SES Ea occurrDence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident 1 T $ UMBRELLA LIAB OCCUR Q I -. EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE B7' ', -- - AGGREGATE $ DED RETENTION$ 10 . 1 . 2021 $ ,1$4 _ PER OTH- WORKERS COMPENSATION ""'�`"'"`�"� AND EMPLOYERS'LIABILITY _ STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liability LPP904157801 08/01/21 08/01/22 $500,000 each claim/$500,000 annual aggregate B Cyber Liability C-4MA1-232882-CYBER-2021 08/01/21 08/01/22 $500,000 each claim/$500,000 annual aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Professional liability policy is written on a claims made basis.A retroactive date of August 1, 2020 applies. The Cyber Liability policy is also written on a claims made basis and includes full prior acts. CERTIFICATE HOLDER CANCELLATION Monroe County BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1111 12th Street, Suite 408 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West, FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Jaclyn Flatt Flatt-Jaclyn@MonroeCounty-FL.gov AUTHORIZED REPRESENTATIVE , ",f ©1988-2015 ACRD CO PORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACOR[ 70T E(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 5/20/2021 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 C. Michael NAME: Halfast Risk Avoidance Managers, Inc. a//�"N Ext: (727)381-1400 A/C No:(727)381-1700 P.O. Box 55038 E-MAIL ADDRESS: michael@yourPLspecialist.com p Saint Petersburg, FL 33732-5038 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Greenwich Insurance Company INSURED Fogarty Mueller Harris, PLLC INSURER B7 110 E. Madison Street INSURER C7 Suite 202 INSURER D7 Tampa, FL 33602 INSURERE: 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 EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MMIDD/YYY MMIDD/YYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAM CLAIMS-MADE 1:1OCCUR PREM SES Ea occurrDence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR w( ' EACH OCCURRENCE $ �tR t 4 EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ 4 _ a, $ WORKERS COMPENSATION BY, ""^' PER OTH- AND EMPLOYERS'LIABILITY Y/N TI 5 20 . 2021 STATUTE ER "w ;gym ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ '" E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A nr" (Mandatory in NH) - -'=w' E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liability LPP9041578 08/01/20 08/01/21 $250,000 each claim $500,000 annual aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Professional liability policy is written on a claims made basis.A retroactive date of August 1, 2020 applies. CERTIFICATE HOLDER CANCELLATION Monroe County BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1111 12th Street, Suite 408 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West, FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Jaclyn Flatt Flatt-Jaclyn@MonroeCounty-FL.gov AUTHORIZED REPRESENTATIVE ©1988-2015 AC J RD CO PORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACOR[