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HomeMy WebLinkAboutCertificates of Insurance THE HARTFORD BUSINESS SERVICE CENTER THE 3600 WISEMAN BLVD HARTFORD SAN ANTONIO TX 78251 June 29, 2023 Monroe County Board of Commissioners 1100 SIMONTON ST KEY WEST FL 33040 Account Information: Contact Us Policy Holder Details : Capitol Group, Inc Need Help? Chat online or call us at (866)467-8730. We're here Monday- Friday. Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team WLTRO05 ,—. DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 06/29/2023 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 SUBROGATIONIS 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 NAME: BROWN&BROWN OF FLORIDA INC PHONE (850)656-3747 FAX 21220466 (A/C,No,Ext): (A/C,No): 3520 THOMASVILLE RD STE 500 E-MAIL ADDRESS: TALLAHASSEE FL 32309 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Hartford Underwriters Insurance Company 30104 INSURED INSURER B: CAPITOL GROUP, INC INSURERC: 300 S DUVAL ST TALLAHASSEE FL 32301-1703 INSURERD: 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 INSR WVD MM/DD/YYYY MM/DD/Y COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED $1,000,000 PREMISES Ea occurrence X General Liability MED EXP(Any one person) $10,000 A X 21 SBM AE9HWL 01/08/2023 01/08/2024 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X JECT LOC PRODUCTS-COMP/OPAGG $2,000,000 POLICY❑PRO- ❑ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) A ALL OWNED SCHEDULED 21 SBM AE9HWL 01/08/2023 01/08/2024 BODILY INJURY(Per accident) AUTOS AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS X AUTOS (Per accident) UMBRELLA LIAB OCCUR APPROVED BY RISK MANAGEMENT EACH OCCURRENCE EXCESS LIAB CLAIMS- DATE H--s�=�3 ✓� AGGREGATE MADE DED I RETENTION$ WAIVER N/A YES WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE I IER ANY Y/N E.L.EACH ACCIDENT PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.DISEASE-EA EMPLOYEE (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below A Employment Practices Liability 21 SBM AE9HWL 01/08/2023 01/08/2024 Each Claim Limit $25,000 Insurance I I I I I I Annual Aggregate Limit $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations.Certificate holder is an additional insured per the Business Liability Coverage Form SL3032 attached to this policy. CERTIFICATE HOLDER CANCELLATION Monroe County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Board of Commissioners BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 1100 SIMONTON ST IN ACCORDANCE WITH THE POLICY PROVISIONS. KEY WEST FL 33040 AUTHORIZED REPRESENTATIVE �,16AII 6f ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD