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HomeMy WebLinkAboutCertificates of Insurance 73/21/2025 E(MM/DDIYYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 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 NAME Marsh&McLennan (CLW) PHONE FAX 101 N Starcrest Dr AIC No Ext: 727-447-6481 A/C,No:727-449-1267 Clearwater FL 33765 ADMDRESS: MMABouchard.certificates@MarshMMA.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Landmark American Insurance Company 33138 INSURED AMERIEMPIR INSURER B:AGCS Marine Insurance Company 22837 American Empire Builders, Inc. 13131 SW 132nd ST., Suite 202 INSURERC:StarNet Insurance Company 40045 Miami FL 33186 INSURER D: Progressive Express Insurance Company 10193 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:1003162025 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 IN SD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY Y Y LHA114947 12/8/2024 12/8/2025 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $100,000 AP ,ro MED EXP(Any one person) $5,000 B _ PERSONAL&ADV INJURY $1,000,ODO GEN'L AGGREGATE LIMIT APPLIES PER: VATC-„„,�3 2'1,�6.25- ^—"—'—"^�"""""` GENERAL AGGREGATE $2,000,000 � PRO- POLICY ❑ LOC WAMP ,_ _ . JECT PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ D AUTOMOBILE LIABILITY Y Y 989662468 11/20/2024 11/20/2025 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY Per accident A UMBRELLALIAB X OCCUR Y Y LHA603995 12/8/2024 12/8/2025 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION$ $ PR C WORKERS COMPENSATION Y KRM626582001 12/8/2024 12/8/2025 X STATUTE EERH AND EMPLOYERS'LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N❑ NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Leased/Rented Equipment MX19307982454970 12/8/2024 12/8/2025 $250000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder is Additional Insured as respects to General Liability and Excess Liability only if required by written contract, and subject to the terms, conditions and limits as specified in the policy. Additional insured with respect to General Liability includes ongoing and completed operations. General Liability is written on a primary and non-contributory basis when required by written contract,agreement or permit and subject to the provisions and limitations of the policy. Waiver of subrogation applies in favor of certificate holder as respects to General liability and Excess Liability only if required by written contract,and subject to the terms,conditions and limits as specified in the policy. Excess Liability is follow form. See Attached... 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. Monroe County Board of County Commissioners 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040-3110 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: AMERIEMPIR LOC#: ACOOR 0 ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Marsh&McLennan(CLM American Empire Builders, Inc. 13131 SW 132nd ST.,Suite 202 POLICY NUMBER Miami FL 33186 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Equipment Deductibles:$2,500 except$5,000 for Cranes PROJECT: #904604 Harbor Drive Bridge Duck Key Monroe County ADDITIONAL INSURED(S):Monroe County Board of County Commissioners when required by written contract, and subject to the terms,conditions,and exclusions as specivied in the policies. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Client#: 720292 AMERIEMPIR DATE(MMIDDIYYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 1 8/22/2023 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 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Certificate Specialists Marsh &McLennan Agency aIC, Ext:727 447-6481 arc,No Bouchard Region ADDRESS: certificates@bouchardinsurance.com 101 N.Starcrest Drive INSURER(S)AFFORDING COVERAGE NAIC# Clearwater, FL 33765 INSURER A:Landmark American Insurance Company 33138 INSURED INSURER B:StarStone Specialty Insurance Company 44776 American Empire Builders, Inc. StarNet Insurance Company 40045 INSURER C: p Y 13775 SW 145th CT INSURER D:Allied World Assurance Company(U.S.)1 19489 Suite B INSURER E:Vanta ro Specialty Insurance Company 44768 Miami, FL 33186 INSURER F: Charter Oak Fire Insurance Co 125615 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 CONTRACTOR 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 INSR WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY Y Y LHA113621 12/08/2022 12/08/2023 EACH OCCURRENCE $1 OOO 000 CLAIMS-MADE � OCCUR PREMISESOERENTED rnce $100 000 MED EXP(Any one person) s5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 RO- POLICY� JECTT LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ E AUTOMOBILE LIABILITY Y Y 5087027304 12/08/2022 12/08/2023 COMBINED SINGLE LIMIT 1 000 000 Ea accident $ > > X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ B UMBRELLA LIAB X OCCUR Y Y 89186A222ALI 12/08/2022 12/08/2023 EACH OCCURRENCE s5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,000 DED RETENTION$ $ C WORKERS COMPENSATION Y KEY0145742 12/08/2022 12/08/202 X PER IER OTH- AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1 000 000 OFFICER/MEMBER EXCLUDED? � N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1 000 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 D Pollution Liab. Y Y 03128724 12/08/2022 12/08/202 $2M/$2M Professional Liab Y Y F Rent/Leased Equip QT6608S92240ATIL 12/08/2022 12/08/202 $1 000 000 per item DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) PROJECT: #904604 Harbor Drive Bridge Duck Key Monroe County ADDITIONAL INSURED(S): Monroe County Board of County Commissioners If required by written contract, Certificate Holder is an additional insured with respect to General Liability, Auto Liability,and Excess Liability,subject to the terms, conditions and exclusions of the policies. a 6X T ) / By 82 "2�3 (See Attached Descriptions) DATE-- A I CERTIFICATE HOLDER CANCELLATION Monroe Count Board f Count Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE County o y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S13169956/M12092801 RCJTF DESCRIPTIONS (Continued from Page 1) If required by written contract,Certificate Holder is an additional insured with respect to General Liability,Auto Liability, Professional Liability, Pollution Liability,and Excess Liability,subject to the terms, conditions and exclusions of the policies.Additional insured with respect to General Liability includes ongoing and completed operations. Coverage with respect to General Liability is primary and noncontributory. When required by written contract,waiver of subrogation applies in favor of Certificate Holder with respect to General Liability,Auto Liability,Workers Comp, Professional Liability, Pollution Liability, and Excess Liability subject to the terms,conditions and exclusions of the policy. There are no exclusions for Jib, Boom and/or Overload on the Rented/Leased Equipment policy. SAGITTA 25.3(2016/03) 2 of 2 #S13169956/M12092801