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HomeMy WebLinkAboutCertificate of Insurance ACC)17DO CERTIFICATE OF LIABILITY INSURANCE DATE 1a2 23DmW) lllk—� F 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 GeeAnn MIs51 MARSH USA LLC NAME: 400 West Market Street,Suite 700 PHONE 8fi6.966.4664 FAX No 0 212.948 0804 Louisville,KY 40202 E-MAILO Louisville.Cert ues@rnarsh.corn Attn:LouiWIle.certreq t marsh.com RESS INSURERS AFFORDING COVERAGE NAIC# CN101863513-DAA-GAWU-23.24 2826 martin SO INSURER A:Mitsui Sumitomo Insurance USA Inc 22551 INSURED INSURER B:Seri ual Company 2PW Oaikin Applied Alrerleas Inc. 13600 Industrial Park Boulevard INSURER C:Sentry Insurance Company 24988 Minneapolis,MN 55441 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: C 7122144-02 REVISION NUMBER: 70 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. ILTTRR ADDTYPE OF INSURANCE LSUBR POLICY NUMBER POLICY EFF MPOLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY GL2122557 04101/2023 0410112024 EACH OCCURRENCE $ 1,0OO,000 CLAIMS-MADE EPREMISES OCcuR I,'sub(ect 10 self insured retentions Ea occwrence $ 1,000,000 for various perils covered) MEO EXP(Any one person) $ %000 PERSONAL SADVINJURY $ 11000,000 GEN1.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ECT ��LOC PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER:' S A AUTOMOBILE LIABILITY BVR840 2(AOS) 04101/2023 04 112024 COMBINED SINGLEL'+MIT $ 2000000 Ea dent X ANY AUTO BODILY INJURY(Per pa ) S A X OWNED SCHEDULED BV 8803074(MA) 04101/2023 04/0112024 BODILY INJURY(Per acddenq $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ x uMBRELULIAB X OCCUR U B5700287 04101I2023 04/012024 EACHOCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X I RETENTIONS10,000 IS B WORKERS COMPENSATION 90-2021 2(Daikin Ded y 04101024 X PER OTH- C AND EMPLOYERS'LIABILITY 90-20216.003 Daikn etra) 04/0112023 04/01/2024 STATUTE ER ANYPROPAIETORIPARTNEPJEXECUTIVE Y 1 N ( E.L.EACH ACCIDENT $ 11000,000 OFFICERIMEMBEREXCLUDED7 a NIA (Mandatory In NMI E.L.DOSEASE-EAEMPLOYE S 1,000,000 Ir yyeas,describe under 1,000,0 DESCRIPTION00 OF OPERATIONS below E.L,DIS E-POLICY OMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remar%s Schedule,may be attached N more space Is required) Monroe County BOCC Ware included as additional insured where required by written contract and allowed by law with respect to General and Autornoble liability coverages. APPROVED BY RISK WMOOLWENT DATE, " � �, ..�� CERTIFICATE HOLDER CANCELLATION Monroe County BOCC, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton St. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West,FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACoR" CERTIFICATE OF LIABILITY INSURANCE 7OT4123/2026 IYYYY) 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 MARSH USA LLC NAME: GeeAnn Missi 400 West Market Street,Suite 700 AICONNo Ext: 866-966-4664 F4Ic,No): 212-948-0804 Louisville,KY 40202 E-MAIL marsh.comuest Attn:Louisville.certrequest@marsh.com ADDRESS: Louisville.CertRe q @ INSURER(S)AFFORDING COVERAGE NAIC# CN 101 863513-GAWU-4/1-26-27 2826 Arleen SO 2029 INSURERA: Mitsui Sumitomo Insurance USA Inc 22551 INSURED Daikin Applied Americas Inc. INSURER B: Sentry Casualty Company 28460 13600 Industrial Park Boulevard INSURER C: N/A N/A Minneapolis,MN 55441 INSURER D INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: CLE-007479083-01 REVISION NUMBER: 1 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 ADDLSUBRTYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP LTR MM/DDIYYYYI iMMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY GL2122557 04/01/2026 04/01/2027 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X❑ OCCUR (subject to self-insured retentions DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 for various perils covered) MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑ PRO-JECT ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY BVR8406442(AOS) 04/01/2026 04/01/2027 COMBINED SINGLE LIMIT $ 2,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ A X OWNED SCHEDULED BVM8803074(MA) 04/01/2026 04/01/2027 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident) $ A X UMBRELLALIAB X OCCUR UMB5700287 04/01/2026 04/01/2027 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE (subject to self-insured retention AGGREGATE $ 5,000,000 DED RETENTION$ for various perils covered) $ B WORKERS COMPENSATION 90-20216-002 04/01/2026 04/01/2027 PER OTH- AND EMPLOYERS'LIABILITY X STATUTE ER YIN ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑N NIA A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under ffl T 1,000,000 DESCRIPTION OF OPERATIONS below A? E.L.DISEASE-POLICY LIMIT $ 77 7 WWAhYW*k r.,=. DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:HVAC Installation,Service,&Repair work 2026 Monroe County Board of County Commissioners is/are included as additional insured where required by written contract and allowed by law with respect to General Liability. This insurance is primary and non- contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract. CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commission SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton St. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West,FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA LLC @ 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Policy umber: GI-21122557 COMMERCIAL GENERAL LtABtLtT'1f GG 20 01 0413 THIS ENDORSEMENT MT"CHANGES THE POLICY. PLEASE READ,IT CAREFULLY. PRIMARY AN D NONCONTRIBUTORY � OTHER INSURANCE CONDITION This dndcrsernent modifies insurance provided under the following: COMMERCIAL GENERA.LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART' The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And N+onconbibutory Insurance trom any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under, your policy provided than (1) The additional insured is a Named Insured under such other 'insurance;and CG 20 01 0413 0 Insurance Services Office, inc., 2012 Page 1 of 1