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HomeMy WebLinkAboutItem C08 581 582 583 584 585 586 587 588 589 58: 591 592 593 594 595 596 597 598 599 59: 5:1 5:2 5:3 5:4 5:5 5:6 5:7 5:8 5:9 5:: 611 612 613 614 615 616 617 618 619 61: 621 622 623 624 625 626 627 628 629 62: 631 632 633 634 635 636 637 638 639 63: 641 642 643 644 645 646 647 648 649 64: 651 652 653 654 655 656 657 658 659 65: 661 662 663 664 665 666 667 668 669 66: 671 672 673 674 675 676 677 678 679 67: 681 682 683 684 685 686 687 688 689 68: 691 692 693 694 695 696 697 698 699 69: 6:1 6:2 6:3 6:4 GARYPLU-02TMARKEE DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/4/2025 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). CONTACT Taylor Markee PRODUCER NAME: PHONEFAX Acrisure Southeast Partners Insurance Services, LLC (239)261-3646 (A/C, No, Ext):(A/C, No): 1317 Citizens Blvd E-MAIL tmarkee@acrisure.com Leesburg, FL 34748 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # Obsidian Specialty Insurance Company16871 INSURER A : Travelers Casualty and Surety Company of America INSURED 31194 INSURER B : The Burlington Insurance Company23620 INSURER C : Gary's Plumbing and Fire, Inc. 6409 2nd Terrace, Suite 1 Technology Insurance Company, Inc42376 INSURER D : Key West, FL 33040 INSURER E : INSURER F : COVERAGESCERTIFICATE 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. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 100,000 CLAIMS-MADEOCCUR X PTCGL000000078-048/13/20258/13/2026 $ PREMISES (Ea occurrence) XX 5,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 2,000,000 X POLICYLOC PRODUCTS - COMP/OP AGG$ JECT OTHER:$ COMBINED SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY $ (Ea accident) X ANY AUTO BA-4S561775-25-42-G8/13/20258/13/2026 BODILY INJURY (Per person)$ XX OWNEDSCHEDULED AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED XX (Per accident)$ AUTOS ONLYAUTOS ONLY $ 4,000,000 C X UMBRELLA LIABOCCUR EACH OCCURRENCE$ 604BE06423038/13/20258/13/2026 4,000,000 EXCESS LIABCLAIMS-MADE XXX AGGREGATE$ DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION D X STATUTEER AND EMPLOYERS' LIABILITY Y / N TWC46572508/13/20258/13/2026 1,000,000 X ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A N OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Monroe County BOCC is included are included as Additional Insured in regards to General Liability, only as required by written contract, including ongoing operations, per form CG2010 0413 and completed operations per form CG2037 0413 on a Primary non-contributory basis per form CG2001 0413 and Waiver of Subrogation per form CG2404 0509. Additional Insured in regards to Auto Liability only as required by written contract per form CAF079 0321 including Waiver of Subrogation. Waiver of Subrogation in regards to the workers compensation per form WC000313. Umbrella follows forms. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St Key West, FL 33040 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. 6:5 The ACORD name and logo are registered marks of ACORD