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HomeMy WebLinkAboutCertificates of Insurance DATE(MM/DD/YYYY) A o CERTIFICATE OF LIABILITY INSURANCE 09/24/2025 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). PRODUCER CONTACT NAME: Aon Risk Services Central, Inc. PHONE (866) 283-7122 FAX (800) 363-0105 Philadelphia PA Office (A/C.No.Ext): A/C.No.: a 100 North 18th street E-MAIL 16th Floor ADDRESS: _ Philadelphia PA 19103 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Everest Indemnity Insurance Company 10851 BrightView Landscape services, Inc. INSURER B: Zurich American Ins Co 16535 Location# 35490 4155 East Mowry Drive INSURERC: American Zurich Ins Co 40142 Homestead FL 33033 USA INSURERD: American Guarantee & Liability Ins Co 26247 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570115678673 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY GLO EACH OCCURRENCE $5,000,000 CLAIMS-MADE X❑OCCUR SIR applies per policy terns & condi ions $2,000,000 PREMISES Ea occurrence MED EXP(Any one person) $10,000 APP- lR( T PERSONAL&ADV INJURY $5,000,000 M GEN'L AGGREGATE LIMIT APPLIES PER: BY--- O 25 _ GENERAL AGGREGATE $5,000,000 00 POLICY PRO �LOC DATA""'-"-"�'m"� PRODUCTS-COMP/OP AGG $5,000,000 JECT WAI NAA` OTHER: ^o B Y BAP 5096426 00 10/01/2025 10/01/2026 COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $5,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) 0 Z OWNED SCHEDULED BODILY INJURY(Per accident) 0 AUTOS ONLY AUTOS R HIRED AUTOS NON-OWNED PROPERTY DAMAGE V ONLY AUTOS ONLY Per accident D X UMBRELLA LIAB X OCCUR ZAU508596821 10/01/2025 10/01/2026 EACH OCCURRENCE $3,000,000 V EXCESS LIAB CLAIMS-MADE SIR applies per policy terns & condi ions AGGREGATE $3,000,000 DED I X RETENTION C WORKERS COMPENSATION AND wc509642100 10/01/2025 10/01/2026 X PER STATUTE OTH- EMPLOYERS'LIABILITY Y/N WC - ADS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $2,000,000 B OFFICER/MEMBER EXCLUDED? N/A wc509642200 10/01/2025 10/01/2026 (Mandatory in NH) INC - WI E.L.DISEASE-EA EMPLOYEE $2,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,000,000- DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County BOCC is included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability Policies. Certificate Holder is included as Loss Payee with respect to the physical damage Automobile policy of covered vehicles by the Named Insured in accordance with the policy provisions.Coll/Comp $5000. ir-- 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 BOCC AUTHORIZED REPRESENTATIVE 1100 Simonton street Key West FL 33040 USA ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLO 5096424-00 COMMERCIAL GENERAL LIABILITY CG20371219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION REQUIRED BY ALL LOCATIONS AND ALL OPERATIONS. WRITTEN CONTRACT OR AGREEMENT. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III— Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations hazard". 1. Required by the contract or agreement; or However: 2. Available under the applicable limits of 1. The insurance afforded to such additional insurance; insured only applies to the extent permitted by whichever is less. law; and This endorsement shall not increase the 2. If coverage provided to the additional insured is applicable limits of insurance. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 Wolters Kluwer Financial Services, Inc. I Uniform Forms POLICY NUMBER: GLO 5096424-00 COMMERCIAL GENERAL LIABILITY CG20261219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III— Limits Of Insurance: with respect to liability for "bodily injury", "property If coverage provided to the additional insured is damage or personal and advertising injury required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. In the performance of your ongoing operations; 1. Required by the contractor agreement; or or 2. Available under the applicable limits of 2. In connection with your premises owned by or insurance; rented to you. whichever is less. However: This endorsement shall not increase the applicable 1. The insurance afforded to such additional limits of insurance. insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 Wolters Kluwer Financial Services, Inc. I Uniform Forms POLICY NUMBER: BAP 5096426-00 COMMERCIAL AUTO CA 20 01 11 20 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR - ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the Policy effective on the inception date of the Policy unless another date is indicated below. Named Insured: BRIGHTVIEW LANDSCAPES, LLC Endorsement Effective Date: 10/01/2025 SCHEDULE Insurance Company: ZURICH AMERICAN INSURANCE COMPANY Policy Number: BAP 5096426-00 Effective Date: 10/01/2025 Expiration Date: 10/01/2026 Named Insured: BRIGHTVIEW LANDSCAPES, LLC Address: 980 JOLLY RD, BLUE BELL, PA 19422 Additional Insured (Lessor): ONLY THOSE REQUIRED BY WRITTEN CONTRACT. Address: Designation Or Description Of"Leased Autos": ONLY THOSE REQUIRED BY WRITTEN CONTRACT. CA 20 01 11 20 © Insurance Services Office, Inc., 2019 Page 1 of 2 Wolters Kluwer I Uniform Forms Coverages Limit Of Insurance Or Deductible Covered Autos Liability $ 5,000,000 Each "Accident" Comprehensive $ Deductible For Each Covered "Leased Auto" Collision $ Deductible For Each Covered "Leased Auto" Specified $ Deductible For Each Covered "Leased Auto" Causes Of Loss Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Coverage 2. The insurance covers the interest of the lessor 1. Any "leased auto" designated or described in unless the 'loss" results from fraudulent acts or the Schedule will be considered a covered omissions on your part. "auto" you own and not a covered "auto" you 3. If we make any payment to the lessor, we will hire or borrow. obtain his or her rights against any other party. 2. For a "leased auto" designated or described in C. Cancellation the Schedule, the Who Is An Insured 1. If we cancel the Policy, we will mail notice to provision under Covered Autos Liability the lessor in accordance with the Cancellation Coverage is changed to include as an Common Policy Condition. "insured" the lessor named in the Schedule. However, the lessor is an "insured" only for 2. If you cancel the Policy, we will mail notice to "bodily injury" or "property damage" resulting the lessor. from the acts or omissions by: 3. Cancellation ends this agreement. a. You; D. The lessor is not liable for payment of your b. Any of your"employees" or agents; or premiums. c. Any person, except the lessor or any E. Additional Definition "employee"or agent of the lessor, operating As used in this endorsement: a "leased auto" with the permission of any "Leased auto" means an "auto" leased or rented to of the above. you, including any substitute, replacement or extra 3. The coverages provided under this "auto" needed to meet seasonal or other needs, endorsement apply to any "leased auto" under a leasing or rental agreement that requires described in the Schedule until the expiration you to provide direct primary insurance for the date shown in the Schedule, or when the lessor. lessor or his or her agent takes possession of the 'leased auto", whichever occurs first. B. Loss Payable Clause 1. We will pay, as interest may appear, you and the lessor named in this endorsement for"loss" to a "leased auto". Page 2 of 2 © Insurance Services Office, Inc., 2019 CA 20 01 11 20