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HomeMy WebLinkAboutCertificate of Insurance DATE(MM/DD/YYYY) A o CERTIFICATE OF LIABILITY INSURANCE 06/05/2026 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 co 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 Northeast, Inc. PHONE (866) 283-7122 FAX (800) 363-0105 New York NY Office (A/C.No.Exit): A/C.No.): One Liberty Plaza E-MAIL 0 165 Broadway, suite 3201 ADDRESS: _ New York NY 10006 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: LM Insurance Corporation 33600 Verizon Communications Inc. INSURERB: Liberty Insurance Corporation 42404 1095 Avenue of the Americas New York NY 10036 USA INSURER C: Liberty Mutual Fire Ins Co 23035 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570120651020 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 TB EACH OCCURRENCE $1,000,000 CLAIMS-MADE x]OCCUR PREMISES Ea occurrence) $2,000,000 X XCU Coverage is Included MED EXP(Any one person) $10,000 X Standard Contractual Liability PERSONAL&ADV INJURY $1,000,000 N GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 it> X POLICY ❑PRO- E ElLOC PRODUCTS-COMP/OP AGG $2,000,000 Co OTHER: o C As2-691-550588-126 06/30/2026 06/30/202 7 COMBINED SINGLE LIMIT n AUTOMOBILE LIABILITY $2,000,000 AOs Ea accident C X ANYAUTO As2-691-550588-136 06/30/2026 06/30/2027 BODILY INJURY(Per person) 0 Z OWNED SCHEDULED NH - Primary BODILY INJURY(Per accident) 0 AUTOS ONLY AUTOS TL2-691-550588-186 06/30/2026 06/30/2027 is HIRED AUTOS NON-OWNED PROPERTY DAMAGE V ONLY AUTOS ONLY NH - Excess Per accident UMBRELLA LIAB HOCCUR EACH OCCURRENCE V EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION A WORKERS COMPENSATION AND WA569D550588096 06/30/2026 06/30/2027 X PERSTATUTE OTH- EMPLOYERS'LIABILITY Y/N AOS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 A OFFICER/MEMBER EXCLUDED, N N/A WC5691550588086 06/30/2026 06/30/2027 (Mandatory in NH) WI, MN E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I I I E.L.DISEASE-POLICY LIMIT $1,000,000— DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Contract No. 57374, Location: Monroe County Tower, 11180 state Road 905, Key Largo, FL. �¢¢-- ti- 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, FL AUTHORIZED REPRESENTATIVE — 11180 state Road 905 Key Largo FL 33037 USA ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000027366 LOC#: A ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMEDINSURED Aon Risk services Northeast, Inc. verizon Communications Inc. POLICY NUMBER see Certificate Number: 570120651020 CARRIER NAIC CODE see Certificate Number: 570120651020 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC# INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD certificate form for policy limits. POLICY POLICY INSR ADDL SUBR POLICY NUMBER EFFECTIVE EXPIRATION LIMITS LTR TYPE OF INSURANCE INSD W VD DATE DATE (MM/DD/YYYY) (MM/DD/YYYY) WORKERS COMPENSATION B N/A WA769D550588076 06/30/2026 06/30/2027 MA ACORD 101(2008/01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD