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Home My WebLink AboutCertificate of Liability InsuranceA� V CERTIFICATE OF LIABILITY INSURANCE DATE0/27/2D/YYYY) 1/27ICATE /2ozo 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 terns 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 Brown 8 Brown of Florida, Inc. 1661 Worthington Rd Ste 175 West Palm Beach FL 33409 CONTACT Maria Molina AAI NAME: AHC NE', EM : (561) 686-2266 IX No): (561) 686-2313 E-MAIL mmolina@bb-wpb.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: American Casualty Company of Reading, Pennsylvania 20427 INSURED GFA International, INC.; Obsidian Group Holdings, LLC Obsidian Group Acquisitions, Inc. 1215 Wallace Drive Delray Beach FL 33444 INSURER B : Transportation Insurance Company 20494 INSURER C : National Union Fire Insurance Company of Pittsburgh PA 19445 INSURER D : Valley Forge Insurance Company 20508 INSURER E : Continental Casualty Company 20443 INSURER F : rnvGoer_Fe r_PPTlVIrATF MIIMRFR- Master2020-2021 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 MAYBE 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. TYPE OF INSURANCE INSD WVD POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 rA CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence 1,000,000 $ X MED EXP Any one person) $ 10,000 Contractual Liability X Cross Liability/Separation of Ins. PERSONAL &ADV INJURY $ 1,000,000 Y 6080697842 04/01/2020 04/01/2021 GEN'LAGGREGATE LIMIT APPLIES PER. POLICY � PRO- ❑ JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG 2,000,000 $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANYAUTO BODILY INJURY (Per accident) $ B OWNED SCHEDULED AUTOS ONLY AUTOS �/ HIRED NON -OWNED X AUTOS ONLY HAUTOS ONLY 6080697887 04/01/2020 04/01/2021 PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAR M CLAIMS -MADE EBU049326298 04/01/2020 04/01/2021 X AGGREGATE $ 5,000,000 DED Xl RETENTION $ 0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y / N OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N /A 6 80697839 04/01/2020 04/01/2021 X1 PER STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below Each Claim 2,000,000 E Professional/Pollution Liability Claims Made Policy MCH591908633 04/01/2020 04/01/2021 Aggregate 4,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) (Lot 40) — 3334 Trinity Circle, Ft. Pierce FL 34945 For Private Provider Plan Review and Inspections. Dr Horton Inc. 1430 Culver Drive NE Palm Bay FL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U 195L3-ZU15 AGUKD G(JKPC)KAI IUN. All ngnts reservea. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD