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Home My WebLink AboutCertificate of Liability InsuranceA� " CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 10/27/2020 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 Brown 8r Brown of Florida, Inc. 1661 Worthington Rd Ste 175 West Palm Beach FL 33409 CONTACT Maria Molina AAI NAME: PHONE (561) 686-2266 FAX No): (561) 686-2313 A/C No Ext E-MAIL SS: mmolina@bb-wpb.com ADDRE 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 INSURERB: 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 : rnvcoer--ce rFaTlrlr_ATF IUIIMRFR• 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 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 I LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE Fx] OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 X MED EXP (Any one person) $ 10,000 Contractual Liability A X Cross Liability/Separation of Ins. Y 6080697842 04/01/2020 04/01/2021 PERSONAL BADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: POLICY ❑X JPEC LOC GENERALAGGREGATE $ 2,000,000 PRODUCTS -COMP/OPAGG $ 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 X HIRED HNON-OWNED AUTOS ONLY AUTOS ONLY 6080697887 04/01/2020 04/01/2021 PeOPERTnDAMAGE $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAB M CLAIMS -MADE EBU049326298 04/01/2020 04/01/2021 X AGGREGATE $ 5,000,000 DED I X1 RETENTION $ 0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? (Mandatory in NH) NIA 680697839 04/01/2020 04/01/2021 ER OTH- X STATUTE ER 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 36) - 3350 Trinity Circle, Ft. Pierce FL 34945 For Private Provider Plan Review and Inspections. nrr�Trrrnw rr unr n=n rAMrFI I ATInM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN DR Horton Inc. ACCORDANCE WITH THE POLICY PROVISIONS. 1430 Culver Drive NE AUTHORIZED REPRESENTATIVE Palm Bay FL 32907 j, ��„� 4a1 V 19UU-ZU15AUUKU GUKYUKAIIUN. AN rlgnLs reservea. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD