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Home My WebLink AboutCertificate of Liability Insurance® "1 - AoCOORv CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 10/27/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 & Brown of Florida, Inc. 1661 Worthington Rd Ste 175 West Palm Beach FL 33409 CONTACT Maria Molina AAI NAME: AH NN Ext : (561) 686-2266 [FAX No): (561) 686-2313 nDORIEss: mmolina@bb-wpb.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: 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 INSURERS: 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 : rnVFRAr.F. CFRTIFICATF NIIMRFR- 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDLIGY EFF POLICYM/D�P, LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 .S CLAIMS -MADE /% OCCUR A N PREMISE Ea occurrence $ 1,000,000 X Contractual Liability MED EXP (Any one person) $ 10,000 X Cross Liability/Separation of Ins. PERSONAL &ADV INJURY $ 1,000,000 A Y 6080697842 04/01/2020 04/01/2021 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY ❑X JEC ❑ LOC JECT GENERAL AGGREGATE $ 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 B OWNED .SCHEDULED AUTOS ONLY AUTOS HIRED HNON-OWNED X AUTOS ONLY AUTOS ONLY 6080697887 04/01/2020 04/01/2021 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAB 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 ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) NIA 680697839 04/01/2020 04/01/2021 H X1STATUTE 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, maybe attached if more space Is required) (Lot 37) — 3346 Trinity Circle, Ft. Pierce FL 34945 For Private Provider Plan Review and Inspections. rFRTIFICATF NAI IIFR CANCELLATION 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 �� %/� 41 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD