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Home My WebLink AboutCertificate of Liability Insurance-7 ® A� o CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 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(les) 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 CONTACT Maria Molina AAI NAME: HONE., Ext : (561) 686-2266 IC, No : (561) 686-2313 E-MAIL mmolina@bb-wpb.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC q INSURERA: American Casualty Company of Reading, Pennsylvania 20427 West Palm Beach FL 33409 INSURED INSURER B : Transportation Insurance Company 20494 GFA International, INC.; Obsidian Group Holdings, LLC INSURER C : National Union Fire Insurance Company of Pittsburgh PA 19445 Obsidian Group Acquisitions, Inc. INSURER D : Valley Forge Insurance Company 20508 1215 Wallace Drive INSURER E : Continental Casualty Company 20443 INSURER F : Delray Beach FL 33444 COVFRAr;FS CERTIFICATE NUMBER_ 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR RENTED DAMAGE ToEa occurrence PREMISES $ 1,000,000 MED EXP (Any one person) $ 10,000A Contractual Liability OGEN'L Cross Liability/Separation of Ins. PERSONAL&ADV INJURY $ 1,000,000 Y 6080697842 04/01/2020 04/01/2021 AGGREGATELIMITAPPLIESPER: POLICY ❑X PRO- ❑ JECT LOC GENERALAGGREGATE $ 2,000,000 PRODUCTS -COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY (CEO accidentMBINED SINGLE LIMIT $ 1,000,000 BODILYINJURY(Perperson) $ ANYAUTO BOWNED SCHEDULED AUTOS ONLY AUTOS HIRED H NON -OWNED AUTOS ONLY AUTOS ONLY Ix 6080697887 04/01/2020 04/01/2021 BODILYINJURY(Peraccident) $ PROPERTYDAMAGE$ Per accident UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 C x EXCESS LIAB CLAIMS -MADE EBU049326298 04/01/2020 04/01/2021 AGGREGATE $ 5,000,000 DED I X1 RETENTION $ 0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) NIA 6 80697839 04/01/2020 04/01/2021 X 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, maybe attached If more space Is required) (Lot 46) — 3306 Trinity Circle; Ft. Pierce FL 34945 For Private Provider Plan Review and Inspections. CFRTIGICATF FI[V nFR CANCFI I ATION 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 /4L @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD