The URL can be used to link to this page

Home My WebLink AboutCertificate of Liability InsuranceA� o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 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 CONTACT Maria Molina AAI NAME: Brown & Brown of Florida, Inc. 1661 Worthington Rd Ste 175 a/c Nr o Ext : (561) 686-2266 FAX No): (561) 686-2313 E-MAIL SS: mmolina@bb-wpb.com ADDRE INSURER(S)AFFORDING COVERAGE NAIC 0 INSURERA: American Casualty Company of Reading, Pennsylvania 20427 West Palm Beach FL 33409 INSURED INSURERB: Transportation Insurance Company 20494 INSURER C : National Union Fire Insurance Company of Pittsburgh PA 19445 GFA International, INC.; Obsidian Group Holdings, LLC 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 334" CAVFRAr,FS CERTIFICATE NUMRFR: Master2020-2021 REVISION NUMBER: THIS IS TO CERTIFYTHAT 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. 1�TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR 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 A Y 6080697842 04/01/2020 04/01/2021 GEN1AGGREGATE LIMITAPPLIESPER: POLICY 19 jEC7 LOC 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 X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY 6080697887 04/01/2020 04/01/2021 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 C EXCESS LIAB CLAIMS -MADE EBU049326298 04/01/2020 04/01/2021 DED I X RETENTION $ 0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N /A 6 80697839 04/01/2020 04/01/2021 X STATUTE OR E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ E Professional/Pollution Liability Claims Made Policy MCH591908633 04/01/2020 04/01/2021 Each Claim Aggregate 2,000,000 4,000,000 1 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) (Lot 39) — 3338 Trinity Circle, Ft. Pierce FL 34945 For Private Provider Plan Review and Inspections. DR Horton Inc. 1430 Culver Drive NE Palm Bay FL 32907 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 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD