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Home My WebLink AboutCertificate of Liability Insurance1 ® /- A� v CERTIFICATE OF LIABILITY INSUR, ►k;E 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 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 Ileu of such endorsement(s). PRODUCER CONTACT Maria Molina AAI NAME: Brown & Brown of Florida, Inc. AICNNo Ext , (561) 686-2266 aC No): (561) 686-2313 a 00 Riess: mmolina@bb-wpb.com 1661 Worthington Rd Ste 175 INSURER(S) AFFORDING COVERAGE NAIC # West Palm Beach FL 33409 INSURERA: American Casualty Company of Reading, Pennsylvania 20427 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 Delray Beach FL 334" INSURER F : COVERAGES CERTIFICATE NUMBER: Master202O-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. INSR LTR TYPE OF INSURANCEADDLIbUSK INSD WVD POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE FRI OCCUR DAMAGE TO-RERTET 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 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑X JEST LOC PRODUCTS -COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COEa aMccBidentINED SINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS 6080697887 04/01/2020 04/01/2021 BODILY INJURY(Peraccident) $ X PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY !� AUTOS ONLY $ UMBRELLALIAB 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 X1 RETENTION $ 0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERWEMBEREXCLUDED? Fq (Mandatory In NH) NIA 680697839 04/01/2020 04/01/2021 X STATUTE ERH 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 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 I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) (Lot 42) — 3322 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