HomeMy WebLinkAboutCertificate of Liability InsuranceACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMDD VYVV)
♦_ 02/03/2021
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
CNAMMEOPACT Edn Condlin
:
Johnson & Company
n/CoNNo Eat), (407) 843-1120 (-N-C Nu : (407) 843-5772
801 N Orange Avenue
EMAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC#
Suite 510
Orlando FL 32801
INSURER A: FCCI Insurance Company
10178
INSURED
INSURER B : Bridgefield Casualty Insurance
10335
Weintraub Engineering and Inspections, Inc.
INSURER C : Continental Casualty Company
20443
Weintraub Inspections & Forensics
INSURER D
3868 Sun City Center Blvd
INSURER E ::
Sun City Center FL 33573
INSURER F:
COVERAGES CERTIFICATE NUMBER: CL20111214948 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 INSURANCE
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE � OCCUR
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
$ 10,000
PERSONAL&ADV INJURY
$ 1,0001000
A
GL 100063261
11/15/2020
11/15/2021
GEN'LAGGREGATE LIMITAPPLIES PER:
GENERALAGGREGATE
$ 2,000,000
POLICY X PRO LOG
ECT
PRODUCTS - COMP/OPAGG
$ 2,000,000
Employee Benefits
$
OTHER:
AUTOMOBILE
LIABILITY
OMBIINEDtSINGLE LIMIT
$ 1,000,000
BODILY INJURY (Per pesom
$
X
ANYAUTO
A,
OWNED SCHEDULED
AUTOS ONLY AUTOS
CA 100063259
11/15/2020
11/15/2021
BODILY INJURY (Per eccidi
$
PROPERTY DAMAGE
Per accitlent
$
X
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
Drive other car
$
X
UMBRELLA LIAS
X
OCCUR
EACH OCCURRENCE
$ 51000,000
AGGREGATE
$ 5,000,000
A
EXCESS DAB
CLAIMS -MADE
UMB100063260
11/15/2020
11/15/2021
DED I X RETENTION $ 10,000
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICEIUMEMBER EXCLUDED?
(Mandatory in NH)
N/A
0196-51752
10/15/2020
10/15/202,
X STATUTE ERN
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
Limit Per Claim
$2,000,000
C
Professional Liability
MCH591943348
10/01/2020
10/01/2021
Aggregate
$2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space is required)
rERTIEIrATE Hi i r.ANr:EI 1 ATIr1N
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Port St. Lucie Building Department
ACCORDANCE WITH THE POLICY PROVISIONS.
121 SW Port St. Lucie Blvd
AUTHORIZED REPRESENTATIVE
Building B
Port St. Lucie FL 34984
JQ
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