Loading...
HomeMy WebLinkAboutCertificate of Liability Insurancei INIVENG-01 KSANCHEZ ACORO" `� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) a/2s/2o21 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 Ames & Gough 8300 Greensboro Drive Suite 980 CONTACT NA E: PHO,NE (acNo, at): (703) 827-2277 (A/c, No): (703) 827-2279 EDDRIEss• admin@amesgough.com McLean, VA 22102 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Evanston Insurance Company 35378 INSURED INSURER B INSURER C Universal Engineering Sciences, LLC INSURER D : 3532 Maggie Boulevard Orlando, FL 32811-6697 INSURER E INSURER F : env=PA1__Gs CERTIFICATE NIIMRFR- REVISION NIIMRFR- 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. INSRR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 1 EACH OCCURRENCE $ DREAGETORENTE ggguren e $ MED EXP An one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: PRO- LOC POLICY 0 JECT OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HbRED NON -OWNED ATOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY AMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY OFFICER/MEMBTE ER EXCLUDED? ECUTIVE ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A SER U OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ A Professional Llab. MKLV7PL0004492 1/1/2021 1/1/2022 Per Claim/Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mores ace Is required) RE: For Private Provider plan review and inspection services for lots: 1, 3, 4,11, 16, 17, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 83, 85, 87, 97, 106, 117,120, 121,123,127 CERTIFICATE Hnl nFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE St. Lucie County ty THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2300 Virginia Avenue Fort Pierce, FL 34982 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A� EF CERTIFICATE OF LIABILITY INSURANCE DATE (MM/I) 04/28/20212021 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 Brown &Brown of Florida, Inc. 1661 Worthington Rd Ste 175 West Palm Beach FL 33409 CONTACT Stephanie Kramer NAME: PHONE (561) 688-5094 FAX (561) 686-2313 AIC No Ext : AINo E-MAIL s: skramer@bb-wpb.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Valley Forge Insurance Company 20508 INSURED Universal Engineering Sciences, LLC Universal Engineering Inspections, LLC 3532 Maggie Blvd Orlando FL 32811 INSURERB: The Continental Insurance Company 35289 INSURER C : Continental Casualty Company 20443 INSURER D : StarStone Specialty Insurance Company 44776 INSURER E : Landmark American Ins. Company 33138 INSURER F : COVERAGES CERTIFICATE NUMBER: 2021-2022 Master 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. TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DD EFF MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE Fx_] OCCUR DAMAGE O R PREMISES Ea occurrence 100,000 $ MED EXP (Any one person) $ 10,000 A Y Y 7011856226 01/01/2021 01/01/2022 PERSONAL aADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: POLICY PRO- LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANYAUTO BODILY INJURY (Per accident) $ B OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Y Y 7011857165 01/01/2021 01/01/2022 PROPERTY DAMAGE Per accident $ Underinsured motorist $ 1,000,000 X UMBRELLALIAB X OCCUR ���„�,,,36 -R" E`N'—C ,,,,,. EACH OCCURRENCE 1,000,000 $ B EXCESS LIAB CLAIMS -MADE Y Y 7012083093 01/01/2021 01/01/2022 AGGREGATE $ 1,000,000 DED X RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBEREXCLUDED? (Mandatory In NH) NIA Y 7011858185 01/01/2021 01/01/2022 ER %� 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 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) For Private Provider plan review and inspection services for lots: 1, 3,4,11,16,17,19,20,21,22, 23,24,25,26, 27,28,29, 30,31, 32,83, 85, 87,97,106,117,120,121,123,127 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN St. Lucie County ACCORDANCE WITH THE POLICY PROVISIONS. 2300 Virginia Avenue AUTHORIZED REPRESENTATIVE /�i� Fort Pierce FL 34982 © 1988-2015 ACORD CORPORATION. All ngnts reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ADDITIONAL COVERAGES Ref # Description Cyber Liability Coverage Code Form No. Edition Date Limit 1 1,000,000 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # I Description Uninsured motorist combined single limit Coverage Code UMCSL Form No. Edition Date Limit 1 1,000,000 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description PIP -Basic Coverage Code PIP Form No. Edition Date Limit 1 10,000 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description WC & Employer's liability Coverage Code WCEL Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount 7Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium [OFADTLCV Copyright 2001, AMS Services, Inc. J AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Brown & Brown of Florida, Inc. Universal Engineering Sciences, LLC POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: OITIONAL REMARKS Page of THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, I FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance: Notes D) Type of Insurance: Excess Liability; Carrier: Starstone Specialty Ins; Policy number: 77102C200ALI; Limit: $4,000,000 - Excess over lead umbrella (7012083093) for General Laibility Only; Policy Period: 01/01/2021 - 01/01/2022. E)Type of Insurance: Excess Liability; Carrier: Landmark American Insurance Co.; Policy number: LHA092746; Limit: $2,000,000- Excess over lead umbrella (7012083093)forAuto Only; Policy Period: 01/01/2021 - 01/01/2022. © 2008 ACORD The ACORD name and logo are registered marks of ACORD CERTIFICATE OF ASSISTANT SECRETARY The undersigned. hereby certifies as follows: b. 1. She is a duly elected, qualified and acting Assistant Secretary of D.R. Horton, Inc.. - Jacksonville; aDelaware corporation (the "Company "), is familiar with the facts herein certified and is duly authorized to certify the same. 2. The: following is a true, correct and complete copy of resolutions related to the subject matter as adopted by the. Consent of Sole Director of the Company dated September 13, 2016 (the "Resolutions"). The Resolutions have not been amended, rescinded: or modified and remain in full force and effect as of the date hereof. . Election of Assistant'Secretary WHEREAS, effective:February 13, 2006; Brian W. Davidson was duly elected to the office of Assistant Secretary of the Company in the Company's North Florida Division;. . WHEREAS, effective: December 22,.2009Brian W. Davidson transferred to the Company's Melbourne Division; and WHEREAS, it is now.desirable to expand Brian W. Davidson's,authority to include execution of documents related to the purchase of improved or unimproved; real property subject: to the approval by certain officers of the Company as set forth in the resolutions below: NOW; _THEREFORE, BE IT RESOLVED, that Brian W. Davidson. shall continue to hold the office of -Assistant Secretary of. the Company (the 'Assistant Secretary':') in the Company's Melbourne Division. (the "Division "), to serve until the next annual meeting of directors of the Company and until his successor is duly -elected and qualified:or until his earlier death, resignation or: removal. :RESOLVED FURTHER, that the Assistant Secretary is hereby'authorized and empowered; in the Division and in the name and on behalf of (i) the Company, (ii) any partnership of which the Company is a general partner, managgr.or agent; and. (iii)'any. linouted liability company of which the Company is a member, manager or agent collective) the "Entities" , :and subject to written corporate approval b an g ( Y ) J rp .Y Y one of the following' ;officers of the. Company: (a) Chairman. of the Board, (b) : President, (c) Senior Executive Vice President,:(d) Executive Vice President or (e) the Region. :President of the, Division (the "Approving Officers "), to execute and deliver contracts, .agreements and other : documents and, instruments (other. than promissory notes) for the purchase of real .property, -and any improvements or appurtenances constructed :thereon or affixed. thereto, or any interest therein, including without limitation any right-of-way, easement; leasehold or other tangible. or intangible property, right or interest, and any personal property relating or incident thereto. RESOLVED FURTHER, that without the prior approval of the Approving Officers and without, the signature of any other officer of the Company, the Assistant Secretary is hereby authorized and empowered, in the Division and in the name and on behalf of the Entities, to execute and deliver any and all documents and instruments, including without limitation home sales contracts, general or special Warranty deeds, bills of sale, lien waivers, owner's affidavits, settlement statements and other, conveyance documents and closing statements, necessary to contract for or close the sale of any one or'more single-family or multi -family residences on behalf of the Entities. RESOLVED FURTHER, that effective as of the date hereof, the authority hereby granted to the Assistant Secretary supersedes authority previously granted by Written Consent of Sole Director to the Assistant Secretary. IN WITNESS WHEREOF, the undersigned has signed on the 15'h day of September, 2016. '9�10 uadw Ashley Dagle Assistant Secretary U.-VTEWALYWinVa xV 6Sep15-COAS.ii pd 2