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HomeMy WebLinkAboutCertificate Liability InsuranceVENG-01 KSANCHEZ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 4/20/2021 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 pollcy((es) 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 NONiACT Ames & Gough 8300 Greensboro Drive Suite 980 PHONE FAX A,c, No, Ext : (703) 827-2277 AIC, Ne):(703) 827-2279 E4ppwg6. admin@amesgough.com McLean, VA 22102 INSURERS AFFORDING COVERAGE NAIC # INSURERA:Evanston Insurance Company 35378 INSURED INSURER B : INSURER C : Universal Engineering Sciences, LLC INSURERO: 3532 Maggie Boulevard Orlando, FL 32811-6697 INSURER E INSURER F COVERAGES CERTIFICATE NIIMRF:R• DCVICInrJ NI IMRFD• 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. ILTR NSR TYPE OF INSURANCE ADS L SUBR POLICY NUMBER POLICY EFF MM POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES occurrence ' $ MED EXP (Any onePerson) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ JECOT LOC OTHER GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG $ AUTOMOBILE LIABILITY ANYAUTO OWNED, SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY AIORTOS ONL� Ea MINED SINGLE LIMIT $ BODILY INJURY Per erson $. BODILY INJURY Per accident $ Pe�acEciden DAMAGE $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNER/EXECUTIVE FFICERIMF�418ER EXCLUDED? Mandatory In NH) Ifyes, describe under DESCRIPTION OF OPERATIONS below N I A STA ETM- ' E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E L DISEASE - POLICY LIMIT A Professionat Liab. MKLV7PL0004492 1/1/2021 1/1/2022 Per Claim/Aggregate 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 Additional Remarks Schedule, may be attached if more s a is required) RE: For Private Provider plan review and Inspection serv(ces for lots: 2, 5, 6, 7, 8, 9,10,13,14,15,19, l7, 76R89, 90, 91, 92, 93, 94, 119, 124, 125, 126, 128 St. Lucie County 2300 Virginia Avenue . Fort Pierce, FL 34982 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIED REPRESENTATIVE -An-,1 ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD