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HomeMy WebLinkAboutCertificate of Liability InsuranceACOR" CERTIFICATE OF LIABILITY INSURANCE OP ID JW DATE (MM/OD/YYYY) POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR BROWN -3 07/20/09 PRODUCES _ POLICYEFFECTIVE DATE MM/DD/YYYY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown of Florida, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Daytona Beach P.O. Box 2412 Office HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Daytona Beach FL 32115-2412 Phone: 386-252-9601 Fax:386-239-5729 INSURERS AFFORDING COVERAGE NAIC7t INSURED 63053550241 INSURER Travelers Prop & Cas of Amer 25674 INSURER B: National Surety Corporation 21881 INSURER C: Charter oak Fire Insurance Co BROWN & BROWN INC ETAL INSURER D XL Specialty Ins Co 37885 P 0 BOX DAYTONA 2412 BEACH FL 32115 INSURER E COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE DATE MM/DD/YYYY POLICY EX (RATIO DATE MM/DD/YYYY LIMITS 444 SW SECOND AVE 9TH FLOOR MIAMI FL 33125 GENERAL LIABILITY EACH OCCURRENCE S 1, 000, 000 PREMISES (Ea occurence) 5300,000 A X COMMERCIAL GENERAL LIABILITY 63053550241 07/19/09 07/19/10 CLAIMS MADE Fil OCCUR MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,00 0, 000 GEN'L AGGREGATE LIMri APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY PRO- JECT X LOC A AUTOMOBILE LIABILITY ANY AUTO BA6854C201 07/19/09 07/19/10 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) 5 X X HIRED AUTOS NON -OWNED AUTOS '—' PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC 5 AUTO ONLY: AGG S ANY AUTO EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE 510,000,000 B X I OCCUR 71 CLAIMS MADE SU000070384227 07/19/09 01/01/11 AGGREGATE $10,000,000 S S DEDUCTIBLE $ RETENTION $ C A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE{---� OFFICER/MEMBER EXCLUDED? U (Mandatory in NH) 9517B580-09 9517B761-09 07/19/09 07/19/09 01/01/11 01/01/11 X TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE S1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 OTHER D INS AGENTS E&O ELU106364-08 08/23/08 08/23/09 EACH LOSS $10,000,000 E EMP DIS/FIDELITY CCP0061089 - $250,000 DED 04/28/07 04/28/10 BLANKET $25,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CANCELLATION: EXCEPT 10 DAYS FOR NON-PAYMENT OF PREMIUM CITY OF MIAMI IS INCLUDED AS ADDITIONAL INSURED WITH REGARD TO GENERAL LIABILITY CERTIFICATE HOLDER CANCELLATION ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. -----------____.._-__The ACORD name an -d -logo -are ragi�t�red rtiaPk� of SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION MICIT02 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR CITY OF MIAMI REPRESENTATIVES. ri�� 444 SW SECOND AVE 9TH FLOOR MIAMI FL 33125 ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. -----------____.._-__The ACORD name an -d -logo -are ragi�t�red rtiaPk� of �AC(:>REP CERTIFICATE OF LIABILITY INSURANCE OP ID J DATE(MM/DD/YYYY)JW `,,,,/ BROWN -3 07/20/09 TYPE OF INSURANCE POLICY NUMBER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION rown of Florida, . Inc . LIMITS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE each Office GENERAL LIABILITY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 412 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. each FL 32115-2412 FDaytona A -252-9601 Fax:386-239-5729 6305355C241 INSURERS AFFORDING COVERAGE NAIC# 07/19/10 INSURER Travelers Prop & Cas of Amer, 25674 CLAIMS MADE FXI OCCUR INSURER B BROWN & BROWN INC ETAL MED EXP (Any one person) $ 5,000 INSURER C P 0 BOX 2412 INSURER D. DAYTONA BEACH FL 32115 GENERALAGGREGATE s2,000,000 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATLE ICY(MMIDDIYYYIYY) ;POLICY EXPIRATION DATE (MWDD/YYYY) LIMITS 444 SW 2ND AVE. MIAMI FL 33130 GENERAL LIABILITY EACH OCCURRENCE S1,000,000 PREMISES (Ea occurence) 5300,000 A X COMMERCIAL GENERAL LIABILITY 6305355C241 07/19/09 07/19/10 CLAIMS MADE FXI OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 X EBL CLAIMS MADE GENERALAGGREGATE s2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS - COMP/OP AGG s 2 , 00 0 , 00 0 POLICY PRO LOC JECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS UUU `, ) BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC S ANY AUTO AUTO ONLY. AGG 5 EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S $ $ DEDUCTIBLE $ RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE�u Al Q I H- TORY LIMITS I I ER E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CANCELLATION: EXCEPT 10 DAYS FOR NON PAYMENT OF PREMIUM NAMED INSURED: BROWN & BROWN OF FLORIDA INC. and BROWN & BROWN INC. dba AMERISYS. CITY OF MIAMI IS ADDITIONAL INSURED AS RESPECTS TO THE NAMED CERTIFICATE HOLDER CANCELLATION ACORD 25 (2009/01) U 19138-2UU9 AGUKLJ GUKNUKA I JUN. All rlgnts reservea. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYM-1 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN — — _ NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR CITY OF MIAMI REPRESENTATIVES. A� EPR ENT IV / 444 SW 2ND AVE. MIAMI FL 33130 ACORD 25 (2009/01) U 19138-2UU9 AGUKLJ GUKNUKA I JUN. All rlgnts reservea. The ACORD name and logo are registered marks of ACORD