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HomeMy WebLinkAboutCertificate of Liability InsuranceACORO® CERTIFICATE OF LIABILITY INSURANCE OP ID JW DATE (MMfDDM YY) LTR NSR BROWN -3 07/20/09 PRODUCER POLICYEXPIRATION DATE MM/DD/YY W LIMITS 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 A HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. X COMMERCIAL GENERAL LIABILITY Daytona Beach FL 32115-2412 07/19/09 Phone: 386-252-9601 Fax:386-239-5729 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER ATravelers Prop s Cas of Amer 25674 INSURER 8. National Surety Corporation 21881 PERSONAL & ADV INJURY $ 1,000,000 INSURER C Charter oak Fire Insurance Co BROWN & BROWN INC ETAL INSURER D: XL Specialty Ins Co 37885 P O BOX DAYTONA 2412 BEACH FL 32115 INSURER E GENERAL AGGREGATE s2,000,000 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 POL CY EFFECTIVE /Y DATE MM/ODYYY POLICYEXPIRATION DATE MM/DD/YY W LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 6305355C241 07/19/09 07/19/10 PREMISES (Ea occurence) s300,000 CLAIMS MADE IK OCCUR MED EXP (Any one person) s 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT 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 s 1,000,000 (Ea accident) BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS -, ]� —�.� �' n ��� I� u � X X BODILY INJURY (Per accident) s PROPERTY DAMAGE s (Per accident) `J'JI`\\�;� � GARAGE LIABILITY AUTO ONLY- EA ACCIDENT s OTHER THAN EA ACC S ANY AUTO AUTO ONLY AGG s EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE 310,000,000 $ X OCCUR ❑CLAIMS MADE SU000070384227 07/19/09 01/01/11 AGGREGATE $10,000,000 5 S DEDUCTIBLE $ RETENTION $ C A(Mandatory WORKERS COMPENSATION AND EMPLOYERS' LIABILITYX ter!: ANY PROPRIETOR/PARTNER/EXECUTIVFr—) OFFICER/MEMBER EXCLUDED? U in NH) 9517$580-09 9517B761-09 07/19/09 07/19/09 01/01/11 01/01/11 - - TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT s 1 , 000 , 0 00 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 1 04/28/10 BLANKET $25,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT / 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 CITY OF MIAMI 444 SW SECOND AVE 9TH FLOOR MIAMI FL 33125 ACORD 25 (2009101) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO 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 REPRESENTATIVES. ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD '�ACORO� CERTIFICATE OF LIABILITY INSURANCE OP ID JW DATE (MM/°°m r' 41� NSR BROWN -3 07/20/09 PRODUCER POLICYEXPIRATION DATE (MM/DD/YYYY) LIMITS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown of Florida, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Daytona Beach Office PREMISES(Ea occurence) $300,000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 2 412 X COMMERCIAL GENERAL LIABILITY 63053SBC241 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Daytona Beach FL 32115-2412 CLAIMS MADE � OCCUR Phone: 386-252-9601 Fax:386-239-5729 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Prop c Cas of .omen 25674 INSURER B. BROWN & BROWN INC ETAL INSURER c: P O BOX 2412 INSURER D. DAYTONA BEACH FL 32115 I 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. INSII LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICYEXPIRATION DATE (MM/DD/YYYY) LIMITS 444 SW 2ND AVE. MIAMI FL 33130 GENERAL LIABILITY EACH OCCURRENCE $1,000,000 PREMISES(Ea occurence) $300,000 A X COMMERCIAL GENERAL LIABILITY 63053SBC241 07/19/09 07/19/10 CLAIMS MADE � 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 LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG s2,000,000 POLICY JE° LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ^n n'r ( I 'j BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO I AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION- AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE= - TORY LIMITS ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 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 CFRTIFICATF HOLDER CANCELLATION ACORD 25 (2009101) U 1968-ZUU9 AGUKU GUKI• L)KA I JUN. All rlgnts reservecl. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYM-I 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�xt+oRl EPR SENT IV 444 SW 2ND AVE. MIAMI FL 33130 ACORD 25 (2009101) U 1968-ZUU9 AGUKU GUKI• L)KA I JUN. All rlgnts reservecl. The ACORD name and logo are registered marks of ACORD