HomeMy WebLinkAboutinsurance certificate�Vare1Y. Iry v11.1 11 IV
PRODUCER
VI I.1,1-71./I1 1 II 1 11\VVe V
NATI-12 1 OW O/04
Brown & Brown, Inc.
P. 0. Box 1229
Tampa FL 33601-1229
Phone:813-226-1300 Fax:813-226-1313
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATIE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE
NAIC
INSURED
National Lift Truck Service
Inc etal
1901 Nw 2nd Street
Ft Lauderdale FL 33311
INSURER A. Southern owners insurance Co.
INSURER B: AUTO OWNERS INSURANCE
1,8988
INSURER C: St. Paul Pita 4 Marina In1.Co.
24767
INSURER D:
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.
INse
LTR
ADDS
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATEIMMIDDIYY)
POLICY EXPIRATION
DATE (MMIDDM}
LIMITS
A
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
20075826
06/01/04
.-..:re.:. •
06/01/05
f�%, IY 1. 4"
EACH OCCURRENCE
$ $1, 000,
000
X
UAMAut IU KhNIkU
PREMISES (Ea accurence)
$$50r000
lCLAIMS MADE '" I.J OCCUR
MED EXP (Any one person}
$ $ 5 F 0 0 0
PERSONAL a ADV INJURY
S Si 0 0 0 0,
0 0 0
GENERAL AGGREGATE
S $2,, 000,
000
GEN'LAGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
S $10 000,
000
POLICY n JECT n LOC
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
t
'`
` ' j,.�
r +
;,I / IQ
0`j
FIE�
COMBINED SINGLE LIMIT
(Ea accidenl)
$
BODILY INJURY
(Per person)
S
BODILY INJURY
(Per accident}
$
PROPERTY DAMAGE
(Per accidenl)
$
B
GARAGE
LIABILITY
ANY AUTO
4507582600
06/01/04
06/01/05
AUTO ONLY - EA ACCIDENT
$ 1, 0 0 (I , 0
00
X
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
C
EXCESS/UMBRELLA LIABILITY
QK06800742
06/01/04
06/01/05
EACH OCCURRENCE
$$ 4 r 000 ,
000
X
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION S
AGGREGATE
S $4 r 000,
000
S
S
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
PROPRIETORIPARTNERlEXECUTIVE
OFFICERJMEMBEREXCLUDED?' --- ...............
If yes, describe under
SPECIAL PROVISIONS below
........ _._ ....
MIOIH• OR L
TORY LIMITTSS ER
E.L. EACH ACCIDENT
4ANY
E.L. DISEASE • EA EMPLOYEE
:i ,
E.L. DISEASE • POLICY LIMIT ,
$
OTHER
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT ! SPECIAL PROVISIONS
Certificate holder is additional insured as respects service of equipment7. ,
r.h0 ..
.-1
CERTIFICATE HOLDER
CANCELLATION
MIAMICI
City of Miami
444 SW 2nd Ave 6th Floor
Miami FL 33130
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 010 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITE AGENTS OR
REPRESENTATIVES.
AU7fIQRIZE RESENTATIV E
ACORD 25 (2001108)
® ACORD CORPORATION 1988
02/04/2005 09:57 FAX 18006101
Ia%1s pMwlDorrm
BD. CERTIFICATE OF LIABILITY INSURANCE atio aos
„ TFlis CERTIFICATE 16 ISSUED CONFINE NO ,,AB MAMA G�I�IF IIiA
10 on
01041oph0r EL Gardner do SSllersltuykandolL LLC HOLDER. T DOZE MT ��re ND CERTIFICATE
1560 Orange Avenue _AMRi- j O • . _ . �.• •• - 1'•- l
Sulta 760
Winter Park, FL 32780-8552 INSURERS AFFORDING COVERAGE
Iil, MO PIeuRP' ZUIIpMArflNiCin Intlurant a Ccf1 PIrIY
3ta1An8 Concept' IntemstIoltal, Inc. Mal AIL Lmp: NATIONALLtI17 TRUCK S'
SERVICE
Iti OIC: _.__
4224 West Henderson dive.
TrrlPe , FL 33629 MASA tst- ---
ultaremw
THE POLICIBB
ANY R!OuIRIM!NT.
MAY PERTAIN,
POLICIES.
OF INeURANCE U8TEO BELOW NAVE BEEN ISIUED TO THE INSURED NAMED ABOVE FORTHTI POIJCV PIR OD INDICATED. No-rwt H*TAIICIING
TERM OR CONDITION OF ANY CONTRACT OR O1NSR DOCUMENT iMT„�{ Ri6PECT TO WHICH T1118 CS -SWIM' M&V YE !SKIED OR
THE INSURANCE AFFORDED BY TM@ POLJCIEI DuI.1t1Et'.0 lIEREIN 16 SMUT TO ALL THE TERMS, EXCLUISI0NB AIJO CONDITIONS OF WON
ASO/MATE Ulan SHOWN MAY HAYS USN REDUCED BY PAID CLAIMS. „
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1PE�C1ALI�o ears •MWl
WC 45-57.044-00
on lam
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1 t160 000
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f +tin0,000
IL 01 4 . POLIC`
$ 1 C0.000
WWII
Location Caverns Fariod:
03/01/2004
03/01/2005
a $etelt: 04FL100737040
ellen* o1d70
DEJICRIPTM]rtOPop.aATIo1Ia&LOGamallmow. summo. , Ammo NY ParomoomorT1J W1 LPRoVI01o.e
moon* N provided Tor only NATIONAL LIFT TRUCK SERVICE
those omPloytoo Nand to 1901 MN 2ND STREET
tut not suboon twist or FT. LAUDERDALE, FL SMS111ST63
CERTIFICATE I1QS.DER
sty of Mend
444 9W 2nd Ave
61h FICor
Miami. FL 33174
ACOIlf Si (250110iy
CANCELLATION
I14O140 AW OT NI AIMS ONOORIMFD MAIM tee OAMILLI1D WORN THE W1I trno"
bwro THIItIOF. PM Msu poem WLL INonwog 7o NAL 30 ems ee.nyiM
NOTICI TO TIE C[ICTPICAT1 IIOLOIII IlWWINN TO TIM LJITT, IUT FAILURE To CO Io 11Ntk
ONPoso No 0111 MT10N c 11ASIWTM OP ANY IdrlD UPON TIM INTUFINN. I I soElhf ea
RNPRI TINTA1Tv
At/MONO= RHnuuENTATNII
waACo CORPORAM1� taes-