HomeMy WebLinkAboutInsuranceACORD,, CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DO/YY)
3/14/06
PRODUCER
•
Acordia
Miami Division
3225 Aviation Ave, Suite 400
Coconut Grove, FL 33133
305-443-4886
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED
Weekley Asphalt Paving, Inc.
20701 Stirling Road
Pembroke Pines, FL 33332
INSURER A: Continental Casualty
INSURER B: Transportation Ins. Co.
INSURER c: American Casualty Ins. Co.
INSURER o: St. Paul Travelers
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.
NSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POUCY EFFECTIVE
DATE (MM YJ /DD/Y
POLICY EXPIRATION
DATE (MM/DD/YYI
LIMITS
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
`CLAIMS MADE X 1 OCCUR
GL2068425464
3/01/06
3/01/07
EACH OCCURRENCE
5 1000000
FIRE DAMAGE lAny one fire)
$ 100000
MED EXP (Any one person)
5 5000
PERSONAL& ADV INJURY
$ 1000000
GENERAL AGGREGATE
5 2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
5 2000000
7 POLICY X MT' 7 LOC
A
1111F
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BUA2068425268
3/01/06
3/01/07
COMBINED SINGLE LIMIT
(Ea accident
5 1000000
X
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
$
GARAGE
UABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
EA ACC
OTHER THAN
5
AUTO ONLY: AGG
5
B
EXCESS UABILITY
CUP2068425819
3/01/06
3/01/07
EACH OCCURRENCE
$ 5000000
X 'OCCUR CLAIMS MADE
AGGREGATE
$ 5000000
DEDUCTIBLE
RETENTION 5 10,000
$
$
X
5
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABIUTY
WC257351877
3/01/06
3/01/07
WC STATU- OTH-
X 1 TORY LIMITS 1 ER
E.L. EACH ACCIDENT
5 500000
E.L. DISEASE - EA EMPLOYEE
$ 500000
E.L. DISEASE - POLICY LIMIT
5 500000
OTHER
Lease/Rent
All Risk ACV
QT6008193B000
3/1/06
3/1/07
L&R Equip 500000
Ded 1000
SCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
BROWARD COUNTY BOARD OF COMMISSIONERS
PROJECT #HZ0537661 - GENERAL ROADWAY / MISCELLANIOUS CONSTRUCTION
NAMED AS AN ADDITIONAL INSURED WITH RESPECTS TO THE GENERAL LIABILITY Approved by•
POLICY. PN +1''^ r.. i wy._ r 1 i '" , Risk Management r.�,��Qcr��
RTIFICATE HOLDER
ADDITIONAL INSURED; INSURER LETTER:
CANCELLATION
"Vrrc. "1jja(J ap
BROWARD COUNTY BOARD OF COUNTY
COMMISSIONERS
115 S ANDREWS AVE, RM 212
FORT LAUDERDALE, FL 33031
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
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 UABILrrY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIV
AUTHORIZE
ESENTATIVE♦
MD 25-S (7/97)
60- 59
g ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
so
ACORD 25-S (7/97)