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HomeMy Public PortalAboutCertificate of Liability Insurance 2020AC Ro® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08/13/2019 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 policy(les) 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 CONTACT NAME: RSC Insurance Brokerage, Inc. PHONE FAX AIC No Ext): AIC, No): 650 Dundee Road E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Suite 170 INSURERA: Valley Forge Ins Co 20508 Northbrook IL 60062 INSURED INSURER B: Continental Insurance Co Baxter & Woodman, Inc. INSURER C: Continental Casualty Company 477 S. Rosemary Avenue INSURER D: Suite 330 INSURER E: West Palm Beach FL 33401 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1981326689 REVISION NUMBER: THIS IS TO CERTIFYTHAT 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. INSR LTR TYPE OF INSURANCEAUU INSD WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO R PREMISES Ea occurrence $ 1,000,000 15,000 MED EXP (Any one person) $ X primary/non contributory X subject to written contract PERSONAL&ADV INJURY $ 1,000,000 A 6045872351 01/01/2019 01/01/2020 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2'000,000 POLICY PE0 7 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Es accident BODILY INJURY (Per person) $ X ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 6045872348 01/01/2019 01/01/2020 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED�/ NON -OWNED AUTOS ONLY X AUTOS ONLY X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5'000,000 B EXCESS LAB CLAIMS -MADE 6045872365 01/01/2019 01/01/2020 AGGREGATE $ 5,000'000 DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANYPROPRIMBR/PARTNER/E?ECUTIVE ❑ (MandatoryOFFICER/MEXCLUDED. in NH) {Mandatory in NH) N/A 6045872379 01/01/2019 01/01/2020 SPER TATUTE EORH X1 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Professional Liability AEH591900841 01/01/2019 01/01/2020 Per Claim 5,000,000 Aggregate 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: General Engineering Services GtK71fIGA1Iz HULDEK Town of Gulf Stream Attn: William Thrasher, 100 Sea Road Gulf Stream SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE FL 33483- ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD