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HomeMy Public PortalAboutPRR 21-2836 Renee Basel From:Jared Maciej <jared.maciej@theclaimscenter.com> Sent:Monday, March 29, 2021 12:56 PM To:Rita Taylor Subject:Public Records Request C: 20D00009614129640045 \[NOTICE: This message originated outside of the Town of Gulfstream -- DO NOT CLICK on links or open attachments unless you are sure the content is safe.\] Hello, I would like to request the certificate of liability insurance for your contractor, Foster Marine Contractors Inc that covers the date of 6/18/2020. They were excavating for you near North Ocean Blvd & Golfview Dr in Gulf Stream, when they damaged a Florida Power & Light underground cable. Thank You, The Claims Center, LLC is a third party claims administrator specialized in research and reconciliation of third party damages to public utility equipment. Jared Maciej Supervisor – Research Department P.O. Box 47604 Plymouth, MN 55447 Phone: 866-233-0353 x143 Fax: 866-233-9627 Jared.maciej@theclaimscenter.com This e-mail is covered by the Electronic Communications Privacy Act, 18 U.S.C.§§ 2510-2521 and is legally privileged. This e-mail, and any attachment, contains confidential and privileged material for the sole use The linked image cannot be displayed. The file may have been moved, renamed, or deleted. Verify that the link points to the correct file and location. of the intended recipient(s). Any review, use, distribution or disclosure by others is strictly prohibited. If you are not the intended recipient (or authorized to receive for the recipient), please contact the sender by reply e-mail and delete all copies of this message and any attachments. 1 TOWN OF GULF STREAM PALM BEACH COUNTY, FLORIDA Delivered via e-mail March 31, 2021 Jared Maciej. [mail to: jared.maciej@theclaimscenter.com] Re: GS #2836 (Certificate of Liability) I would like to request the certificate of liability insurance for your contractor, Foster Marine Contractors Inc that covers the date of 6/18/2020. They were excavating for you near North Ocean Blvd & Golfview Dr in Gulf Stream, when they damaged a Florida Power & Light underground cable. Dear Jared Maciej. [mail to: jared.maciej@theclaimscenter.com]: The Town of Gulf Stream received your public records request on March 30, 2021. Your request and responsive record can be found at the following link: https://portal.laserfiche.com/Portal/DocView.aspx?id=174770&repo=r-430100cc We consider this request closed. Sincerely, Reneé Rowan Basel As requested by Rita Taylor Town Clerk, Custodian of the Records FOSTMAR-01 KDACRES r ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDmrrY)a/2212020 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(ies) 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 Collinsworth, Alter, Fowler 8r French, LLC 8000 Governors Square Blvd Suite 301 Miami Lakes, FL 33016 NAME CT Karen Dacres PHONE FAX No, Ext): (A/c, No): E- A oRIE , Kdacres@caffllc.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Everest National Insurance Co 10120 INSURED INSURERB:LIbe Insurance Corp. 42404 INSURER C : North River Insurance Company 21105 Foster Marine Contractors, Inc. INSURER D : Liberty Mutual Fire Insurance Company 23035 3180 Fairlane Farms Road, Suite 1 INSURER E : Federal Insurance Company 20281 Wellington, FL 33414 INSURER F : rnvccnr_Ge 1'I={7TICIf`ATl= n111nnRF=P- RFVISION NIIMRFR- THIS IS TO CERTIFY THAT 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 IL TYPE OF INSURANCE ADDL IN D SUBR WV POLICY NUMBER POLIC MM/DDY EFF POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X CF3GL00032191 9/27/2019 9/27/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 100,000 $ MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [ JJECT El LOC OTHER: Capped at $5,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X NON- ONES AS7Z91470980029 9/27/2019 9/27/2020 a.lc tlerr'SINGLE LIMIT (CEO $ 1,000,000 BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPER, cenIDAMAGE $ C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 5821127883 9/27/2019 9/27/2020 EACH OCCURRENCE $ 4,000,000 X AGGREGATE $ 4,000,000 DED X I RETENTION $ 0 $ D WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY OFFICER/MEMBER EXCLUDED ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA �WC2Z91470980019 9/27/2019 9/27/2020 PER OTH- X I TAT TE ERY1,000,000 E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ E Equipment Floater 45467613 9/27/2019 9/27/2020 Leased/Rented 300,000 1 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) REF: State Road A1A Water Main Improvements - Phase 2 (Bid No. 20-100) Town of Gulf Stream is included as an additional insured with respects to general liability when required by written contract. Town of Gulf Stream 100 Sea Road Gulf Stream, FL 33483 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD