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HomeMy Public PortalAbout2020 Certificate of Liability Insurance.pdfACORO� ��. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/3012020 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 Marsh USA Inc. PHONE 2929 Allen Parkway, Suite 2500 Houston, TX 77019 CN102369057-PoI-Poi-20-21 CONTACT NAME: IAIC. No. Exti: FAX (A/C, No): E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC # INSURER A : Starr Indemnity 8. Liability Company 38318 INSUREDWitt O'Brien's LLC O'Brien's Response Management, LLC 1201 15th Street NW, Suite 600 Washington, DC 20005 INSURER B : N/A N/A INSURER C : N/A N/A INSURER D :NIA N/A INSURER E : N/A N/A INSURER F : COVERAGES CERTIFICATE NUMBER: HOU-003672890-04 REVISION NUMBER: 2 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 LTR TYPE OF INSURANCE ADDL ,lotSD SUER .1!10/12. POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP IMM/DD/Y1fYY] LIMITS A X COMMERCIAL GENERAL LIABILITY MASILHS00105720 06/01/2020 06/01/2021 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PR S RENTED PREEMIMI E SES ( (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER. LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED SCHEDULED AUTOS NON -OWNED AUTOS ONLY 1000198884201 Excludes US Virgin Islands. 10/01/2020 10/01/2021 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS LIAB O OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N NIA 1000003889 10/01/2020 10/01/2021 x PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Subject always to policy terms, conditions and exclusions, Certificate Holder is named as Additional Insured (excluding Professional Liability and Workers' Compensation and Employers' Liability) but only to the exten of risks and liabilities assumed by the Named Insured in a signed written contract. The polices certified hereon are primary and non-contributory only to the extent of risks and liabilities assumed by the Named Insure in a signed written contract and subject always to policy terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION Village of Key Biscayne 88 West McIntyre Street, Suite 220 Key Biscayne, FL 33149 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 of Marsh USA Inc. Manashi Mukherjee ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Dear Certificate Holder: As many companies have moved to a remote working environment, mailing Certificates of Insurance to a physical address can cause unnecessary delays in providing you proof of insurance. To streamline delivery and in an effort to support our firm's commitment to sustainability, going forward, we would like to distribute your Certificates of Insurance electronically if possible. We are kindly requesting Certificate Holders provide us an emait address where we can deliver your COI in the future. Please send your response to: USOperatrons.email@marsh.com and provide the following information so that we can expedite your COI delivery: • Certificate # (Shown below Insured Name — e.g.: ABC -123456789-0.0 • E -Mail for future delivery: For undeliverable email addresses, our system is configured to automatically redirect the Certificate for deliveryvia USPS. Lastly, if you no longer need this COI please respond to USOperations.emaii(wmarsn.com with the Certificate number and we will inactive the record in our system to avoid future automatic delivery, Thank you. US Operations, Marsh USA, Inc.