HomeMy Public PortalAbout2015 Certificate of Liability Insurance.tifSOUTENG-01
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ACORo CERTIFICATE OF LIABILITY INSURANCE
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5/15/2015
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 POUCIES
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 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 & French, LLC
8000 Governors Square Blvd
Suite 301
Miami Lakes, FL 33016
NSURED
Southeastern Engineering Contractors,
12054 NW 98th Avenue
Hialeah Gardens, FL 33018
CONTACT
NAME:
PHONE 305 822-7800 FAX
INC NoMAIL' EXt):( ) lArc, Nog (305) 362-2443
ADDRESS.
INSURER(S) AFFORDING COVERAGE
NAIL S
INSURER A:First Mercury Ins. Company
10667
Inc.
INSURER 8:Ohio Security Insurance Company
24082
enuRERc: Federal Insurance Company
20281
NSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS
INDICATED.
CERTIFICATE
EXCLUSIONS
MA
LTR
IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
TYPE OF INSURANCE
'LSO Policy NUMBER
(MWOCIYYYY)
(MWWDDDWY)
LIARS
A
X
COMMERCIAL GENERAL
LABILITY
T occUR
X
MICGL000005150501
01/31/2015
EACH OCCURRENCE
S 1,000,000
I CWMS-MADE
01131/2016
PRDA M arIE D ,,l
E 50,000
GEN'L
MED EXP (Any one person)
S Excluded
PERSONAL S ADV INJURY
S 1,000,000
AGGREGATE UNIT APPUES PER.
POIJCY C] jEd LOC
OTHER:
GENERAL AGGREGATE
S 2,000,000
PRODUCTS- COMP/OP AGG
S 2,000,000
E
B
AUTOS10B11JE
X
X
LIABILITY
AN,AUTO
ALL OWNED
AUTOS
HIRED AUTOS
X
SCHEDULED
AUTOS
NON -OWNED
AUTOS
X
BA566460090
01/31/2016
01/31/2018
COMBNED SINGLE LIMIT
(Ea accident)
j 1,000,000
BODILY INJURY (Per parson)
S
BODILY INJURY (Per accident)
PROPERTY DAMAGE
(Per accident)
S
USBRELLAUAB
EXCESS LAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
S
DED RETENTIONS
E
WORKERS COMPENSATION OTH-
AND EMPLOYERS' LABILITY YIN
ANY PROPRIETORPARTNERIEXECUTNE
OFFICER EMBER EXCLUDED?
/M
(Mandatory In NH)
H yea. describe OF O
DESCRIPTION OF OPERATIONS below
NIA
STATUTE ER
EL EACH ACCIDENT
E.L DISEASE - EA EMPLOYEE
S
EL DISEASE -POLICY SW
E
C
Leased/Rented
45468421
03/26/2016
03/26/2016
w15000 Ded Applies 300,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addlttoml Remade Schedule, may be attached I/ more specs N required)
Village of Key Biscayne and Stantec are named as additional insureds
CERTIFICATE HOLDER CANCELLATION
Village of Key
88 W. Mclintyre
Key Biscayne,
Biscayne
Street
FL 33149
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORED REPRESENTATIVE
N n
ACORD 25 (2014/01)
CO 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo a e registered marks of ACORD