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2013-079A
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2013-079A
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Last modified
11/2/2015 10:43:47 AM
Creation date
10/1/2015 5:16:19 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
04/23/2013
Control Number
2013-079A
Agenda Item Number
8.E
Entity Name
EMC Divers, Inc.
Subject
Master Agreement Sediment Removal
Area
PC Main Pollution Control Facility
Bid Number
201320
Supplemental fields
SmeadsoftID
11886
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.•�'"1 EMCDI-1 OP ID: MB <br /> CERTIFICATE OF LIABILITY INSURANCE 1 °"'04PAWDWYYM <br /> /2 <br /> 04124N113 3 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. if SUBROGATION IS WAIVED, subject <br /> to <br /> the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights <br /> to the <br /> certificate holder in lieu of such endorsement (s). <br /> PRODUCER 140743694962 NAME; Michelle Benedict <br /> SIHLE INSURANCE GROUP, INC. PHONE <br /> P. O. BOX 160398 407-774-0936 c No E ; 407-389-3827 AIC No): 407489=8427 <br /> ALTAMONTE SPRINGS, FL 32716 ADDRESS: <br /> James Blakeley Newman mbenedict sihie.com <br /> INSURERS) AFFORDING COVERAGE NAIC <br /> INSURER A : Commerce & Industry Insurance 19410 <br /> INSURED EMC Divers, Inc. INSURER 8 : <br /> 1190 Turnbull Bay Road INSURER C : <br /> New Smyrna Beach, FL 32168 <br /> INSURER D <br /> INSURER E : <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER : REVISION NUMBER : <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br /> TERMS , <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ADUL BUISH POLICY EFF POLICY EXP <br /> ITER TYPE OF INSURANCE POLICY NUMBER M MMIDDNYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAMAGE TO RENTLIY <br /> COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence f <br /> CLAIMS-MADE El OCCUR MED EXP (Any one person) $ <br /> PERSONAL & ADV INJURY S <br /> GENERAL AGGREGATE S <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ <br /> POLICY PRO LOC S <br /> AUTOMOBILE LIABLMCOMBINED SINGLE LIMIT <br /> Ea accident E <br /> ANY AUTO BODILY INJURY (Per person) S <br /> ALL OWNED SCHEDULED BODILY INJURY (Per accident) S <br /> AUTOS NON AUTOWNED POP TY DAMAGE S <br /> HIRED AUTOS AUTOS Per accident <br /> S <br /> UMBRELLA LIAB H OCCUR EACH OCCURRENCE S <br /> EXCESS LIAB CLAIMS•MADE AGGREGATE S <br /> DED RETENTIONS S <br /> WORKERS COMPENSATION XWC LIMITS U• O H- <br /> AND EMPLOYERS' LIABILITY YIN 00 <br /> A ANY PROPRIETOR/PARTNEREXECUTIVE ❑ N / A 04321709 05/03/12 05/03/13 E.L. EACH ACCIDENT $ 1I , 00 <br /> OFFICERIMEWBER EXCLUDED? <br /> (Mandatory In NH) E.L. DISEASE • EA EMPLOYEE S _ 1 , 000, <br /> Nq <br /> Ryes, describe under 1000 0 <br /> DESCRIPTION OF OPERATIONS below E .L. DISEASE - POLICY LIMIT $ r r <br /> A USLBH WC4321709 05/03/12 05103/13 USL&H Statutory <br /> A arltlme WC4321709 05/03/12 05/03/13 Marine Em 10000, 0 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACach ACORD 101 , Additional Remarks Schedule, if more space is required) <br /> (Place of Operations ) Bid # 2013023 - Annual Bid for Sediment Removal at PC <br /> in <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Indian River County Purchasing ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Division <br /> 1800 27th Street AUTHORIZEDREPRESErfrATNE <br /> Vero Beach , FL 32960 <br /> ® 1998-2010 ACORD CORPORATION . All rights reserved. <br /> ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />
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