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2010-148
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2010-148
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Last modified
2/18/2016 11:40:06 AM
Creation date
10/1/2015 2:18:43 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
06/15/2010
Control Number
2010-148
Agenda Item Number
8.E.
Entity Name
Andrew Thomas with A. Thomas Construction, Inc.
Subject
Gifford Community Center Repairs
Bid Number
2010045
Supplemental fields
SmeadsoftID
9710
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ATE <br /> MMtODIYYYYI <br /> � c CERTIFICATE OF LIABILITY INSURANCE 0611812010 <br /> 06!18/2010 <br /> T=ERF IS ISSUED AS A MATTER OF INFORMATION <br /> PRODUCER <br /> Bill Knight Insurance Agency Inc . S NO RIGHTS UPON THE CERTIFICAT2301 Sunrise B {vd . TIFICATE <br /> DOES NOT AMEND, EXTEND OR <br /> GE AFFORDED BY THE POLICIES BELOW. <br /> Fort Pierce , FL 34982 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER Al State Farm Mutual Automobile Lnsuranco Company 25178 I 2 $178 1 <br /> ANDREW THOMAS INSURER B: <br /> 7945 99TH AVE INSURER C: <br /> VERO BEACH FL 329674428 INSURER D j <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED . NOTIMTHSTANDING <br /> ANY REQUIREMENT , TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INS ADO' POLICY NUMBER 13ATE�MMIMIpp�) DAATEEIMMM YYYYI LIMITS <br /> LTR 1NSR <br /> TYPE OF INSURANCE <br /> EACH OCCURRENCE f <br /> GENERAL LIABILITY <br /> PREMISES Eaoccwrence S <br /> COMMERCIAL GENERAL LIABILITY <br /> MED EXP iAnY �° Pew") $ <br /> CLAIMS MADE D OCCUR <br /> PERSONAL 8 ADV INJURY f <br /> GENERAL AGGREGATE S <br /> PRODUCTS • COMPIOP AGG S <br /> GENT AGGREGAT E UMrT APPLIES PER: <br /> POLICY JECOT <br /> LOC f <br /> X AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S <br /> (Ea accident) <br /> ANY AUTO <br /> ALL OWNED AUTOS 6451994-E79-59A 0511912010 11 /1912010 BODILY INJURY f 11000 ,000 <br /> (Per Penson) <br /> X SCr1EDULED AUTOS <br /> BODILY INJURY S 100004000 <br /> HIRED AUTOS (Per accident) <br /> NON-OWNED AUTOS <br /> PROPERTY DAMAGE S 1 ,000 ,000 <br /> (Per atcidenq <br /> AUTO ONLY - EA ACCIDENT f <br /> GARAGE LIABILITY <br /> ANY AUTO OTHER THAN <br /> EA ACC S <br /> AUTO ONLY: AGG S <br /> EACH OCCURRENCE f <br /> EXCESS I UMBRELLA LIABILITY <br /> AGGREGATE $ <br /> OCCUR CWMS MADE <br /> S <br /> f <br /> DEDUCTIBLE <br /> 5 <br /> RETENTION S TATLI- OTH <br /> WORKERS COMPENSATION AND TORY LIMITS ER <br /> EMPLOYERS' LIABILITYE.L EACH ACCIDENT f <br /> ANY PROPRIETORIPARTNERIEXECUTIVE Y <br /> OFFICERIMEMBER EXCLUDED? F E. L. DISEASE . EA EMPLOYE 5 <br /> (Mandatory in NH ) <br /> If yes describe under E.L. DISEASE - POLICY LIM-Al PROVISIONS below <br /> IT S <br /> OTHER I <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> BID #2010045 <br /> CERTTE HOLDER CANCELLATION <br /> IFICA <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> FNDAN RIVER COUNTY DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> CHASING DIVISION NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILIRE TO DO SO SHALL <br /> 27TH STREET, COUNTY ADMINISTRATION IMPOSE No OBLIGATION OR LIABILITY OF ANY KIND UPON THE CNSURER, ITS AGENTS OR <br /> O BEACH FL 32960 -3365 EPRESENTATTVES. <br /> IZE REPRESENTA � <br /> G <br /> l � L4 lf� tJr <br /> 0198 - 9 ACO CORPO ION . A lights reserved . <br /> ACORD 25 (2009101 ) 1001486 132849 . 3 04-06-2009 <br /> The ACORD name and logo are registered marks of ACORD <br />
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