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2010-091
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2010-091
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Last modified
2/10/2016 10:22:54 AM
Creation date
10/1/2015 2:09:36 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
04/06/2010
Control Number
2010-091
Agenda Item Number
12.J.1.
Entity Name
R.K. Contractors
Bond-Hanover Insurance Company
Indian River State College
Subject
College Lane Extension Water Main
Supplemental fields
SmeadsoftID
9641
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®� CERTIFICAOF LIABILITY INSURAK E OP ID JL DATE � <br /> RRCON- 1 03 / 05 / 10 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Kearns Agency of Florida Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND , EXTEND OR <br /> P O Box 1849 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Jensen Beach FL 34958 <br /> Phone : 772 - 334 - 5822 Fax : 772 - 334 - 0940 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: Owners Insurance CO an <br /> INSURER B: An Go ovners In "ra Coapa y <br /> R K Contractors Inc - INSURER C: soutbers ov ors Ineuren Co . 10190 <br /> 2860 S Brocksmi -Eh Rd . INSURER D: <br /> Fort Pierce , EL 34945 - 4446 <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING <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 WSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE UMrTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> LTR N TYPE OF INSURANCE POLICY NUMBER DATE DATE MM/DD U"TS <br /> GENERAL LIABILITY EACH OCCURRENCE s 1 , 000 , 000 <br /> A X X COMMERCIAL GENERALLIANuTY 72698658 10 / 03 / 09 10 / 03 / 10 PPR EMISF��accurence s 300 000 <br /> CLAIMS MADE ® OCCUR MED EXP (Any one person) $ 101000 <br /> PERSONAL BADV INJURY S 1 , 000 , 000 <br /> GENERAL AGGREGATE s3 , 0001000 <br /> GENOLAGGREGATEUMTTAPPUESPER: PRODUCTS - COMP/OPAGG s3 , 000 , 000 <br /> X POLICY J� LOC <br /> AUTOMOBILE LJABILTTY COMBINED SINGLE LIMIT a1 , 000 , 000 <br /> g ANY AUTO 95 - 434 - 709 - 00 10 / 03 / 09 10 / 03 / 10 (Eaacudent) <br /> ALL OWNED AUTOS BODILY INJURY f <br /> X SCHEDULED AUTOS (per person) <br /> X HIRED AUTOS BODILY INJURY S <br /> X NON-OWNED AUTOS (Per acadonL) <br /> PROPERTY DAMAGE f <br /> (Per I0cident) <br /> GARAGE LIABILTrY AUTO ONLY - EA ACCIDENT f <br /> ANY AUTO OTHER THAN EA ACC f <br /> AUTO ONLY: AGG S <br /> EXCESS I UMBRELLA L.IABETTY EACH OCCURRENCE S <br /> OCCUR FICLAIMS MADE AGGREGATE $ <br /> f <br /> DEDUCTIBLE $ <br /> RETENTION f S <br /> WORKERS COMPENSATION TORY UMITS I 71MERT: <br /> AND EMPLOYERS' LIABILITY Y I N — <br /> ANY PROPRIETOR/PARTNERIEXECUTNq --i EL EACH ACCIDENT OFFICER/MEMBER EXCLUDED? u <br /> EL DISEASE - EA(Mandatory In NH) f <br /> M yes, desulbe under E.L DISEASE - POLICY UMIT f <br /> SPECIAL PROVISIONS below <br /> OTHER <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> The certificate holder is also listed as an additional insured in regards to <br /> the General Liability only . <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLJC>ES BE CANCELLED BEFORE THE EXNRATIO <br /> DATE THEREOF, THE ISSUING INSURER VALL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> REPRESENTATIVES. <br /> Indian River BOCC AUTHORIZED REPRESENTATIVE <br /> 1800 27th Street Lawrence E . Kearns <br /> Vero Beach FL 32960 <br /> ACORD 25 (2009/01 ) ® 1988-2009 ACORD C TION . All rights reserved . <br /> The ACORD name and logo are registered marks of ACORD <br /> Z000 / Z0001n XVA 9T : TT OTOZ / 80 / EO <br />
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