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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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L µ 1. V J / V / LV1Vo 11111G . 1V . Vz n1.1 1V • U V , lIILZVLVIVv <br /> Page : 001 <br /> DATE A ®TM CERTIMA� _ OF LIABILITY INSURANC _ o3 /08/ <br /> � 03 /08 /2010 <br /> PRODUCER ( 407 ) 788 - 3000 FAX ( 407 ) 788 - 7933 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Insurance Office of America , Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT, AMEND, EXTEND OR <br /> P • 0 . Box 162207 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Altamonte Springs , FL 32716 - 2207 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED R • K . Contractors Inc . INSURER A: Bridgefield Employers Ins Co 10701 <br /> 2860 S . Brocksmith Road INSURER B: <br /> Ft . Pierce , FL 34945 - 4446 INSURER C : <br /> INSURER D <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. 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 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 /> INSR D' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> t TR DATE fMWDDffYI DATE (MMIDDI'M <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ <br /> PREMIc�FSiEnncmIno Al <br /> CLAIMS MADE OCCUR MED EXP (Any one person) $ <br /> PERSONAL 6 ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ <br /> POLICY JPERCOT- LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea accident) $ <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person ) <br /> $ <br /> HIRED ALITOS BODILY INJURY <br /> NON-OWNED AUTOS (Per accidert) $ <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> *GELIABILrTY AUTO ONLY - EA ACCIDENT AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG S <br /> EXCESSAIMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR ❑ CLAIMS MADE AGGREGATE $ <br /> S <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND 0830 - 40508 12 /31 /2009 12 /31/2010 X We srATu oTH- <br /> EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 11000 , 0001 <br /> A ANY PROPRIETOWPARTNER(EXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ 11000 , 000 <br /> If yes, describe oder <br /> SPECIAL PROVISIONS below E .L. DISEASE - POLICY LIMIT I $ 1 , 000 , 000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPE AT)ON DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAL <br /> 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> Indian River BOCC BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br /> 1800 27th Street OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br /> Vero Beach , FL 32790 AUTHORIZED REPRESENTATIVE // `A <br /> 3eff La os RICIA C�f9 <br /> CORD 25 ( 2001 /08) OACORD CORPORATION 1988 <br />
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