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2011-134B
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2011-134B
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Entry Properties
Last modified
2/10/2016 10:22:50 AM
Creation date
10/1/2015 2:40:31 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
06/14/2011
Control Number
2011-134B
Agenda Item Number
8.D.2
Entity Name
Unified Recovery Group, LLC
Subject
Disaster Debris Removal and Disposal
Secondary Contract
Bid Number
2011040
Supplemental fields
SmeadsoftID
9990
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DATE <br /> aco CERTIFICATE OF LIABILITY INSURANCE Pagel of 1 06 /(14 / 2011 <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 ( ies) must be endorsed . If SUBROGATION IS WAIVED , subject to <br /> the terms and conditions of the policy , certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement (s ) . <br /> PRODUCER CONTACT <br /> Willis of Alabama , Inc . PHONE FAX 888 - 467 - 2378 <br /> 26 Century Blvd . (ALC..NO..EXT) 877 - 945 - 7378 to/CNoa <br /> P . 0 . Box 305191 E- MAILADDRESS certificates@willis , com <br /> Nashville , TN 37 23 0 - 5191 INSURE R(S )AFFORD ING COVERAGE NAIC # <br /> INSURERA: Chartis specialty Insurance Company , USA 26883 - 003 <br /> INSURED INSURERB : Commerce and Industry Insurance Company 19410 - 001 <br /> Unified Recovery Group , LLC <br /> 631 Main St . INSURER C: <br /> Baton Rouge , LA 70801 INSURER D : <br /> INSURER E : <br /> INSURER F : <br /> COVERAGES CERTIFICATE NUMBER : 16074241 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 TERMS <br />, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS . <br /> INSR DO' SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> I TR TYPE OF INSURANCE <br /> A GENERAL LIABILITYY PROP1982902 7 / 26 / 2010 7 / 26 / 2011 EACHOCCURRENCE $ 11000 , 000 <br /> DAMAGE TO RENTED <br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurence $ 500 , 000 <br /> CLAIMS- MADE[ x] OCCUR M ED EXP (Anyone person) $ 25 , 000 <br /> PERSONAL B ADV INJURY $ 10 000 , 000 <br /> GENERAL AGGREGATE $ 2 , 000 , 000 <br /> GEN' L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2e000 , 000 <br /> POLICY X PRO- LOC $ <br /> B AUTOMOBILE LIABILITY CA7170734 7 / 26 / 2010 7 / 26 / 2011 COMBINED SINGLE LIMIT(Ea accident) $ 1 , 000 , 000 <br /> X ANY AUTO BODILY INJURY( Per person) $ <br /> ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> HIRED AUTOS NON-OWNED (Per IR acatlent)AMA E $ <br /> AUTOS <br /> A X UMBRELLALIA13 X OCCUR PROU2025310 7 / 26 / 2010 7 / 26 / 2011 EACH OCCURRENCE $ 5 000 , 000 <br /> EXCESS LAB CLAIMS- MADE AGGREGATE $ 5 1 0000000 <br /> DED I X RETENTION $ 10 , 000 $ <br /> B WORKERS COMPENSATION WC5867667 7 / 26 / 2010 7 / 26 / 2011 X WC STATU- 1 ER <br /> OTH- <br /> AND EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE � E.L. EACH ACCIDENT $ 11000 , 000 <br /> N / A <br /> OFFICER/MEMBER EXCLUDED? E .L. DISEASE - EA EMPLOYEE $ 11000 , 000 <br /> I(Mandatory in NH) <br /> f yes, describe under <br /> DESCRIPTION OF OPERATIONS below E .L. DISEASE - POLICY LIMIT $ 11000 , 000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach Acord 101 , Additonal Remarks Schedule, if more space is required) <br /> It is agreed that Indian River County is included as an Additional Insured as respects to General <br /> Liability if required by written contract but only for liability arising out of your work . <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 /> ACCORDANCE WITH THE POLICY PROVISIONS . <br /> Indian River County <br /> Office of Management and Budget AUTHORIZED REPRESENTATIVE <br /> Purchasing Division <br /> 1800 27th St , <br /> Vero Beach , FL 32960 <br /> Coll : 3389574 Tpl : 1124938 Cert : 16074241 © 1988 -2010ACORD C RPORATION . Allrightsreserved . <br /> ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />
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