2016-188A - Laserfiche WebLink

Home Browse Search

AC CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDD/YYYY) 11/9/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER SUNZ Insurance Solutions, LLC ID: (Essential) NAME:CONTADT Jennifer Hau er c/o Essential HR, Inc. dba First Star HR PHONE-MAIL 972.404-0295 FAX No: 4455 LBJ Freeway, Suite 1080 E Dallas, TX 75244 ADDRESS: jennifer.hau.qer@firststarhr.com INSURERS AFFORDING COVERAGE NAIC 0 INSURER A: SUNZ Insurance Company 34762 INSURED Essential HR Inc INSURER B dba FirstStar HR INSURER C 4455 LBJ Freeway INSURER D: Suite 1080 Dallas TX 75244 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 32771312 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR I TYPE OF INSURANCE—_INSDWVDPOLICY NUMBER MMIDD/YYYY) (MMIDD[YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE [I OCCUR DAMA E T RENTED PREMISES Ea occurrence E MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE E POLICY 7 PRO- ❑ JECT LOC PRODUCTS-COMP/OPAGG E OTHER: E AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident S S UMBRELLA LIAR OCCUR EACH OCCURRENCE 3 EXCESS LIAR CLAIMS-MADE AGGREGATE g DED RETENTION E $ A WORKERS COMPENSATION WCPE0000018404 10/1/2016 10/1/2017 PER OTH- AND EMPLOYERS'LIABILITY YIN ✓ STATUTE ER ANYPROPRIETOR/PARTNER/EXECU7IVE WCPE00000184 03 10/1/2015 10/1/ 6 OFFICER/MEMBE R EXCLUDED? N/A 201E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE E 1 000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Coverage provided for all leased employees but not subcontractors of:Timothy Rose Contracting, Inc. 1360 SW OLD DIXIE HWY SUITE 106 Effective date: 10/1/2013 RE:8th Street Sidewalk Improvements 58 Avenue to 21st Court CERTIFICATE HOLDER CANCELLATION 62200099 Indian River County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Board of County Commissioners 1800 27th Street ACCORDANCE WITH THE POLICY PROVISIONS. Vero Beach FL 32960 AUTHORIZED REPRESENTATIVE Glen J Distefano ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 32771312 1 1 Master Essential HR dba First Star HR I Natalie Matthews 1 11/9/2016 10:26:39 AM (CDT) I Page 1 of 1