2017-009 - Laserfiche WebLink

Home Browse Search

� CERTIFICATE OF LIABILITY INSURANCE AC R» DATE (MMIDDlYYW) 12/08/2016 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(les) must 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 Bouchard Insurance for WBS P.O.Box 6090 Clearwater. FL 33758-6090 CONTACT NAME: PHONE 666 293-3600 ext. 623 FAX (AIC. ( ) (AIC, Nog E-MAILExtl: IL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 0 INSURER A : American Zurich Insurance Company COMMERCIAL GENERAL LIABILITY 40142 INSURED Workforce Business Services, Inc. Alt. Emp: Guettler Brothers Construction LLC 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708 INSURER B : INSURER C ; INSURER D : $ INSURER E : INSURER F : 1 I OCCUR 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 IN LTRTYPE OF INSURANCE ADDL D SUER WVD POLICY NUMBER .JMMIDDIYYYYUMMIDD/YYYY) POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 I OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY I 1 PRO- LOC PRODUCTS - COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS —' SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS _ NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION x PER OTH- STATUTE ER AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN WC 90-00-818-05 12/31/2015 12/31/2016 E.L. EACH ACCIDENT $ 1,000,000 A OFFICERIMEMBER EXCLUDED'l (Mandatory In NH) N / A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 Location Coverage Period: 12/31/2015 12/31/2016 Client# 050682 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space la requl ed) Guettler Brothers Construction LLC Coverage Is provided for 4401 White Way Dairy Road only those co -employees of, but not subcontractors Fort Pierce, FL 34947 to: CERTIFICATE HOLDER CANCELLATION I Indian River County 1800 27th Street Vero Beach, FL 32960 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD