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2017-009
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Last modified
2/20/2017 3:36:36 PM
Creation date
2/20/2017 3:28:12 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
01/17/2017
Control Number
2017-009
Agenda Item Number
8.F.
Entity Name
Marbrisa Homeowners Association
Subject
Seagrape Trail Beach Park
Dune Stabilization Projects
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OP ID: MK <br />ACRD' <br />41.1..... -"--.CERTIFICATE OF LIABILITY INSURANCE <br />DATE IMMIDDIYYYY) <br />02/09/2017 <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 <br />Stuart Insurance, Inc. <br />3070 S W Mapp <br />Palm City, FL 34990 <br />NAME CT Joseph E Coons <br />PHONE 772FAX <br />.286-4334 lac, No. Exn: (ac, No):772-286-9389 <br />E-MAIL jADDREcoons@stuartinsurance.net <br />Joseph E. Coons, CPCU. CIC. <br />PRODUCER <br />CUSTOMER ID #: GUETB"1 <br />INSURERS) AFFORDING COVERAGE <br />NAIC # <br />INSURED Guettler Brothers <br />Construction LLC <br />Ben G. Guettler <br />P.O. Box 12271 <br />Fort Pierce, FL 34979-2271 <br />INSURER A:Westfield Insurance <br />24112 <br />INSURER e <br />TRA7630158 <br />INSURER C : <br />06/3012017 <br />INSURER D : <br />$ 1,000,000 <br />INSURER E <br />PREDAMMISESAGE TO(Ea RENTEoccurreDnce) <br />INSURER F : <br />COVERAGES <br />CERTIFICATE NUMBER: <br />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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />' DOI.SUBR <br />JNSR <br />W <br />YD <br />POLICY NUMBER <br />POLICY EFF <br />MI <br />(MDD/YYYY) <br />POLICY EXP <br />IMM/DO1YYYY) <br />LIMITS <br />A <br />GENERAL <br />LIABILITY <br />COMMERCIAL GENERAL <br />LIABILITY <br />X <br />OCCUR <br />TRA7630158 <br />06/30/2016 <br />06/3012017 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />X <br />PREDAMMISESAGE TO(Ea RENTEoccurreDnce) <br />$ 500,000 <br />CLAIMS -MADE <br />MED EXP (Any one person) <br />$ 10,000 <br />X <br />Contractual <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />X <br />INCLUDES XCU <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GE <br />'L AGGREGATE LIMIT APPLIES PER: <br />POLICY I ^ I jECT n LOC <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,000 <br />$ <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />TRA7630158 <br />06/30/2016 <br />06/30/2017 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1,000,000 <br />X <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per acddent) <br />$ <br />X <br />PROPERTY DAMAGE <br />(PER ACCIDENT) <br />$ <br />X <br />X <br />PIP <br />$ 10,000 <br />$ <br />A <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />TRA7630158 <br />06/30/2016 <br />06/30/2017 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />AGGREGATE <br />$ 5,000,000 <br />DEDUCTIBLE <br />RETENTION $ <br />$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS <br />Y IN <br />N 1 A <br />WC STATU- OTH- <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />GS PTI OF PERATI NS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) <br />RADING OF LAND * Blanket Additional Insured in regards to General <br />Liabilityand Automobile Liability. Blanket Waiver of Subrogation for <br />General Liability. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />MARBH-1 <br />Marbrisa Homeowners <br />Association, Inc <br />8300 N. AIA <br />Vero Beach, FL 32963 <br />l <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 />AUTHORIZED REPRESENTATIVE <br />c5,1 014. E. ,. e_if>1--. <br />• <br />ACORD 25 (2009109) <br />© 1988-2009 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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