Laserfiche WebLink
.4CORO® CERTIFICATE OF LIABILITY INSURANCE <br />�/ <br />DATE(MM/DD/YYYY) <br />02/09/2017 <br />THIS CERTIFICATE I5 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(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Bouchard Insurance for WBS <br />P.O.Box 6090 <br />FL 33758-6090 <br />CONTACT <br />PHONE FAX <br />(Arc. No. Exl); (866) 293-3600 ext. 623 (A/C, No): <br />E-MAIClearwater, <br />ADDRESS: <br />I NSURER(S) AFFORDING COVERAGE <br />NAIC t! <br />INSURERA: American Zurich Insurance Company <br />40142 <br />INSURED <br />Workforce Business Services, Inc. Alt. Emp: Guettler Brothers Construction LLC <br />1401 Manatee Ave. West Ste 600 <br />Bradenton, FL 34205-6708 <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />$ <br />INSURER E : <br />INSURER F: <br />COVERAGES <br />CERTIFICATE NUMBER:16FL079902691 <br />• <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 />INSRLR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MM/OD/YYYY) <br />POLICY EXP <br />IMM/DD/YYYYI <br />LIMITS <br />COMMERCIAL GENERAL UABILITY <br />EACH OCCURRENCE <br />$ <br />CLAIMS -MADE <br />OCCUR <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />$ <br />MED EXP (Any ono person) <br />$ <br />PERSONAL &ADV INJURY <br />$ <br />GEN'L <br />AGOREGATE <br />POLICY <br />OTHER: <br />LIMIT APPLIES <br />PRO <br />JECT <br />PER: <br />LOC <br />GENERAL AGGREGATE <br />$ <br />PRODUCTS - COMP/OP AGG <br />$ <br />S <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED <br />AUTOS ONLY <br />HIRED <br />AUTOS ONLY <br />_ <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS ONLY <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY accident <br />( ) <br />$ <br />PROPERTY DAMAGE <br />(per accident) <br />$ <br />$ <br />UMBRELLA LIAR_ <br />EXCESS LIAB <br />OCCUR <br />CLAIMS•MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED <br />RETENTIONS <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />OFFIC R/MEM EREXCLUDEmrECUTIVE <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />Y / N <br />N/A <br />WC 90-00-818-06 <br />12/31/2016 <br />12/31/2017 <br />X PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />S 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />Location Coverage Period: <br />12/31/2016 <br />12/31/2017 <br />Client# 050682 <br />DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />Coverage Is provided for Guettler Brothers Construction LLC <br />only those co employees 4401 White Way Dairy Road <br />of, but not subcontractors Fort Pierce, FL 34947 <br />to: <br />CERTIFICATE HOLDER <br />CANCELLATION <br />Maribrisa Homeowners Association Inc <br />8300 N A1A <br />Vero Beach, FL 32963 <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 />©1988-2015 ACORD CORPORATION. All rights reserved. <br />