01/10/2017 (2) - Laserfiche WebLink

Home Browse Search

AC GRb® �_ CERTIFICATE OF LIABILITY INSURANCE 1 DATE {MMIDDNYYI ) 1/5/2017 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. HIS 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 poticy(Ies) 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 Schlitt Insurance Services 1717 Indian River Boulevard 1717 Suite 300 Vero Beach FL 32960 CONTACT Lois Robertson NAME: PHOO No NE Ext):(772)567-1188 (A/ (772)778-1416 MAIL lois@schlittservices.com ADDRESS: INSURER(8) AFFORDING COVERAGE NAIC • INsuRERA American States Insurance Co. COMMERCIAL GENERAL LIABILITY INSURED Clerk of the Circuit Court Jeffrey R. Smith 325 28th CT SW Vero Beach FL 32968 INSURERS INSURER C: INSURERD: $ INSURER E. $ INSURER F. CLAIMS -RADE _ OCCUR COVERAGES CERTIFICATE NUMBER:CL171503323 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 LTR TYPE OF INSURANCE ADDL IN6D SLBR %VD POLICY NUMBER POLICY EFF (MMIOONYYY) POLICY EXP (MMIOONYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ PREMISES (Ea occurrN ence) $ CLAIMS -RADE _ OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJJRY $ GENERAL AGGREGATE $ GEM AGGREGATE POLICY OTHER: LIMIT APPLIES PRO - JECT PER. LOC PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS RED AUTOS ^ SCHEDULED AUTOS AUTOSNON-OWNED COMBINED SINGLE LMR (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ POPT DAMAGE (Per acciderH) $ $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE 6 AGGREGATE S $ DEO RETENTION $ WORNERSCOMPENSATION AND EMPLOYERS' LIABLITY YIN ANY PROPRIETORIPARTNER)EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes. describe under DESCRIPTION OF OPERATIONS below NTA PER ERH E.L. EACH ACCIDENT $ E L. DISEASE - EA EMPLOYEE,. $ E.L. DISEASE - POLICY LMR $ A Public Official Bond 326372367 1/7/2013 1/17/2017 Limit 8100,000 DESCRIPTION OF OPERATONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached11 mon span Is required) CERTIFICATE HOLDER CANCELLATION Sample Certificate Only for one Registered in Your Name Please call 772-567-1188 Ext 126 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 R Schlitt Jr./LAR 4,4644e12 � J ACORD 25 (2014101) INS025 (201401) O 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD P52