2017-032A - Laserfiche WebLink

Home Browse Search

ACOREP CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `-� 3/8/2017 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. 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). CONTACT PRODUCER SUNZ Insurance Solutions, LLC ID- (Essential) NAME: Jennifer Hau er c/o Essential HR, Inc dba First Star HR PHONE E g72 404-0295 FAX No: 4455 LBJ Freeway, Suite 1080 'E MAIL Dallas, TX 75244 ADDRESS. 'ennifer.haU er firststarhr.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA. SUNZ Insurance Company 34762 INSURED INSURER B. Essential HR Inc dba FirstStar HR INSURER C. 4455 LBJ Freeway INSURER D. Suite 1080 INSURER E. Dallas TX 75244 INSURER F. COVERAGES CERTIFICATE NUMBER: 34568759 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 TYPE OF INSURANCE INSID WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE FIOCCUR DAMAGES(RENTED PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY F PRO JECT ❑LOC PRODUCTS-COMP/OP AGG $ OTHER: $ 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 UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION WCPE00000184 04 10/1/2016 10/1/2017 ,/ STATUTE EORH _ AND EMPLOYERS'LIABILITY Y/N WCPE0000018403 10/1/2015 10/1/2016 ANYPROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe 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 CERTIFICATE HOLDER CANCELLATION 62200099 Indian River Count SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Indi Inds 27th Street y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Vero Beach FL 32960 AUTHORIZED REPRESENTATIVE N Glen J Distefano ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 34568759 1 1 Master Essential HR dba First Star HR I Natalie Matthews 13/8/2017 1 24 21 PM (CDT) I Page 1 of 1