Laserfiche WebLink
ACORD <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />09/17/2014 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />• CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE <br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />, <br />NT VICROQDOGER,►NDTifECER44FICA 3ER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 />Amsley Insurance Services Inc <br />1.61.7 1_3th.St <br />CONTACT Lance Turck <br />NAME: <br />MIL EM1: (407) 892-9645 FAX No)_ (407) 892-7807 <br />E-MAIL e It insurance.com <br />ADOREss: It@amsleyinsurance.com <br />ANSURER{S):AF.F.ORDING:GOVERAGE <br />-NAIC.fl <br />St Cloud FL 34769-4306 <br />INSURER A : Colony Insurance Co <br />37150 <br />INSUREDINSURER <br />TSI Disaster Recovery, LLC. <br />4130 Canoe Creek Rd <br />St Cloud FL 34772-7702 <br />B : Integon National Insurance Co <br />01140 <br />INSURER c :American Alternative Insurance Co <br />19720 <br />INSURER D : Granite State Insurance:Co <br />23809 <br />INSURERE: RL1 Insurance Co <br />13056 <br />INSURER F : American Zurich Insurance Co <br />RAGES <br />CERT4 JGATENUMBER: <br />REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN 'ISSUED TO -THE MITRED -NAMED ABOVE I uitTHE'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 />INSRADDL <br />LTR <br />TYPE OF INSURANCE <br />INSR <br />1 B - <br />WVD <br />POUCY NUMBER <br />POUCY EFF <br />,JMMIDD <br />POLICY ,- <br />MIDD/YYYY) <br />LIMBS <br />A <br />B <br />GENERAL <br />X <br />LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />X <br />X <br />X <br />103GLU0-0294600 <br />2001298439 <br />'03/1472014 <br />05/29/2014 <br />03/1412015 <br />.05/29/2015 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE PREMISESX (Es occurrence) <br />$ 100,000 <br />MED—EXP (Any onepersort) <br />$ .5,000 <br />-CLAIMS,MADE <br />X <br />.'OCCUR <br />PERSONAL 8 ADV INJURY <br />$ 13:00,uUU <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,000 <br />GEN'L <br />3-<-1 <br />AUTOMOBILE <br />X <br />AGGREGATE LIMIT <br />POLICY n JECT <br />LIABILITY <br />ANY AUTO <br />ALL OWNED <br />AAUTOSyy <br />HIRED AUTOS <br />APPLIES <br />•V <br />^ <br />PER: <br />n LOC <br />SCHEDULED <br />AUTOS <br />©N�WNE[i <br />AUTOS <br />ECOMBINEDcadeSINGLE LIMIT nt <br />$ <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />.BODILYJNJURY.(Pe-eccident) <br />S <br />•PROP.ERTYJDAMAGE <br />(Per accident) <br />S <br />$ <br />C <br />X <br />UMBRELLA UAB <br />EXCESS LLAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />X <br />X <br />60A2FF0000254001 <br />05/27/2014 <br />03/14/2015 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />AGGREGATE <br />$ <br />$ <br />DED I RETENTION $ <br />D <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />i�NYPROPRIETOR/PARTNER/EXECUTtVE -YIN <br />DFFICERJMEMBEREXCLUDED? <br />(Mandetory'in•NH) <br />It yes. describe under <br />DESCRIPTION OF OPERATIONS below <br />N1A <br />X <br />WC1672405 <br />07/01/2014 <br />07/01/2015 <br />WC STATU- OTH- <br />I TORY LIMITS I I ER <br />USL&H Included <br />-EL.•EACHACCIDENT <br />-$ 1,-00%000 : <br />-E:L:DISEASE-EWE/API.-OYEE <br />$ 11;060;000 <br />El. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />E <br />Marine General Liability <br />Protection and Indemnity <br />X <br />X <br />MRP0200036 <br />07/01/2014 <br />07/01/2015 <br />Per Occ 1,000,000 Gen Agg 2,000,000 <br />1,000,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) <br />• <br />CERTIFICATE HOLDER <br />CANCELLATION <br />5-an/IA- <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THERhu , WOTICE WILL 'BE 'DELIVERED -IN <br />ACCORDANCE WITH THE POUCY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />AC -ORD 25:(2010/05) <br />© 1988-2010 AC-ORO-©RPORATION. All -rights reserved/ 9 3 <br />The ACORD name and logo are re,gistered marks of ACORD <br />