My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2018-038B
CBCC
>
Official Documents
>
2010's
>
2018
>
2018-038B
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
12/21/2020 12:47:22 PM
Creation date
3/15/2018 11:41:37 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
02/20/2018
Control Number
2018-038B
Agenda Item Number
8.T.
Entity Name
Hinterland Group, Inc.
Subject
Culvert Replacement
Area
Blue Cypress Lake Road
Project Number
1748
Bid Number
2018033
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
101
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
CERTIFICATE OF LIABILITY -INSURANCE <br />DATE(MMIDDIYYYY) <br />01/27!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(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 />South Shore Insurance Inc. <br />901 SW Martin Downs Blvd <br />Palm City FL 34990. <br />CONTjACT Jennie Duke <br />PHONE 772 426 9973 Fax 772 221.1960 <br />Ma1L ennie southshore-insurance,com <br />INSURERS AFFORDING COVERAGE NAIC N <br />INSURER United States Fire Insurance Company 21113 <br />INSURED <br />Hinterland Group Inc. <br />992 W. 15th Street <br />Riviera Beach, FL 33404 <br />INSURER B • North River Insurance Company 21105 <br />INSURER C AGCS Marine Insurance Company 22837 <br />INSURER D <br />INSURER I-: <br />INSURER F• <br />r1nVFRAi±FR CFRTIFICATF NUMBER' KEVISIUN NUIVIIitK' <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 />TYPE OF INSURANCE <br />ADDL <br />SUER <br />POLICYNUMBER <br />POLICY EFF <br />POLICY EXPLTIR <br />LIMITS <br />X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $1,000,000 <br />B <br />CLAIMS•MADE Q OCCUR <br />DAMAGE TO RENTED $0,000 <br />MED EXP lAny one rson $5,000 <br />X XCU Coverage Included <br />Y <br />Y <br />543-998915-1 <br />01131/2017 <br />01/31/2018 <br />PERSONALS ADV INJURY $ 1,000,000 <br />GEN'LAGGREGATE LIMIT APPLIES PEP: <br />POLICY PRO - <br />ICY EILOC <br />GENERAL AGGREGATE 2,000,000 <br />PRODUCTS -COMPIOPAGG $2,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE LIABILITY <br />_ <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />BODILY INJURY (Pw person) $ <br />A <br />NyATO <br />BODILY INJURY (Per accident$AUO <br />ALL SCHEDULED <br />AUTOS <br />HIRED AUTOS X NON -OWNED <br />AUTOS <br />Y <br />133-740178-2 <br />01/31/2017 <br />01/31/2018 <br />PROPERTYOAMAGE $ <br />$ <br />X <br />UMBRELLA UAB <br />X <br />OCCUR <br />EACH OCCURRENCE $4,000,000 <br />AGGREGATE <br />B <br />EXCESSLIA13 <br />CLAMS -MADE <br />5821069842 <br />01/31/2017 <br />01/3112018 <br />NT <br />$ <br />WORKERS COMPENSATION <br />X I PER OTH- <br />rR <br />B <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE YIN <br />OFFICERIMEMBER EXCLUDEOt <br />(Mandatory in NH) <br />NIA <br />Y <br />408-730540.5 <br />01/31/2017 <br />01/31/2018 <br />E.L. EACH ACCIDENr $ 1,000,000 <br />E.L. DISEASE • EA EMPLOYEE $1,000,000 <br />DISEASE • POLICY LIMIT $ 1,000,000 <br />ItSsC, describeF under ERA belowE.L. <br />C <br />Inland MarineMZ193075677 <br />01131/2017 <br />01/31/2018 <br />Rented/Leased Equi $300,000 <br />DESCRIPTION OF OPERATIONS /LOCATIONS IVENCLES (ACORD 101, Additional Remarks Schedule, maybe attached If more apace Is required) - <br />Should any of theabove policies be cancelled before the.expiration date thereof, the issuing insurer will endeavor to mail 30 days written <br />notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurar, its <br />agents or representatives. <br />Certificate holder is listed as an additional insured only if required by written contract/agreement with the insured executed prior to <br />accident or loss. <br />A Waiver of Subrogation is provided only if required by written contractfa reement with the insured executed prior to accident or loss. <br />CERTIFICATE HQLDFR CANCELLATION <br />FOR BIDDING PURPOSES ONLY <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 <JND> <br />ACORD 25 (2014101j'_ <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
The URL can be used to link to this page
Your browser does not support the video tag.