Laserfiche WebLink
AC!ORO� CERTIFICATE OF LIABILITY INSURANCE <br />ATE(MMIDDIYYYY) <br />r <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 />9/26/2017 <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(ies) 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 SUNZ Insurance Solutions, LLC ID: (Essential) <br />c/o Essential HR, Inc. dba First Star HR <br />4455 LBJ Freeway, Suite 1080 <br />Dallas, TX 75244 <br />CONTACT <br />NAME: Jennifer Hau er <br />PHONE ----FAX <br />972-404-0295 we No: <br />E-MAIL <br />ADDRESS: jennifer.hau er. firststarhr.com <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURER A: SUNZInsurance Company 34762 <br />INSURED <br />Essential HR Inc., Essential HR II, Inc. <br />dba FirstStar HR <br />INSURER B: <br />- <br />INSURER C: <br />4455 LBJ Freeway <br />Suite 1080 <br />Dallas TX 75244 <br />INSURER D: <br />INSURERE: <br />INSURER F <br />UUVtKRU1:J CFKIIF-I(.AIF NUIVIRPR• 4rtnnna1)n APVIQInKI klllaa C2CD• <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 />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUER <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD/YYYY) <br />POLICY EXP <br />fMM/DDNYYYJ <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />EACH OCCURRENCE $ <br />_ <br />DAMAGE TO REMED <br />PREMISES Ea occurrence $ <br />MED EXP (Any one person) $ <br />PERSONAL & ADV INJURY $ <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />POLICY PRO- <br />JECT LOC <br />GENERAL AGGREGATE $ <br />PRODUCTS - COMP/OP AGG $ <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ <br />Ea acddenl <br />BODILY INJURY (Por person) $ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />Per accent <br />id <br />BODILY INJURY ( ) $ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident $ <br />UMBRELLALIAB <br />OCCUR <br />EACHOCCURRENCE <br />AGGREGATE $ <br />EXCESS 'AB <br />CLAIMS -MADE <br />DED RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANYPROPRIETOR/PARTNER/EXECUTIVEE.L. <br />OFFICER/MEMBEREXCLUDED7 ❑ <br />N/A <br />WCPE0000018405 <br />WCPE0000018404 <br />10/1/2017 <br />10/1/2016 <br />10/1/2018 <br />10/1/2017 <br />�/ STATUTE FORTH- <br />EACH ACCIDENT $ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000 <br />(Mandatory In NH) <br />Mas describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Coverage provided for all leased employees but not subcontractors of: Timothy Rose Contracting, Inc. 1360 SW OLD DIXIE HWY SUITE 106 <br />Effective date: 10/1/2013 <br />CERTIFICATE HOLDER CANCELLATION <br />62200099 <br />Indian River County Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />1801 27th r 9 P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Vero Beach FL 32960 <br />AUTHORIZED REPRESENTATIVE <br />Glen J Distefano <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />36008820 1 Essential HR Inc PEO 164 MASTER CERT I Natalie Matthews 1 9/26/2017 5:16:08 PM (CDT) I Page 1 of 1 <br />