2018-253F - Laserfiche WebLink

Home Browse Search

c ' :> "1 JOHNINC-02 PANDREE '4�fzo9 CERTIFICATE OF LIABILITY INSURANCE COVERAGES CERTIFICATE NUMBER: REVI-SION NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD DATE 071216/2018'Y) 07/26/2018 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). PRODUCER Johnson Insurance Racine 1103 Hunter Dr Ste 100 Mount Pleasant, WI 53406 CONTACT Sharon Majeski, ARM PHONE FAX (A/C, No, Ext): (920) 433-7107 (AIC, No);(877) 254-8586 AEDDRIEss: smajeski@johnsonins.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Zurich North America 16535 GLO 9813382-00 INSURED INSURER B: American Guarantee & Liability Insurance Co26247 INSURER C, Johnson -Davis, Inc. INSURER 0, 604 Hillbrath Drive Lantana, FL 33462 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVI-SION 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 LT TYPE OF INSURANCE ADDL SUBR WV POLICY NUMBER POLICY EFF DD I POLICY EXP (MMIDDrfYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE .00CUR GLO 9813382-00 07/01/2018 07/01/2019 EACH OCCURRENCE $ 1'000'000 DAMAGE TO RENTED 300,000 PREMISES Ea occurrence MED EXP (Any oneperson) $ 10'000 PERSONAL & ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT F—]LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2'000'000 $ OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea acciden $ BODILY INJURY Perperson) $ X ANY AUTO OWNED SCHEDULED BAP 9813380-00 07/01/2018 07/01/2019 AUTOS ONLY AUTOS BODILY INJURY Per accident $ Pe�acadent DAMAGE $ X AUTOS ONLY X AUOTOS ONLDY $ BUMBRELLA LABX OCCUR EACH OCCURRENCE $ 5'000'000 X EXCESS LAB CLAIMS -MADE AUC 5676415-00 07/01/2018 07/01/2019 AGGREGATE $ 5'000'000 DED I X I RETENTION $ 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under N I A E.L. DISEASE - EA EMPLOYE $ DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ A Equipment Floater CPP 4289118-00 07/01/2018 07/01/2019 Leased Rented 300,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Contractor's Pollution Liability - Policy # 7930030920003- Limit - $1,000,000 - 3/1/2018-3/1/2019 - Homeland Insurance Company of NY Johnson -Davis, Inc. 863 S. Kings Highway Fort Pierce, FL 34945 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD