2020-238A - Laserfiche WebLink

Home Browse Search

o n_ -__.i , A Data CERTIFICATE OF LIABILITY INSURANCE 4/2/2020 Producer: Plymouth Insurance Agency This Certificate is issued as a matter of information only and confers no 2739 U.S. Highway 19 N. Holiday, FL 34691 rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Insurers Affording Coverage NAIC # (727) 938-5562 Insured: South East Personnel Leasing, Inc. & Subsidiaries Insurer A: Lion Insurance Company 11075 Insurers: 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer C. Insurer D: Insurer E: Coverages The policies of insurance listed below have been issued to the insured named above for the policy period Indicated. NoWthstanding any requirement, term or condition of any.'tract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described harem is subject to all the terms, exdusions, and conditions of suds policies. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL INSRD i Type of Insurance Policy yP Y Number Policy Effective Date Policy Expiration Date Limits (MM/DDJYY) (MM/DD/YY) GENERAL LIABILITY Each occurrence Commercial General Liability Claims Made ❑ Occur Damage to rented premises (EA occurronco) Med Exp General aggregate limit applies per: Personal Adv Injury General Aggregate Policy 11Project® LOC Products - ComplOp Agg AUTOMOBILE LIABILITY combined S1n91e Lloilt Any Auto (EA Accident) Bodily Injury All Owned Autos Scheduled Autos (Per Person) Bodily Injury Hired Autos i Non -Owned Autos (Par Accident) Property Damage (Per Accident) Each Occurrence EXCESS/UMBRELLA LIABILITY Occur ❑ Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2020 L01/01/2021 e X I We stat.- oTH- Employers' Liability tofy Limits ER E.L. Each Accident $1,000,000 Any proprietor/partner/executive offirer/member excluded? NO E.L. Disease - Ea Employee $1,000,000 If Yes, describe under special provisions below. E.L. Disease - Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616 Descriptions of Operations/Locations[Vehicles/Exclusions added by Endorsemont/Special Provisions: Client]D: 81-67-368 Coverage only applies to aL-tive employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company": Kerns Construction and Property Management Corp. Coverage only applies to injuries Incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s), while working in: FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or email certifketes@lloninsurancecompany.com Project Name: Benin nate: 12 10 2o12 CERTIFICATE HOLDER CANCELLATION Should any of the above described policies be cancelled before the expiration date thereof, the issuing Insurer vAll endeavor to mall 30 days written 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 insurer, its agents or representatives. rp.