2020-238A - Laserfiche WebLink

Home Browse Search

Date CERTIFICATE OF LIABILITY INSURANCE 1118/2020 Producer: Plymouth Insurance Agenc This Certificate is issued as a matter of information only and confers no 2739 U.S. Highway 19 N. rights upon the Certificate Holder. This Certificate does not amend, extend Holiday, FL 34691 or alter the coverage afforded by the policies below. Insurers Affording Coverage NAIC # (727) 938-5562 Insured:Insurer South East Personnel Leasing, Inc. & Subsidiaries A: Lion Insurance Contltany 11075 Insurer B: 2739 U.S. Highway 19 N. Insurer C: Holiday, FL 34691 Insurer D'. insurer E: Coverages The policies of insurance listed below have been issued to the insurednamed 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. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL I INSRD Type of Insurance Policy Number Policy Effective Date Policy Expiration Date Limits (MM/DD/YY) (MM/DD/YY) GENERAL LIABILITY Each occurrence S Commercial General Liability Damage to premises (EA Claims Made 11Occur occurrence) b If: Med Exp Personal Adv Injury General aggregate limit applies per: General Aggregate Policy ❑ Project1:1LOC Products - Comp✓Op Agg AUTOMOBILE LIABILITY Combined Single Limit Any Auto (EA Accident) $ Bodily Injury All Owned Autos Scheduled Autos (Per Person) Bodily Injury Hired Autos Non -Owned Autos (Per Accident) Property Damage (Per Accident) EXCESS/UMBRELLA LIABILITY Each Occurrence Occur ❑ Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2020 01/01/2021 X WCStatu- OTH- Employers' Liability I tory Limits ER E.L. Each Accident $1,000.000 Any proprietor/partner/executive officer/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 Endorsement/Special Provisions: Client ID: 81-67-368 Coverage only applies to active ernployee(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 certificates@lioninsurancecompany.com Project Name: IRC -1855, 2020053 ROSELAND COMMUNITY CENTER BUILDING & SITE IMPROVEMENTS, 12973 83RD AVE, SEBASTIAN FL 32958 ISSUE 11-18-20 (SS) CERTIFICATE HOLDER CANCELLATION Begin Date: 12 10 2012 INDIAN RIVER COUNTY Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the len, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its 1800 27TH ST agents or representatives. ` r' •- VERO BEACH, FL 32960 � `^ M a