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2007-237
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2007-237
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Last modified
5/31/2016 1:44:37 PM
Creation date
9/30/2015 10:59:19 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Amendment
Approved Date
07/24/2007
Control Number
2007-237
Agenda Item Number
7.Y.
Entity Name
Omni Pinnacle, LLC
Subject
Disaster Debris Removal and Disposal
Amendment and Extension to Agreement
Supplemental fields
SmeadsoftID
6410
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ADM CERTIFICATE OF LIABILITY INSURANCE <br /> PRODUCER <br /> (504) 455-4545 FAX ( 504) 888-6645 THIS CERTIFICATE 13 ISSUED ASA MATTER OF INFORMATION <br /> Ellsworth CorPoration CNLYANDCONFERSNOMIGHT$ UPONTHECERTIFICATE <br /> P , 0 , Box 8210 HOLDER, THIS CERTIFICATE Does NOT AMEND, EXTEND OR <br /> Metairie , LA 70011 -8210 ALTER THE O FORDED BY THE POLICI68 BELOW, <br /> 225 -282 -2430 NSURER6 AFFORDING COVERAGE INAIC <br /> INSuREO Omni Pinnacle , L INSURLRA: Scottsdale Insurance Co , 41297 <br /> 130 W , Howze Beach Rd , INSURERS: Praetorian Specialty Insurance C . <br /> Slidell , LA 70458 � W6URERC: LanCIM&rk American Xns . Co , <br /> (985 ) 781- 9819 ""WKIIA' D' " Hampshire Insurance Co , <br /> ' INR:AERE American Int ' 1 <br /> Simacfalty Lines 16s , CO . <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEF,N ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> PO�LICIES, AGGREGATE UMTS SHOWN MAY HAVE BEEN REDUCED BY PAID .,LAIMB. <br /> 12B 1uR0 TYPE OF mSURAMCE POLICYNUMBER POV EPPE P Y N <br /> uRRB <br /> c4mEFALLwILnY CL.SIM 95 05/07/2007 55/07/2008 BACHODOURRENCE S 10000I, 000 <br /> X I COMMnMALOENERA_ LIASILI Y BLANKET ADD ' L INSURED . E 50 4000 <br /> ICLARAMADE i X iOCB; KET WAIVER OF SUBR00 , MEDEXP (ArV � pa n1 E S , 00 <br /> ! A <br /> PERSONAL 4 11000 , 00 <br /> GENERAL AGGREMTE i 2 000 50 <br /> GEMLAGGREGATEppLIRRM��ITAPPLIEBPERT PROOUCTS • COMPOPAGG 6 2 000 00 <br /> POLIOY X JECT LOO <br /> AUTOMOBILE LIABILITY PS <br /> ILAOOOI898 65/07/2007 05/07 2008 <br /> COMBINED SINGLE LIMIT <br /> ANY AUTO BLANKET ADD ' L INSURED (ER =dI IE 1 , 000 , 00 <br /> ALLOWNEDAUTOB BLAIKET WAIVER OF SUBROG , BODILY INJURY <br /> B X SCMEDIAED AUTOS (pK p6Ngg1 E <br /> X HIREDALTDS <br /> X NON-OVYNEDAUTOB BODILY INJURY(POW WA0604 <br /> iS <br /> PROPERTY DAMAGE 6 <br /> (Per RWIEP I <br /> G'ARAGe LUBILTr! AUTO ONLY , EA ACCIDENT 15 <br /> ANYAUTO <br /> OTNERTMAN EAACC S <br /> AUTOONLY; aaG I e <br /> ETCORMMBRM.LA LIABILITY LHA039693 55/07 2007 05/07/2008 EACH OCCURRENCE i E S 000 . 00 <br /> X OCCUR ASCIIB 5 000 <br /> C -- IE <br /> 100( <br /> DEDUCTIBLE E <br /> X RETENTION : 10 , 0 a <br /> WORKERS PE <br /> COMMRATION AND WCIISS453 00%21/2006 i 09/21/2807OLL. <br /> €ETnn: DT-I., <br /> hm"WTIP IJA"ILITY B KEY WAIVER OF SUBRDG . <br /> D ANY AROPREEYOMFARTNEWMECUTIVS CHACGDENT 16 11000405 <br /> OFF MER NWER BXCLUDED? <br /> IryBB SRealbe unCPr EASE • EA EWLOY26. S 1 , 000 , 00 <br /> 6PECIA: PROlAB IONOb EABE • POLICY LMR E 1 50 ORO <br /> OO <br /> nt�actors Pollution CP02026130 09/13/2006 09/13/2007 Limit $2 , 000 , 000 Par Occ . <br /> E Liability t I <br /> DESCRIPTION OF OPERA ONB I LOCATIONEI ifBI LX^ 08J0NS AO BY ENDO SEMENT Iso I P ONE <br /> t IS agreed t�iat the cert it cata h0laer s name t� as Au lloearinsured on the General <br /> Liability policy , as required by written contract , <br /> SI HOLDER NrELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANOELLM BEFORE THE <br /> Indian Rivers County 0PIRATION DATE THEREOF, THE DUNG INSURER WILL ENDEAVCR TO RAP. <br /> Purchasing Division )5 GAYSWRITTEN ]ROTICETOYHECERTPIOATBHOLDERNAMEOTOTHELEFT, <br /> 1840 25th Street NUT FAILURE TO MAIL SUCM NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY <br /> Suite N118 OF MY KNO UPON THE INSURER, ITS AGENTS OR REPRESENTATmEE <br /> Vero Beach , FL 32960 AUTHORISED RBPRUENTAMVE f� wy � <br /> Holl Mahrtens J�P�P� <br /> NN 0 <br /> ACORD 25 (2D01108) WACORD CORPORATION i388 <br /> 7 d ti971' GhJ rldo � • C 1QIJ ? b7 'AVA <br />
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