Laserfiche WebLink
From: Brittany Caraballo At: Bouchard Iral;ranca Faxi To: Indian River Count; <br />ACOR.D_ CERTIFICATE OF LIABILITY INSURANCE <br />Data: 10!20/2008 41:01 MI Pape: 2 of 3 <br />DATE IMMfDDNYYYI <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Bouchard - Kissimmee HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />222 Church Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br />Kissimmee FL 34741 <br />Phone:407-847-2841 Fax:407-846-2841 _ INSURERS AFFORDING COVERAGE NAIC# <br />INSURED I INS_RER A <br />aridgalLaloy.ra znr co 10701 <br />INS- PER 6 INatlLald xnsu_sane. Company <br />Derrico Construction Corp. INb_RE:RC tlatttIoLd Inaurane. Company 1 <br />PO Box 361177s.aERD �— <br />Melbourne rL 32936-1177 /lastes.ld Lnruraxa Company <br />NS PEP E'-- <br />Ct)VEROGES <br />THE=OLICIES OF INSOPA',CE sTED B=LOW I -AVE BEEN ISSIJED TC M9 PIzURED NAMcD ABOVE FOR T -E POLI' d PERIOD NCI: ATEO NOTAir-STANDINi <br />AN'T P.EOU REMEN TERM OR CONDITIC;1 OF ANv coNr--ACT OR OTHER COCUHENT 144-1-1 RESPECTTJ WHICH THIS ;:ERTIFIUS-E I/A'T BE .SSUEr. OR <br />M4" PEP.-A!N. !HE NSURANC'E AFFORJEC z.Y THE POL CIES DE5Y:PIEEL) HEREIN iS SUBJECT TO AL- rFE TERMS, E'(CUfiIONSAir) COnDT IONS JF SUCH <br />PCLICIES. AGGREGATE LVriS SripYVN MA' FY,v= ?EEN REDUCED BY' FA D CLAIMA <br />LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE (AM R ppm D"ry <br />(MM/DI j LIMITS <br />GENERAL LIABILRY EACH Ck d IP:FIrE $1000000 <br />D X II X{� cc—GT'MERCIAL "oENERALLIABILm TRA4527267 09/06/08 09/06/09 Fl3=.h11S'ES )Eap �cLpp:e1 $150000 <br />^LA MS MACE �, OCCIJF —___- --_ <br />,- _ _� <br />L --I J i i WD EXP (Any <br />one pecan; $10000 <br />XI Broad corm PD � a scnAL s AD✓ <.'NJ_RY 1000000 <br />----- — — L ' ' <br />�II---X-----���!Contractual I --- G --- <br />'SENLkG:;?EGATE' c — -NERALAGG:EG4� 12000000 <br />IIF J'JR ePP_i E.. PE:; I PROCVCT.S- COMP/OP AGG <br />1 <br />i- _R,y f—! F— --- 2000000 <br />F';�JCY IX I -Ecr � <br />nLr .mvaLe LU1Du I I I <br />C-MEIiNEC=!OGLE-INIT <br />C IWAL17O I TRA4527267 09/06/08 09/06/09 $1000000 (Ee aJUCEIIq <br />. L JN?!'D AJTOS I I - <br />eC DL'r INJJR" I 1 <br />S7H=011EDAL'._JS I i j (Per rear} <br />HIRED A -TO <br />I <br />F--1 BCD LY INJUF" <br />I NC NC..LVNEG AUT?S ! I ;Per esl7r;iq g <br />-J --------------- ------ -- I PROPERT'r DAMAGE <br />(Par aclyu ) 1 <br />1 <br />ALTO OCL" - EA Arco ENT g <br />AW, 'VJ! J I � <br />OTHFR T-AEA ACC 1 N,I <br />I A1JTG.)`.l" cGG g <br />DYESWUMBRELLAL SILrrY EACHOC.'xIR:ENCE 15000D00 <br />B X OCCUR ❑ cLZLSntacE TRA4S27267 09/06/08 09/06/09 ACCP c>c-F I g 5000000 <br />i ----- - ------ I g ---- <br />I DEL>`'CTIPI-F— <br />X RETE'.TIvN $10000 I I IT-h- <br />1%ORKERS CONPENSArON AND X TW <br />AC STC iT ER <br />EMPLOYERS' LIABILITY <br />lhP..^<PRIETOR+PAkR7i EP/E'+FCUT VE 83034631 06/03/081 06/03/09 ,EL. EACH ACS,'DEe.T 1500000 <br />OFF:=EF/MEMBEP. E>;.LU�,EC - I E L I5E.ASE - E4 Eft LOYE° 1 5000 00 <br />d.,es, des.rta LnJer I I --_ <br />SPECIAL PROd iJNS bracr I + IEL CISEASE-PCL CY_V!7 1500000 <br />*10 Day notice of cancellation in the event of non-payment of premium. <br />Certificate Holder is an Additional Insured with respects to General <br />Liability subject to the terms, condition & exclusions of the policy, <br />79ZI m <br />�.nns,CLWl11Vr1 <br />rN'DIAM SHOULD A14V JF THE ABOVE DESCRIBED POLICIES SE CANCELLED SEFC-RE THE EYPIRATION <br />DATE T8EREJF THE ;SSUWG INSURER WILL ENDEAVOR TO MAIL 30* _ DAYS WRITTEN <br />Indian River County NOTICE TOTr.ECERTIFICATE HOLDER 14AMEDTOTHE LEFT, BUM FAILURETODOSOSHALL <br />Fax: 772-770-5140 <br />1800 27th Street IMPOSE NC OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, TS AGENTS CR <br />Vero Beach FL 32960 REPRESENTATIVES. <br />25 (2001/08} OACORD <br />