16-17951 - Laserfiche WebLink

Browse Search

: i . � i � � %°��o�� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/WYI� q 11/17/2016 THIS CER7'IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICdTE 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 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 CONTACT NAME: Bouchard Insurance for WBS PHONE g66 293-3600 ext.623 F� P.O.Box 60��0 ruc No e:c: � ) ivc No: E-MAIL Clearwater,I L 33758-6090 ADDRESS: INSURER(S AFFORDING COVERAGE NAIC# iNsuRean. American Zurich Insurance Com an 40142 INSURED INSURER B: Workforce Bu iness Services,Inc.Alt.Emp:Sun Coast Roofing Services Inc. 1401 Manate� Ave.West Ste 600 INSURER C: Bradenton,FL 34205-6708 INSURER D: I INSURER E: INSURER F. COVERAG�S CERTIFICATE NUMBER:15FL079893947 REVISION NUMBER: THIS IS Td CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATEC�. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFIC�TE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIO S AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �TR I T�'PE OF INSURANCE NSD SWVD POLICY NUMBER MMIDDY� MM DD� LIMITS CO�MERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE �OCCUR DAMAGE TO RENTED PREMISES Ea occurrence S I MED EXP(My one person) $ I PERSONAL 8 ADV INJURY $ GEN'L A�GREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY� PRO- ❑ LOC PRODUCTS-COMP/OP AGG $ II JECT OTHER: $ AUTOM�BILE LIABILITY COMBINED SINGLE LIMIT � Ea accident AN�4I AUTO BODILY INJURY(Per person) $ ALU OWNED SCHEDULED BODILY INJURY(Per accident) $ AU OS AUTOS I NON-OWNED PROPERTY DAMAGE $ HI I ED AUTOS AUTOS Per accident $ UMBRELLALIAB pCCUR EACH OCCURRENCE $ EXI�ESS LIAB CLAIMS-MADE AGGREGATE $ DE RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EM LOYERS'LIABILITY X STATUTE ER ANY PR�PRIETOR/PARTNER/EXECUTIVE Y�N E.L.EACH ACCIDENT $ 'I,OOO,OOO A OFFICEi�/MEMBEREXCLUDED? � N�A WC 90-00-818-05 12/31/2015 12/31/2016 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE 5 �,�00,000 Ifyes,d�escribe under DESCRIPTION OF OPERATIONS 6eiow E.L.DISEASE-POLICY LIMIT $ 'I,OOO,OOO Location Coverage Period: 12/31/2015 12/31/2016 Client# 054357 DESCRIPTIO�OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) covera9e is�rovided tor Sun Coast Roofing Services Inc. onlythosec employees 843 N Dixie Highway of,but not su contractors New Smyrna Beach,FL 32168 to: CERTIFIC�ATE HOLDER CANCELLATION City of Zephyrhills Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I 5335 8th Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN I Zephyrhilis,FL 33542 ACCORDANCE WITH THE POLICY PROVISIONS. iAUTHORIZED REPRESENTATIVE � ` O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD II5(2014/011 The ACORD name and logo are registered marks of ACORD �