09-9138 - Laserfiche WebLink

Browse Search

ACORD rM CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD /YYYY) S/4 /2009 Pi(ODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Lassiter - Ware Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE of Orange/Seminole, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 940159 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Maitland, FL 32794 - 0159 (407) 6 3441 fax: (888)883-8680 INSURERS AFFORDING COVERAGE NAIC# — INSURED A Catapano Plumbing, Inc. — INSURER A: North Pointe Insurance Company 277' INSURERB: Hanover American Ins. Co. 3601 I 1406 N. Chickasaw Trail r • Orlando, FL 32825 -5235 INSURER C: North River Insurance Company 211' INSURER D: Florida Hospitality Mutual Ins 106 INSURER E: Progressive Express Ins. Company , COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED 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 ADD' Ia - -. -.. _-- — -- --- -- - -._ - -_ _._ POLICY EFFECTIVE POLICY LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE (MM /DDIYY) DATE TE (MM /DD /YY) IMM /DDIYYI LIMITS GENERAL LIABILITY 2094119739 09/18/2008 09/18/2009 EACH OCCURRENCE 1$ 1,000,000 DAMAGE TO It X 1 COMMERCIAL GENERAL LIABILITY PREM SES ((Ea RETE occurence) i $ CLAIMS MADE X i OCCUR ' MEDEXP (Any one person) S 5,000 i I A I I PERSONAL &ADV INJURY I 5 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I - -- PRODUCTS- COMP /OP AGG S 2, 000,000 ' —_- PRO POLICY r iX I JECT - r 7 LOC AUTOMOBILE LIABILITY AZJ071782001 09/18/2008 09/18/2009 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 — ALL OWNED AUTOS - j I BODILY INJURY SCHEDULED AUTOS (Per person) $ B X HIRED AUTOS 1 BODILY INJURY LX NON - OWNED AUTOS ', (Per accident) $ , PROPERTY DAMAGE Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT I $ ANY AUTO EA ACC I S AGG S AfTRYN _ - -i ' AUTO O ONLY: E EXCESS/UMBRELLA Y: LIABILITY 5530915737 09/18/2008 1 09/18/2009 EACH OCCURRENCE $ 2,000,000 X OCCUR 1 CLAIMS MADE AGGREGATE 15 4,000,000 1 , s DEDUC TIBLE_ - -- - - - - - -- $ IX RETENTION $ 0 $ WORKERS COMPENSATION AND WCO53466 01/17/2009 01/17/2010 X WC STATU- X OTH- TORY LIMITS ER EMPLOYERS' LIABILITY —_ - -- -- - - -- D ANYCER /MEETOREXCLUER /EXECUTIVE E.L. DISEASE - EA EMPLOYEES 500,000 E.L. EACH ACCIDENT OFFICER /MEMBEREXCLUDED? $ 500,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT SOG,OGG OTHER WC306-0020401-2009 01/25/2009 01/25/2010 Combined Single $1,000,000 E Auto Liability i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Blanket Additional Insured including Products and Completed Operations are included in General Liability as required per written contract with respect work being performed by the insured for Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF ZEPHYRHILLS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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 5335 8th Street REPRESENTATIVES. Zephyrhill s, FL 33542 AUTHORIZED REPRESENTATIVE fax: (813) 7800005 Ron Brown - ACORD 25 (2001/08) © ACORD CORPORATION 1988