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HomeMy WebLinkAboutFolio 2025 Permit - CR 6587 CR 6587 - 9/24/2024 i 41....../ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE 6/1/2025 CERTIFICATE H/OL9DER. THIS CERTIFICATE 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 polic y(iesIf SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,) I cy,)erta nmusthave polic pAolicies may r qui eITIONALSURED an endprovisions or be endorsed. orsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies CONTACT 3280 Peachtree Road NE,Suite#1000 NAME: PHONE Atlanta GA 30305 FAX (404)460-3600 E MAIi A/C No 1� ADDRESS: loSJ, INSURER S)AFFORDING COVERAGE INSURER A:Starr Indi &Liabili Com.an 38318 NAIC N emn INSURED LLC — 38 1500960CCU, INSURER B:Markel American Insurance Com I an 12595 SW 137 Avenue Suite 207 INSURER c:Indemni National Insurance Corn•an 28932 Miami FL 3318618468 INSURER D: INSURER E: COVERAGESINSURER F: CERTIFICATE NUMBER: 17999833 REVISION THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLIER: CY�PER OD 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR r ADDLISUBR LTR TYPE OF INSURANCE -- — ---- ,ur POLICY NUMBER MM/DD/YLICY VYY MM%D A J{ COMMERCIAL GENERAL LIABILITY LIMITS N N 1000090547241 6/15/2024 OCCUREACH OCCURRENCE 6/15/2025 XDAMAGE TO RENTED CLAIMS-MADE $ 1,000,000 I i I PREMISES(Ea occurrence) $ 300,000 MED EXP(Any one person) $ 5,000 GEN'L AGGREGATE LIMIT APPLIES PER: I PERSONAL 8 ADV INJURY II$ 2,000,000 POLICY X PE I X I LOC GENERAL AGGREGATE $ 2 000 000 OTHER: PRODUCTS-COMP/Op AGG $ 2 000 000 1 AUTOMOBILE LIABILITY N N 1000198921241 $ x ANY AUTO 6/15/2024 6/15/2025 Ea accideD SINGLE LIMIT $ I2 000 000 OWNED AUTOSSCHEDULED BODILY INJURY(Per person) $ XXXXXXX AUTOS ONLY HIRED NON-OWNED BODILY INJURY(Per accident)1$ - - _ I XXXXXXX PROPERTY DAMAGE - - - - - - Per accident I$ XXXXXXX AUTOS ONLY ■AUTOS ONLY C A UMBRELLA LIAR © OCCUR N N j XS0001091 24 x EXCESS LIAB 6/15/2024 6/15/2025 EACH OCCURRENCE $ XXXXXXX a CLAIMS-MADE I 10000095573241 6/15/2024 6/15/2025 $ 6 000 000 III DED ■ RETENTIONS AGGREGATE $ 6 000 000 WORKERS COMPENSATION Completed OPS $ 6 000 000 A 'AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE ��Y/N� N 100000373306 6/1/2024 6/1/2025 �■ ERH- OFFICER/MEMBER EXCLUDED? I t 1 N/A (Mandatory in NH) �� �� E.L.EACH ACCIDENT $ 1 000 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-EA EMPLOYEE $ 1 000 000 13 Equipment Floater N MKLM21M0002553 E.L.DISEASE-POLICY LIMIT $ 1 000 000 6/15/2024 6/15/2025 Schedule Equip:5,298,404.83 Unscheduled:50k subject to$5K max any one item DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ***EQUIPMENT LEASED OR RENTED TO OTHERS$150,000 MAX***PLEASE SEE ATTACHED FOR POLICY COVERAGE FORMS CERTIFICATE HOLDER CANCELLATION See Attachments ANY OF BE 17999833 THE SHOULD THE HDATBEOVE THER OF, NOTICE DESCRIBEDPOLICI WILL ES CBE CDELIVERED BEFORE IN CITY OF DANIA BEACH ACCORDANCE WITH THE POLICY PROVISIONS. 100 W.DANIA BEACH BLVD. DANIA BEACH FL 33004 AUTHORIZED REPRESENTATIVE _ __ �. 1 ACORD 25(2016/03) The ACORD name and logo are registered O 9 8- 01. RD CORPO-ATION. All rights reserved. co I— o a, o ,-- 0 a.) tea 0 Li (-.4 > c j E `O al N c ) 'CD .� CU Q a.) -a Z o cocoO U� N CD 0 O w a s O ca CCS 173 0cu W ♦ ,� cu ZI cu +rco Q O ifl cu cy) U cn _ W ..+N •� F-- > O N 5?::ri cs. Lc, CD CNJ M N CD CD CD O L id g U. 1/4o o = - i