The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (177)BCHMECH -01 SESSER ACCPRO. Iii.......-- CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDD/YYYY) 6/28 /2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES 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 Insurance Services, Inc. 1300 Riverplace Blvd Ste 101 Jacksonville, FL 32207 CT CONTACT Melissa Beckworth =O PHONE 888_1 988 FAX 904 388$199 (ac, No. Ext): ( ) (NC, No): ( ) ADDDRESS: mbeckworth @alliant.com INSURER(S) AFFORDING COVERAGE NAIC • INSURER A : AmerlSUre Insurance Company 19488 INSURED BCH Mechanical, Inc. 6354118th Ave N Largo, FL 33773 INSURER B:AGCS Marine Insurance Company 22837 INSURER C : 7)1/2013 �.- ) °.t • INSURER D : EACH OCCURRENCE INSURER E : DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POUCY NUMBER POUCY EFF (MMIDD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR X GL2046905 ` �� ,� -;, --, ,� �1 °' - y 7)1/2013 �.- ) °.t • 7/1/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 CLAIMS -MADE X MED EXP (Any one person) $ 10,000 X XCU Included PERSONAL & ADV INJURY $ 1,000,000 X GEN'L 7 I BIkt.All & WOS GENERAL AGGREGATE $ 2,000,000 AGGREGATE LIMIT APPLIES PER- . PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY --)C ECT LOC DESIGN SERVICES $ 1,000,000 A AUTOMOBILE X X X LIABIUTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS $500 Ded Co X X SCHEDULED AUTOS NON - AUTOS OWNED $500 Ded Coll - .,•J CA2046911 ....., 7/1/2013 7/1/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1000 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PER ACCIDENT) $ PIP $ 10,000 A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE CU2046910 7/1/2013 7/1/2014 EACH OCCURRENCE $ 5,000,000 1 AGGREGATE $ 5,000,000 DED X RETENTION $ Follow Form $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AFYiPROPRIETORPARLNER�ECUTIVEI N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC2048516 -08 7/1/2013 7/1/2014 X WC STATU- 0TH - TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 B B Scheduled Equipment UR Equipment MZ193042627 MZ193042627 7/1/2013 7/1/2013 7/1/2014 7/1/2014 See Below $150k item /$300k max DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule If more space Is required) '*30 DAY NOTICE OF CANCELLATION** Re Daryl W Blume #CAC0018935, Jeffrey Metzger #CFC1426761, Russell Samo #EC13001642 CERTIFICATE HOLDER CANCELLATION I City of Clearwater Building Dept P 0 Box 4748 Clearwater, FL 33755 -0000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, ACCORDANCE WITH THE POUCY PROVISIO SCE WILL BE DELIVERED IN AUTHORIZED REPRESENTATIVE /'l ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD