Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
CERTIFICATE OF LIABILITY INSURANCE (1095)
FLORCHA-01 DANTE1 ACOR©"" CERTIFICATE OF LIABILITY INSURANCE DAT/11/2DIYYYY) 2/11/2022 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 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 have ADDITIONAL INSURED provisions or 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: FDA Services Inc. PHONE 545 John Knox Road Suite 201 (A/C,No,Ext): (800)877-7597 (A/c,No):(850)681-9782 Tallahassee,FL 32303 ADD"RIESS:insurance@fdaservices.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Nautilus Insurance Company INSURED INSURER B:Progressive Casualty Ins. CO. Florida Chamber of Commerce Safety Council INSURER C:Zenith Insurance Company 13269 136 S.Bronough Street INSURER D:Lloyd's of London Tallahassee,FL 32301-7706 INSURER E 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 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE � OCCUR NN1314892 11/1/2021 11/1/2022 PREMISES ETORENTED 100�QQQ PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 1 JECT F—] LOCPRODUCTS-COMP/OP AGG $ OTHER: $ OMBINED SINGLE LIMIT 250,000 B AUTOMOBILE LIABILITY C Ea accident $ ANY AUTO 04133757-4 10/10/2021 10/10/2022 BODILY INJURY Perperson) $ 250'000 OWNED XSCHEDULED 500,000 AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIREDX NON-OWNED PROPERTY DAMAGE 100�QQQ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ C WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN 2137303302 11/1/2021 11/1/2022 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,66-0 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Professional Liabili MPL6080706 2/10/2022 2/10/2023 Per Occurrence 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Liability is premises only. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Clearwater Gas Systems THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. A��U'J�T"H�'O�RIZED REPRESENTATIVE* ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD