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HomeMy WebLinkAboutInsurance Certificate: Brown & Brown Inc Etal BROWN-3 OP ID: JW /2014 Y) CERTIFICATE OF LIABILITY INSURANCE 1 F D2/23 12014 12/23 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 Uir INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUREK(S), AUTriORiZED REPRESENTATIVE OR PRODL-L;tR, 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). CONTACT PRODUCER NAME: SANDRA RAKAUSKAS #15009 Brown & Brown of Florida, Inc. PHONE 386-252-9601 FAC No:386-239-5729 Daytona Beach Office A/c No Ext : 86 P.O. Box 2412 E-MAIL SRAKAUSKAS@BBDAYTONA.COM Daytona Beach, FL 32115-2412 ADDRESS: M. Decker Youngman INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Prop & Cas of Amer 25674 INSURED BROWN & BROWN INC ETAL INSURERB:Continental Casual Co 20443 P O BOX 2412 INSURERC:Travelers Indemnity 25658 DAYTONA BEACH, FL 32115 INSURERO:XL Special Ins Inc. 37885 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. ADDL SUB POLICY EFF POLICY EXP ILTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 TC2JGLSA9527687415 01/01/2015 01/01/2016 DAMAGE T RENTED PREMISES Ea occurrence $ 1,000,00 CLAIMS-MADE OCCUR MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 D 2,000,000 POLICY ❑ JERT D LOC PRODUCTS - COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY Ea acct NEDtSINGLE LIMIT $ 1,000,00 A ANY AUTO TC2JCAP9527B86215 01/0112015 01/01/2016 BODILY INJURY (Per person) $ ALL OWNED F_ SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS AUTOS Per accident r UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 B EXCESS LIAB CLAIMS-MADE 6011849429 01/01/2015 01/01/2016 AGGREGATE $ DED RETENTION $ $ OTH- WORKERS COMPENSATION X PERTUTE ER STA AND EMPLOYERS' LIABILITY A ANY PROPRIETOR/PARTNERlEXECUTIVE Y/ N TC2JUB9517B58015 01/01/2015 01/01/2016 E.L. EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? ❑ N! A C (Mandatory in NH) TRKUB9518B76115 01/01/2015 01101/2016 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,00 D INS AGENTS E&O ELU13729715 01/01120415 01/01/2016 EACH LOSS 10,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE NAMED INSURED: BEECHER CARLSON INSURANCE SERVICES, INC.; ON POINT UNDERWRITING, INC.; BROWN & BROWN OF ARIZONA, INC.; BROWN & BROWN OF OREGON, INC. CERTIFICATE HOLDER IS ADDITIONAL ON THE GENERAL LIABILITY PER FORM #CGD248 0805. CERTIFICATE HOLDER CANCELLATION CITYAS 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF ASHLAND ACCORDANCE WITH THE POLICY PROVISIONS. KART OLSON 90 N MOUNTAIN AVENUE AUTHORIZED REPRESENTATIVE ASHLAND, OR 97520 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD HOLDER CODE CrrYAS1 BROWN-3 PAGE 2 NOTEPA : INSURED'SNAME BROWN & BROWN INC ETAL OP ID: JW Date 12123/2014 INSURED TO THE GENERAL LIABILITY PER FORM #CGD248 08-05