HomeMy WebLinkAboutInsurance Certificate: Brown & Brown Inc Etal
BROWN-3 OP ID: JW
2017 Y)
'4C~'RD CERTIFICATE OF LIABILITY INSURANCE 0 D1/06/
/2017
01/06
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 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).
ONTACT LAURIE KOHLER #17009
PRODUCER C
NAME:
Brown & Brown of Florida, Inc. PHONE 386-239-7242 Fvc No :386-323-9159
Daytona Beach Office MA Lo Ext
P.O. Box 2412 ADDRESS: lkohler@bbdaytona.com
Daytona Beach, FL 32115-2412
M. Decker Youngman INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A :Travelers Prop & Cas of Amer 25674
INSURED BROWN & BROWN INC ETAL INSURER B :Continental Casualty Co 20443
P O BOX 2412 INSURER C :Travelers Indemnity 25658
DAYTONA BEACH, FL 32115
INSURER D :XL Specialty 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.
INSR 'TYPE OF INSURANCE IN ADDL SUB WVD
LTR POLICY NUMBER MM DD/YYYY MM/DD/YYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
❑ OCCUR X TC2JGLSA9527B87417 1 01/01/2017 01/01/2018PREMDAMAGEISES S( Ea RENTED occurrence $
CLAIMS-MADE 1,000,00
~
MED EXP (Any one person) $ 5,00
PERSONAL & ADV INJURY $ 1,000,00
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00
❑ PRO-
PRODUCTS - COMP/OP AGG $ 2,000,00
POLICY JECT LOC
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00
Ea accident
A ANY AUTO TC2JCAP9527B86217 01/01/2017 01/01/2018 BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
X X NON-OWNED PROs E TY DAMAGE $
HIRED AUTOS AUTOS (Per id nt)
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00
B EXCESS LIAB CLAIMS-MADE 6011849429 01/01/2017 01/01/2018 AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION X PER OTH-
STATUTE ER
AND EMPLOYERS' LIABILITY
A ANY PROPRIETOR/PARTNER/EXECUTIVE Y~ TC2JUB9517B58017 01/01/2017 01/01/2018 E.L. EACH ACCIDENT $ 1,000,00
OFFICER/MEMBER EXCLUDED?
C (Mandatory datory in NH) N / A TRKUB9518B76117 01/01/2017 01/01/2018 E.L. DISEASE - EA EMPLOYEE $ 1,000,00
If yes, describe under 1 000 00
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ , ,
D INS AGENTS E&O ELU14796717 01/01/2017 01/01/2018 EACH LOSS 10,000,00
AGGREGATE 25,000,00
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 CG D2 48 08 05.
CERTIFICATE HOLDER CANCELLATION
CITYAS1
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
C 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD