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HomeMy WebLinkAboutFINFROCK ENTERPRISES - INSURANCE CERTIFICATEClient#: 1559798 131 FINFRIND ACORD. CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDD/YYYY) 1102/2015 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(les) 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 endomement(s). PRODUCER CONTACT NAME: BBSTJ. Rolfe Davis Insurance PHONE 407 691-9600 8864i35�163 NC Eat: NC No: PO Box 4927 IL E-Mna Orlando, FL 32802-4927 ADDRESS: 407 691-9600 INSURERS AFFORDING COVERAGE NNCi INSURER A: Amerisure Insurance Company 19488 INSURED Finfrock Enterprises Inc INSURER B Finfrock Construction Inc (see below) INSURER C: 2400 Apopka Blvd INSURER D: Apopka FL 32703 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 14/15 BAL BWS. PNC 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 CONTRACTOR 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. I�TR TYPE OF INSURANCE NSRL SUBR WVD POLICY NUMBER MMIDDYEFF MM(DDryyyy UMns A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fill OCCUR X GL20912180201 2131/201412131/201 EACH OCCURRENCE $1000000 PRE MISEEaErrence $100000 MEDEXP(My weperson) $5000 PERSONAL B ADV INJURY $1000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC JECTA PRODUCTS - COMPIOP AGO $2000000 $ AUTOMOBILE LIABILITY ANY AUTO ALLOWNEDOSCHEDULED AUAUTOS HIRED AUTOS X NON-0WNED AUTOS X CA20805610401 21311201412131/201 EeeBIINNEEDtSINGLELIMIT 1,000,000 X BODILY INJURY (Per person) $ m BODILY INJURY (Paw adem) S X PROPERTY DAMAGE Perecddent $ 8 A X UMBRELLALIAR EXCESS LIAR X OCCUR CLAIMS -MADE CU20855370301 2131/2014 12/31/2015 EACH OCCURRENCE $10000000 AGGREGATE $10 000 000 DED X RETENTION$0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR PARTNERIEXECUTIVE Y I N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) OESCRIPTTIION OF OPERATIONS Oebv NIA X WC20805630301 2/31/2014 12/31/2011 X WC STATLL OTH. E.L. EACH ACCIDENT $500 000 E.L. DISEASE - EA EMPLOYEE $500 000 E.L. DISEASE -POLICY LIMIT s500 000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more spar Is mqulred) Named Insureds Include: Finfrock Industries, Inc., Finfrock Transportation, Inc., Finfrock DC, Inc, Finfrock Development, LLC Additional Insured (including completed operations) status is granted with respect to General Liability if required by written contract per endorsement "Contractors Blanket Additional Insured Endorsement" form (See Attached Descriptions) City of Fort Collins PO Box 580 4 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 2 #S13508034/M13500656 The ACORD name and logo are registered marks of ACORD EMTU or "Contractors GL Extension Endorsement" form CG7049(1109). Primary and Non -Contributory granted with respects to General Liability per "Additional Insured -Primary Non Contributory Coverage when Required by Written Contract, Written Agreement, or Certificate of Insurance" Form CG7213(1112). Additional Insured status is granted with respect to Automobile Liability if required by Form written contract per endorsement "Florida Advantage Commercial Automobile Broad Form Endorsement" form #CA7171(0508). Waiver of Subrogation status is granted if required by written contract as respects to: General Liability per endorsement Contractors General Liability Extension Endorsement form CG7049(1109); Automobile Liability per endorsement "Florida Advantage Commercial Automobile Broad Form Endorsement" form # CA7171 (0508); and Workers' Compensation endorsement "Waiver of Our Right to Recover from Others Endorsement" form #WC000313 (4184) Amerisure Umbrella Policy is follow form over General Liability, Auto Liability, and Employers Liability. SAGITTA 25.3 (2010105) 2 of 2 #S13508034/Ml3500656