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HomeMy WebLinkAboutFINFROCK ENTERPRISES - INSURANCE CERTIFICATE (3)Client#: 1559798 131 FINFRENT ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 12/22/2015 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(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 CONTACT NAME: BB&T.J. Rolfe Davis Insurance PHONE FAX ac No Ext : 407 691-9600 A/C, No): 888-635-4183 PO Box 4927 E-MAIL Orlando, FL 32802-4927 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 407 691-9600 INSURER A:Amerisure Insurance Company 19488 INSURED INSURER B : Aspen Specialty Insurance Co. 10717 Finfrock Enterprises, Inc. Finfrock Construction, Inc.* INSURER C : 2400 Apopka Blvd INSURER D Apopka, FL 32703 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 15116BAIBWSPNC 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. LTR TYPE OF INSURANCE NSRL SUBR WVD POLICY NUMBER MM/DDY� EXP MM/DDY/YYYY LIMITS A X X COMMERCIAL GENERAL LIABILITY _ CLAIMS -MADE 4 OCCUR BI/PD Ded: $10,000 X GL209121803001 12/31/2015 12/31/2016 EACH OCCURRENCE $1 OOO 000 PREMISES Ea RENTED $100 000 MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: RO- POLICY F7X JET 7 LOC OTHER. GENERAL AGGREGATE s2,000,000 PRODUCTS - COMP/OPAGG s2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS X CA20805610501 12/31/2015 12/31/201 COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE Par accident $ B X UMBRELLA LIAB EXCESS LIAB I X OCCUR CLAIMS -MADE CX0041U15 12/31/2015 12/31/2016 EACH OCCURRENCE $10000000 AGGREGATE $10000 000 DIED I X RETENTION $O $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N f A X WC208056304 12/31/2015 12/31/2016 X PER OTH- E.L. EACH ACCIDENT $1 000000 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) *Named Insureds Continued: Finfrock Industries, Inc., Finfrock Transportation, Inc., Finfrock DC, Inc.; Finfrock Development, LLC,; Finfrock Design, Inc. 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 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 I ACORD 25 (2014/01) 1 of 2 #S15295700/M15294063 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EMTU DESCRIPTIONS (Continued from Page 1) #CG7048(0913) 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 (4/84) Aspen Umbrella Policy is follow form over General Liability, Auto Liability, and Employers Liability 0M%J11 IA LO.J t4u-14/u-1) L Or Z #S15295700IM15294063