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(19-08-02) Janitorial Maintenance Services
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Clean Space, Inc.
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Last modified
9/30/2019 2:52:28 PM
Creation date
9/30/2019 11:39:47 AM
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CityClerk-Bids_RFP_RFQ
Project Name
Janitorial Maintenance Services
Bid No. (xx-xx-xx)
19-08-02
Project Type (Bid, RFP, RFQ)
Bid
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CLEASPA-01 <br />A13ELI <br />CERTIFICATE OF LIABILITY INSURANCE <br />DAT1112OIYYYY) <br />9/111/2019 <br />FTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />iELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />AEPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in Ileu of such endorsements). <br />PRODUCER <br />C CT <br />CKP Insurance LLC <br />21845 Poweriine Road <br />Suite 205 <br />PHONE <br />N Exf : 561 807-0900 A/C, Na : 561 826-3782 <br />Joh,39, Publlc@ckpinsurance.com <br />Boca Raton, FL 33433 <br />I URER a AFFORDING COVERAGE NAIC S <br />INSURER A: Ohio Security Insurance Company 24082 <br />6/1/2020 <br />INSURED <br />I :Ohio Casualty Insurance Company 24074 <br />INSURER C: Great American Assurance Company 26344 <br />Clean Space, Inc. <br />INSURER D: <br />375414W 124th Ave #207 <br />Coral Springs, FL 33065 <br />INSURER E: <br />INSURER F: <br />COVFROnF-R r_FRTIFI('.ATF 1111MRFR• RFVLCIAN NI IMRFR• <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INBR <br />TYPE OF INSURANCE <br />ADDLSUBR <br />POLICYNUMBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE FX OCCUR <br />BKS (20) 58 45 28 16 <br />6/1/2019 <br />6/1/2020 <br />EACH OCCURRENCE S 1'000,000 <br />DAMAGE TO RENTED 300,000 <br />MED EXP ons arson 15,000 <br />PERSONAL AVINJURY 1'000'000 <br />NI- AGGREGATE LIMIT APP ES PER: <br />POLICY❑ j XI LOC <br />OTHER: <br />L AGGREGATE 2,000,000 <br />PRODUCTS - COMPIOP A 2,000,000 <br />AUTOMOBILE LIABILITYCOMBINED <br />ANY AUTO <br />OWNED X SCHEDULED <br />AUTOS ONLY <br />X XAUUTOSS <br />ONLY AOSONp <br />13AO (20) 58 45 2818 <br />61112019 <br />81112020 <br />SINGLE LIMIT 1,000,000 <br />BODILY INJURY Per rson <br />INJURY (Per accident) S <br />R0aAeAMAGE <br />B <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />USO (20) 58 45 2816 <br />6/1/2019 <br />611/2020 <br />EACH OCCURRENCE S 2'000'000 <br />AGGREGATE s 2,000,000 <br />rlDED <br />I X I RETENTIONS 10,000 <br />Products Agg 21000,000 <br />A <br />WORKERS coMPENBATION <br />AND EMPLOYERS' LIABILITY <br />ANYCPRRO/PRIRIETgOERR/PARTNER/EXECUTNE Y / N <br />IM d.NM In NN) EXCLUDED? L <br />I► es, describe under <br />0 SCRIPTION F OPERATIONS b <br />N / A <br />WS (20) 58 45 2816 <br />BN/2019 <br />6/1/2020 <br />X PER ATUT- OTH- <br />E L EACH ACCIDENT 1'000'000 <br />DISEASEEMPLOYEE 1,000,000 <br />I -POU Y LIMIT 1,000,000 <br />C <br />Crime4ncl Burglary <br />SAAE39124300 <br />10/18/2018 <br />10/18/2019 <br />Limits 1,000,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Addldonal Remarks Schedule, may be attached If more space Is required) <br />Sample of Coverage, <br />certificate holder will be <br />added upon proposal <br />approval <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016103) ® 1988-2015 AGORD GVRPVRATIVN. All ngnts reserveo. <br />The ACORD name and logo are registered marks of ACORD <br />
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