Laserfiche WebLink
COnntB-lnAA71R <br />nnannRnn <br />ACORD. CERTIFICATE OF LIABILITY INSURANCE <br />DATE IMMODOTYYI <br />ADOL <br />TYPE OF INSURANCE -1NSR <br />1011012013 <br />THIS 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 />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />MODUCER CONTACT <br />(_NAME:_ <br />USI Insurance Services, LLC, PHONE 813 321.7500 I 813 321.7525 <br />(AK: XO tit: IAJC. Ng,: <br />1715 N. Westshore Blvd. Suite 700 EAUa <br />I ADORERS: <br />INSURER B AFFORDING COVERAGE HAI[ <br />Tampa, FL 33607 INSURER A: Old Dominion Insurance Co 140231 <br />DISURED INSURER B: XL Specialty Insurance Company 137885 <br />Cordova Rodriguez 8 Associates, Inc. <br />6941 SW 196th Ave., Ste 28 INSURER C: I <br />Pembroke Pines, FL 33332 I INSURER D: <br />INSURER E: <br />INSURER F : <br />COVERAGES CERTIFICATE NIIMRFR- RFVLCIn1U MIIMRFR• <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 CONTRACTOR 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 />INSfl <br />LTp <br />ADOL <br />TYPE OF INSURANCE -1NSR <br />BURR' <br />WVOI POLICY NUMBER <br />POIN:Y EFF <br />M=D <br />POLICY EXP LIILfiS <br />NMID I <br />A <br />GENERAL lU81lITY I X <br />XI COMMERCIAL GENERAL LIABILITY <br />I I CINMS Mn]E I X OCCUR <br />!BPG99955 <br />10104120131010412014 <br />EACH OCCURRENCE <br />A Eip RENTED <br />13R�4 =S IEa aceerrenrsl <br />-0 EXP IA, 7 pa o:l <br />FERSCNAL 11431 , <br />GENERAL AGGREGATE <br />/PRODUCTS - COMP,OP AGG <br />�s1,000,000 <br />: 500,000 <br />5,000 <br />1' <br />51,000,000 <br />52,000,000 <br />GENT AGGREG TE LIMIT APPLIES PER ' <br />POLICY PF0. I LOC <br />I <br />$2,000,000 <br />1 5 <br />A <br />1 AUTOMOBILE <br />1 X <br />I <br />LIABILITY I BPG99955 <br />ANY AUTO <br />ALL AUi0.A OWNED 4UTOSUL-D <br />NONUVNED <br />HIREDAUTOS X ALTOS <br />I I I <br />1 UMBRELLA UAB I I OCCUR I <br />LAjS CLAIMSMADEI <br />oEl O i RETENTIONS <br />101041201310,10412014 <br />COM.BINED11"11 UI T <br />(EA A..,) <br />BOOBY INJURY(Per peraan) <br />BcD LLY INJURY (Pw a,mwQ <br />PROPERTY DAALAGE <br />IlPge o]eml <br />I <br />151,000,000 <br />1$ <br />15 <br />1 5 <br />IS <br />_{I—EXCESS <br />EACH OCCURRENCE <br />I S <br />1AGGREGATE <br />15 <br />15 <br />WORKERS COMPENSATON <br />AND EMPLOYERS' LIABIL" YIN <br />ANY PROPRIE70%PARTNERJEAECUTNE <br />OFFICERMENBER EXCLUDED7 NIA <br />(M tor, In NH) <br />D les. oa.. umer <br />DESCRIPTION OF OPERATIONS peiP.e <br />I IVCSTATLL IOTH -1 <br />T()RY LI <br />I EL. EACH ACCIDENT ( <br />E.L. DISEASE - EA EMPLOYEE/ <br />EL. DISEASE POUCY LIMIT I <br />5 <br />5 <br />S <br />B <br />Professional iDPS9111957 <br />Liability I <br />9128/2013 <br />09/2812014 $500,000 per claim <br />$1,000,000 annl aggr. <br />DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES IAnech ACORD ID1, A*dibAMI R.m . B W, it mere apace iA '.quirt l <br />Professional Liability coverage is written on a claims -made basis. <br />For Proposal Purposes I 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 />OLai M OD—Wt AO-- <br />© 1988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD <br />#S110872251M11087215 KEBEW <br />Cordova Rodriguez 8 Assoc., Inc. RFO# 14 -07 -02 8 <br />