ABC Construction, Inc - Laserfiche WebLink

Home Browse Search

1 ~ , 1 ACORO@ CERTIFICATE OF LIABiliTY INSURANCE I DATE (MMIDDIYYYY) ~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMA T1VEL Y OR NEGA TIVEL Y 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 ILEANA CABRERA RODRIGUEZ ~~~~~CT MAGDALENA DETRINIDAD rA~gN~o, Ext\: 305-529-9966 I FAX 1925 PONCE DE LEON BLVD iAIC Nol: 305-529-2856 E.MAIL CORAL GABLES, FL 33134 ADDRESS: ~ INSURERISl AFFORDING COVERAGE NAIC# INSURER A: State Farm Mutual Automobile Insurance Comoanv 25178 INSURED ABC CONSTRUCTION INC INSURER B : 7215 NW7TH ST INSURER C : MIAMI, FL 33126 INSURER D : INSURER E : INSURER F : '1 11 , 1 I 1 II 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 ADOL ISUBR (~3M5~ 1,~2~J~~ LIMITS LTR POLICY NUMBER GENERAL LIABILITY D D EACH OCCURRENCE $ f-- ~~~~~~S tEa occurrence\ f-- 3MMERCIAL GENERAL LIABILITY $ CLAIMS.MADE D OCCUR MED EXP (Anyone person) $ I- PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ ~'L AGGREAE LIMIT APAS PER: PRODUCTS - COMP/OP AGG $ I POLICY ~~8T LOC $ I AUTOMOBILE LIABILITY D D 0256901-B01 02101/2012 08/01/2012 fi:~~~~~~t~INGLE LIMIT $ 1,000,000 - ANY AUTO 0353117-B01 02/01/2012 08/01/2012 BODILY INJURY (Per person) $ - ALL OWNED X SCHEDULED BODILY INJURY (Per accident) $ - AUTOS 1_ AUTOS 0637061-801 02/01/2012 08/01/2012 X X NON.OWNED rp~?~.i~d~~t?AMAGE $ - HIRED AUTOS f-- AUTOS 1832531-B01 02/01/2012 08/01/2012 $ D D -- UMBRELLA L1AB H OCCUR EACH OCCURRENCE $ I - EXCESS LIAB CLAIMS.MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION I WCSTATU-:I 10J~- AND EMPLOYERS' LIABILITY Y / N fORY LIMITS ANY PROPRIETORIPARTNERIEXECUTIVE D D E,L. EACH ACCIDENT $ OFFICE/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $ ow D D DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) iSHOULDANY OF THE ABOVE POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE STATE FARM WILL PROVIDE 30 DAYS WRITTEN NOTICE i r 1 , I .J CERTIFICATE HOLDER CANCELLATION SUNNY ISLES BEACH 18070 COLLINS AVENUE SUNNY ISLES BEACH, FLORIDA 33160 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2010/05) TJoI RIl:. 0 R~RE;'~~~ I' . / "'c.:.uti /'.$;'Z~L IV) L::r 1:l(:1';:~(I /!!- ?ltt6.~' e7. U?\... '.- @1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1001486 132849,6 11-15-2010 /