CERTIFICATE OF LIABILITY INSURANCE€¦ · Florida Citrus Sports Florida Coca-Cola Bottling Company...

CERTIFICATE OF LIABILITY

INSURANCE

Table of Contents

1310 Congress Partners, LLC

Abacoa Property Owners’ Assembly, Inc.

Abacoa Town Center Master POA

Aberdeen Golf & Country Club

Abocoa Condominium Assoc.

Academy of Health Science and Pre-Medicine

Advent Lutheran Church/School

Aleman & Associates, LLC and SMG

Allen & Arts

American Academy of Dermatology

American Heritage – Delray Beach

Applebees

Arbern Investors IV, LP

Atlanta Independent School District

Atlantic Community High School

Avis Budget Group, Inc.

Bank of America, N.A.

Belle Glade Board of County Commissioners

Benoist Farms Elementary School

Best Buy

Bethel Assembly of God

Big Brothers Big Sisters of PBC

Big Lots

Boca Ballet Theatre

Boca Lago Country Club, Inc.

Boca Mission, LP

Boca Museum of Art @ Mizner Park

Boca Raton Board of City Council

Boca Raton Resort & Club

Boca Raton Wine & Food Festival

Boca Woods Country Club Association, Inc.

Boynton Beach BOCC

Boynton Beach Mall

Boys & Girls Club of PBC

Brevard Community College

Broadmoor Apartments Associates

Broward County Parks and Rec

Broward County Public Schools

Broward Paper & Packaging

Bureau of Land Management

Burlington Coat Factory



Casanova Custom Tile & Marble, LLC

CB Richard Ellis Investment Property Group

Center for Spiritual Living

Cheney Brothers, Inc.

Children’s Services Council of Palm Beach

Chris Evert Charities, Inc.

City Council of Greenacres; City of Greenacres

City of Belle Glade

City of Boca Raton

City of Boynton Beach Recreation & Parks, Denson

Pool

City of Boynton Beach Recreation Department

City of Delray Beach

City of Lake Worth

City of Palm Beach Gardens Risk Mgmt

City of Riviera Beach Parks and Recreation

City of Riviera Beach Parks and Recreation Dept.

City of Riviera Beach

City of St. Petersburg

City of West Palm Beach and Board of Supervisors of

West Palm Beach Golf Club

City of West Palm Beach

City Place Community Development

Clarke Holdings Corporation

Clifford O. Taylor/Kirklane Elementary

Colonial High School

Cosmopolitan AME Church

Cross Match Technologies, Inc.

Custom World, Inc.

CVS Pharmacy

Dayton Ballet Association

Delray Beach Board of City Commissioners

Delray Beach BOCC

Department of Army, JROTC Program

Department of Juvenile Justice, Project MIND

Department of Juvenile Justice, Delinquency

Prevention Program

Department of Juvenile Justice, School Accountability

Boards

Department of the Army, c/o Forest Hill High School

JROTC

Department of Transportation

Devos Blum Family YMCA of Boynton Beach

Diocese of Palm Beach

District Office of Vocational Rehabilitation

Dolly Hand Cultural Arts Center

Drum Corps International

Early Learning Coalition of Palm Beach County, Inc.

Eastern Florida State College

Everglades Youth Camp

Family Central Inc.

Famoso, Inc. DBA: Manpower

FAU Athletics

FDOT

FHSAA

Firehouse Subs

First Baptist Church of Boca Raton

First Baptist Church of Orlando

First Methodist Church of Oviedo

First United Methodist Church of Jupiter

Florida Atlantic Board of Trustees

Florida Charter Schools Conference

Florida Children’s Forum

Florida Citrus Sports

Florida Coca-Cola Bottling Company

Florida Community College

Florida Department of Agriculture and Consumer

Services

Florida Department of Education

Florida Department of Transportation c/o DBI Services

Corp

Florida Expo / Aleman & Associates

Florida High School Athletic Association

Florida Institute of Technology

Florida Power & Light Co.

Florida Southern

Follett Bookstore

Fullerton Civic Light Opera Co., Inc.

Gateway Performing Arts

GBYSA / Boca United FC

George Snow Scholarship Foundation Inc.

George Snow Scholarship Fund Inc.

Georgia State University

Gibbs High School

Girls Scouts of Southeast Florida, Inc.

Global Rental Company, Inc.

Gold Coast Christian Camp

Good Shepherd United Methodist Church

Grace Covenant Presbyterian Church

Grandview Preparatory School

Greater Boca Raton Beach & Park District

Greater Boca Raton Beach & Park District – James A.

Rutherford Community Center

Greenacres Community Center

Greenacres Learning Center

Grosh Scenic Rentals, Inc.

Gulfstream Council

Gulfstream Race Track

Gwinnett County Board of Commissioners

Hardee County School District

Harid Conservatory

Haverhill Town Council

Health Care District of Palm Beach County

Hillsborough County Public Schools

Holy Spirit Catholic Church

Home Depot

Hyatt Place

Hypoluxo Town Council

Indian River County School District

Indian Trail Improvement District

IPC Operations, LLC

Janoura Partners, LLC DBA Sims Creek Plaza

JC Penney’s

JCB Enterprises, Ltd.

Joann Fabrics

John C Bills Enterprises LTD

Johnathan’s Landing Golf Club

Johnathan Dickinson State Park

Juno Beach Town Council

Jupiter Christian School

Jupiter Community Center

Jupiter High School Government Association

Jupiter Inlet Colony Town Council

Jupiter Lanes Bowling Alley

Jupiter Medical Center, Inc. and Pavilion

Jupiter Town Council

Kelly Tractor

Keystone – Florida Property Holding Corp.

KFC

K-Mart

Kravis Center

Lake Clarke Shores Town Council

Lake County School Board

Lake Park Town Commission

Lake Worth BOCC

Lantana Homes HOA

Lantana Town Council

LBS South, LLC/Jacksonville Facility

Lutheran Services Florida, Inc.

Lynn University

Macy’s Department Store #757-town Ctr.

Maddox – Joines, Inc. dba Sunshine Golf Carts

Main State Musical Theatre Costume Rental

Maltz Jupiter Theatre

Mangonia Park Town Council

Mar-a-Lago Club

Mariela Castillo

Marjon Specialty Foods, Inc.

MBIA Insurance

Menin Development Companies

Miller Legg

Mission Bay Shopping Center

Mobile Gas

Mobile Mini, Inc. – Fort Pierce, FL

Mobile Mini, Inc. – Tempe, ZA

Modular Space Corporation

Neff Rental

North Broward Preparatory School

Northern Palm Beach County Improvement District

Northwest College

Nova Southeastern University – Fort Lauderdale

Nova Southeastern University – Palm Beach Gardens

O.B. Festival Events, LLC

Oakstone Academy Palm Beach Corporation

Ocean Ridge Town Commission

Office of Family & Community Outreach

Old Navy

Olympic Heights Community High School

Orange County Public Schools

OXXO Care Cleaners

Pahokee City Commission

Pahokee Middle Senior High School

Palladium Management Company

Palm Beach Atlantic College

Palm Beach Atlantic University

Palm Beach County Board of County Com. – Summer

Camp

Palm Beach County Board of County Com. - Head Start

Palm Beach County Board of County Com. – Film &

Television Commission

Palm Beach County Board of County Com. – Film &

Television Commission

Palm Beach County Board of County Com. – Prop &

Real Estate Mgmt Div

Palm Beach County BOCC, Risk Management Dept

Palm Beach County Convention Center

Palm Beach County Health Dept, Environmental Health

& Engineer

Palm Beach County Health Dept, Lairsey/Childcare

Licensing

Palm Beach County Health Dept, Child Care Facility

Board

Palm Beach County Health Dept, Div of Finance and

Accounting

Palm Beach County Parks & Recreation

Palm Beach County Youth Services Department

Palm Beach County

Palm Beach County Southwinds Golf Course

Palm Beach County Parks and Recreation – BB Swan

Palm Beach County Youth Services Department

Palm Beach County Convention Center

Palm Beach County BOCC, Div of Human Services

Palm Beach County

Palm Beach Gardens Aquatic Complex

Palm Beach Gardens City Council

Palm Beach Institute for Contemporary Art

Palm Beach Mall Holdings, LLC

Palm Beach Mall Holdings, LLC; PBM Developer, LLC

Palm Beach Maritime Museum

Palm Beach Outlets & UG2

Palm Beach Shores Town Commission

Palm Beach State College

Palm Beach State College

Palm Beach State College and its District Board of

Trustees

PBSC and its District Board of Trustees

Palm Springs Village Council

Park Avenue BBQ and Grille

Park Vista High School

Penske Truck Leasing Co., L.P. – Reading, PA

PGA National Resort & Spa

Pinellas County School Board

Pleasant City Multicultural Center

Port of Palm Beach District

Promenade Mobil

PSI Services

Publix @Village Commons

Publix Store #1384

Publix Super Market

Quantum Foundation

Ramco-Gershenson Properties, LP

Ramco-Gershenson, Inc., Attn: Isabel E. Feldman

Refugee Programs Administration

Regency Party Rentals

Ridgecreast YMCA

Riviera Beach Marina Event Center

Riviera Beach Marina Event Center

Rosen Shingle Creek

Royal Inn

Royal Palm Beach Hess

Royal Palm Beach Village Council

Royal Palm Beach Chick-Fil-A

Royal Palm Exxon

Ryder Truck Rental, Inc.

San Diego County Office of Education

Sandypines

Saxon Archives Palm Beach, Inc.

School Board of DeSoto County

School Board of Pinellas County

School District of Manatee County

School District of Philadelphia

SeaWorld Parks & Entertainment, Inc.

Self Storage

Shadowwood Square, Ltd. & Terranova Corp

Shape Students Changing the World

Single School Culture Initiatives

Sloan's

Solid Waste Authority

Soroptimist International of Stuart

Sound Advise Amphitheater

South Bay City Commission

South Florida Fair and Palm Beach County Expositions,

Inc.

South Florida Water Management District

South Palm Beach Town Commission

Southeastern University

Spring Lake Partners

St. Andrews School

St. Leo University

St. Luke’s UMC

St. Vincents Ferrer Catholic Church

Stanbery Development

State of Florida Division of Drivers Licenses

Statewide Mutual Aid Program

Steven R. Morgan, Principal Avison Young

StrawberryCrest High School

Sun State International Truck, LLC

Suncoast High School

SunFest of Palm Beach County, Inc.

Sunset Cove Amphitheater

Sunshine Golf Car

Sweet Tomatoes

Sysco Southeast Florida, LLC

T.J. Maxx

Tampa Armature Works

TD Equipment Finance, Inc.

TD Equipment Finance, Inc.

Temple Beth El

Tennis Club of the Palm Beaches

Tequesta Village Council

The Alliance for Community Enrichment at The Borland

Center

The Ballpark of the Palm Beaches

The Benjamin School

The Boca Raton Bridge

The Breakers Hotel

The City of Boca Raton

The City of Boca Raton

The City of Boca Raton, The Greater Boca Raton

Beach & Park Dist

The First Academy, Attn: Ginger Millsaps

The First Academy, FHSAA Board of Directors

The Flagler Museum

The Florida Department of Children and Families

Refugee Service Program

The Harriet Himmal Gilman Theater

The Home Depot

The Kings Academy

The Mall at Wellington Green and The Taubman

Company Limited Partnership

The National Memorial Day Parade

The Resort at Singer Island

The School District of Pinellas County

The Scripps Research Institute

The Society of The Four Arts

Therapeutic Recreation Complex

Thomas Jefferson High School

Tiburon Corp.

TJ Maxx; The TJX Companies Inc.

TJX Companies, Inc.

Town Center Mall at Boca Raton

Town of Jupiter

Town of Lake Park

Town of Lantana – 500 Greynolds Cir

Town of Lantana – 510 West Pine

United Way of Palm Beach County Conference

Unity School

University of Central Florida

University of South Florida

US Armory

VC1, LLC

Versa Property Management, LLC

Village Academy Early Head Start

Village of Royal Palm Beach

Village of Wellington – 11700 Pierson Rd

Village of Wellington – 1279 W. Forest Hills Blvd

Village of Wellington, Amce Improvement Dist

Weight Watchers North America, Inc.

Wellington Regional Medical Center

West Orange High School

West Palm Beach BOCC

Whole Food Market – Austin, TX

Whole Food Market – Wellington, FL

Wireless Systems Group, Inc.

Workforce Alliance Contracts Unit

YMCA of South Palm Beach County

The ACORD name and logo are registered marks of ACORD

CERTIFICATE HOLDER

© 1988-2014 ACORD CORPORATION. All rights reserved.

ACORD 25 (2014/01)

AUTHORIZED REPRESENTATIVE

CANCELLATION

DATE (MM/DD/YYYY)

CERTIFICATE OF LIABILITY INSURANCE

LOCJECTPRO-

POLICY

GEN'L AGGREGATE LIMIT APPLIES PER:

OCCURCLAIMS-MADE

COMMERCIAL GENERAL LIABILITY

PREMISES (Ea occurrence) $DAMAGE TO RENTEDEACH OCCURRENCE $

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $

PRODUCTS - COMP/OP AGG $

$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $

EACH OCCURRENCE $UMBRELLA LIAB

EXCESS LIAB

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

INSRLTR TYPE OF INSURANCE POLICY NUMBER

POLICY EFF(MM/DD/YYYY)

POLICY EXP(MM/DD/YYYY) LIMITS

PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

$

$

$

ANY PROPRIETOR/PARTNER/EXECUTIVE

If yes, describe underDESCRIPTION OF OPERATIONS below

(Mandatory in NH)OFFICER/MEMBER EXCLUDED?

WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY Y / N

AUTOMOBILE LIABILITY

ANY AUTO

ALL OWNED SCHEDULED

HIRED AUTOSNON-OWNED

AUTOS AUTOS

AUTOS

COMBINED SINGLE LIMIT

BODILY INJURY (Per person)

BODILY INJURY (Per accident)

PROPERTY DAMAGE $

$

$

$

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE 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.

INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE 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 tothe terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to thecertificate holder in lieu of such endorsement(s).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

INSURED

PHONE(A/C, No, Ext):

PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

INSURER(S) AFFORDING COVERAGE

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.

INS025 (201401)

3/19/2018

The Beacon Group, Inc.

6001 Broken Sound Pkwy.,N.W.

Suite 500

Boca Raton FL 33487-2730

(561)994-9994 (561)997-7087

School Board of Palm Beach County

3370 Forest Hill Blvd.

Suite A-103

West Palm Beach FL 33406

School Board of Palm Beach

Master 18/19A

A X

X Also applies to Child

Abuse and Molestation

SUBJECT TO INSURER A: 07/01/2018 07/01/2019

FLA STATUTE 768.28

*200,000 PER PERSON

*300,000 PER OCCURRENCE

200,000

Excluded

300,000

Included

A SUBJECT TO INSURER A: 07/01/2018 07/01/2019

FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X

This certificate supercedes and voids all previous certificates. The School Board of Palm Beach County isself insured under the laws of the State of Florida for the above limits for tort liability.

D Dresback, CPCU, ARM

1310 Congress Partners, LLC Attn: Shelly 5201 Village Blvd. West Palm Beach, FL 33407

(561)687-1903


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Abacoa Property Owners' Assembly, Inc. 1200 University Blvd. Suite 102 Jupiter, FL 33458


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Abacoa Town Center Master Property Owners Association, Inc/ c/o Versa Property Management 661 University Blvd. Suite 200 Jupiter, FL 33458


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Aberdeen Golf & Country Club Attn: Sean Lutwin 8251 Aberdeen Drive Boynton Beach, FL 33437

(561)493-6854


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Abocoa Condominium Assoc. Attn: Terri 4798 Central Blvd. Jupiter, FL 33458


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Academy of Health Science & Pre-Medicine Jensen Beach High School 2875 NW Goldenrod Road Jensen Beach, FL 34957


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Advent Lutheran Church/School Attn: Kevin Wrenne 5001 NE 4th Avenue Boca Raton, FL 33431


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Aleman & Associates, LLc and SMG (Puerto Rico Convention Center) Janet Freyre 1000 Convention Blvd. San Juan, PR 00907


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Allen & Arts Attn: Paul Allen 215 South County Road Bellport, NY 11713

(163)128-6425


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



American Academy of Dermatology 930 E. Woodfield Road Schaumburg, IL 60173

(561)775-7249


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



American Heritage - Delray Beach 6200 Linton Blvd. Delray Beach, FL 33484


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Applebees 1570 W. Boynton Beach Blvd. Boynton Beach, FL 33436

applebeesboynton@dohertyin


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Arbern Investors IV, LP & Stoltz Management of FL Inc 301 Yamato Road,Suite 3101 Boca Raton, FL 33431


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Atlanta Independent School District 1631 LaFrance Street NE Atlanta, GA 30307

[email protected]


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Atlantic Community High School Attn: JROTC (LTL Rodriguez) 2445 West Atlantic Avenue Delray Beach, FL 33445


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



$

$

$






ANY AUTO

ALL OWNED SCHEDULED


AUTOS AUTOS

AUTOS




PROPERTY DAMAGE $

$

$

$


INSDADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

OTHER:




INSURED


PRODUCER

ADDRESS:E-MAIL

FAX(A/C, No):

CONTACTNAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :



INS025 (201401)

3/19/2018



Suite 500


(561)994-9994 (561)997-7087



Suite A-103



Master 18/19A

A X




FLA STATUTE 768.28

*200,000 PER PERSON


200,000

Excluded

300,000

Included


FLA STATUTE 768.28

*200,000 PER PERSON


200,000

300,000

Included


FLA STATUTE 768.28

X



Avis Budget Group, Inc. and it's Subsidia 4500 S 129 E Avenue, Suite 100 P.O.Box 690360 Tulsa, OK 74169-0360


CERTIFICATE HOLDER


ACORD 25 (2014/01)


CANCELLATION

DATE (MM/DD/YYYY)


LOCJECTPRO-

POLICY


OCCURCLAIMS-MADE





GENERAL AGGREGATE $


$RETENTIONDED

CLAIMS-MADE

OCCUR

$

AGGREGATE $


EXCESS LIAB





PERSTATUTE

OTH-ER

E.L. EACH ACCIDENT



CERTIFICATE OF LIABILITY INSURANCE€¦ · Florida Citrus Sports Florida Coca-Cola Bottling Company...

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Transcript of CERTIFICATE OF LIABILITY INSURANCE€¦ · Florida Citrus Sports Florida Coca-Cola Bottling Company...