Laserfiche WebLink
From: Enka Stone At Plastridge Insurance Agency FaxID: To: Nancy Lee Date: 1117f2000 03:44 PM Page: i of 1 <br />A-0-080I. CERTIFICATE OF LIABILITY INSURANCE OP ID E <br />C &WEN -1 <br />01/17/06 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />LTR <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />The Plastridge Agency -PBGO <br />HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />10337 N Military Trail <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />LIM TS <br />AUTHORIZED REPRESENTATIVE <br />Palm Beach Gardens FL 33410 <br />Phone: 561-630-4955 Fax:561- 630 -4966 <br />INSURERS AFFORDING COVERAGE <br />NAIL9 <br />INSURED <br />INSURERA. Old Dominion Ins- <br />40231 <br />C & w Engineering <br />Dale Walker <br />INSURER 8 Insurance Companies -- <br />- -_ -_ <br />INSURER c. <br />08/25/05 <br />2326 S. Congress Avenue #IF <br />West Palm Beach FL 3340 <br />INSURER <br />PREMISES (Eaa -) <br />- — - -- <br />,NSI RER E: <br />CLAIMS MADE a OCCUR <br />LVVtKACitS <br />THE POLICIES OF INSURANCE LISTED BELC'.H HAVE BEEN ism(' lEO TC THE INBRED LIMBED ABOVE FOR THE POLICY PERIOC ) DK'ATED NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CCNOMON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSL.RANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SLIM <br />POLICIES ArXRECATE LIMITS SHOYvN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br />LTR <br />NOTICE TO T14E CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />OATS (MM/DDIYY) <br />DATE (F@Ai0{N1 V) <br />LIM TS <br />AUTHORIZED REPRESENTATIVE <br />nrnan 7A r�nn�rrrol <br />GENERAL LL42LITY <br />EACH OCCURRENCE <br />4 $00000 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />RF.N OF BPGO6032 <br />08/25/05 <br />08/25/06 <br />$50000 <br />PREMISES (Eaa -) <br />CLAIMS MADE a OCCUR <br />( <br />I <br />$ 5000 <br />MED EX.- (A,Iry one pecan) <br />PERSONAL & ADV IN.A.RY <br />$ 500000 <br />_ <br />GENERALAGGREGATE <br />$ 1000000 — <br />BENI- AGGREGATE LIMIT APPLIES <br />PRODUCTS - COWtO41 AGO <br />51000000 <br />�PER <br />POLKY 27 r I LOC <br />- - --� <br />A <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />RF:N OF B1(306032 <br />I 08/25/05 <br />08/25/06 <br />•COWINED SINGLE LIMIT <br />IEa acct dw) <br />5500000 <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />DODILY lN.fL;RY <br />(FCr p) <br />5 <br />HIRED AUTOS <br />NON-OWNED SOS <br />BODILY INJURY <br />iPel aCd6em) <br />5 <br />PROPERTY DNWAC -E <br />fPer aecederR) <br />I <br />I <br />5 <br />-- _— <br />C"A LIABILnY <br />i <br />AUTO ONLY - EA ACCIDENT <br />5 <br />PINY AUTO <br />OTHER THAN EA ACC <br />5 <br />AUTO ONLY AGO <br />E %CESSAMtBRELtA LIABILTY <br />EACH OCC�WRENCE <br />5 <br />- OCCLR CIAIMS MAI)F <br />I <br />AGGREGATE <br />5 <br />S <br />i <br />DEDUCTiELE <br />RETENTION <br />WORKERS COMPENSATION AND <br />EMPLOYERS'UABILnY <br />WO <br />TO LFA ER <br />- - - <br />EL EACH ACCIDENT <br />--- -_ _ <br />5 --- - - - - -- <br />ANY PRCPRIETORIPARTPER/EXEafTIVE <br />OFFICERR.±EMSER EXCLUDED? ' <br />It Yt . describe tm <br />EL DISEASE - EA EMPLOYEE <br />b ^ <br />E L. DLV -NSF -POLICY LIMIT <br />5 <br />S PECIAL PROVISIONS bebv, <br />OTHER <br />B <br />Professional iBINDER <br />98765 1 07 /01 /05� <br />07/01/06 <br />Prof 500000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />0000000 <br />SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br />Ms. Talia Garcia, El <br />NOTICE TO T14E CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />Chen and Associates <br />IMPOSE NO OBL)GATION OR LIABILITY OF ANY KIND UPON TIE INSURER, ITS AGENTS OR <br />5100 NW 33rd Ave. Ste 250 <br />REPRESENTATIVES. <br />Fort Lauderdale FL 33309 <br />AUTHORIZED REPRESENTATIVE <br />nrnan 7A r�nn�rrrol <br />� rrwR V l.vR rL7 KA 1 I V n l `Jifil <br />