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Certificate of Insurance Expires 11-08-2018
USASERV-01 DSMITH2 ,acoRO" CERTIFICATE OF LIABILITY INSURANCE `--� DATE(MM/DD/YYYY) 11107/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY 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 have ADDITIONAL INSURED provisions or 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 Hub International Southeast 1560 Orange Avenue Suite 750 Winter Park, FL 32789 CONTACT NAME: PHONE FAX (A/C, No, Ext): (407) 894-5431 (A/c, No(407) 629-6378 ADDRESS: Certificates.FLA@Hubinternational.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Westfield Insurance Company 24112 INSURED USA Services Of Florida, Inc. 448 Spring Hammock Ct Longwood, FL 32752 INSURER B : American Guarantee & Liability Insurance Company 26247 INSURER C : 11/08/2018 INSURER D : $ 1,000,000 INSURER E : INSURER F : X 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 POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY1 POLICY EXP (MM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY X CMM1915269 11/08/2017 11/08/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGETORENTED PREMISES (Ea occunence) 500,000 $ X contractual terms MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES TE f X PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE X X LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOS ONLY Comp: $1,000 X SCHEDULED AUTOS AUUTOS ONLY Coll: $1,000 CMM1915269 11/08/2017 11/08/2018 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ BODILY INJURY (Per person) $ BODILY BODILY INJURY (Per accident) $ (Per PROPERTYtDAMAGE $ Basic PIP$ 10,000 B X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE AUC 0161392-00 11/08/2017 11/08/2018 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 $ DED RETENTION $ 0 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFIE/MEMBERECUDPROPRIETOR/PARTNER/EXECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A STATUTE ERH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Equipment CMM1915269 11/08/2017 11/08/2018 Leased/Rented 200,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Job: Tampa office Sweeping the City of Okeechobee, FL. City of Okeechobee is incuded as an Additional Insured on General Liability, when required in a written contract or agreement with the Insured. Should a policy be cancelled before the expiration date, a 30 days notice is to be provided by the Insurer to the Certificate Holder. CANCELLATION Cityof Okeechobee 55 Southeast 3rd Avenue Okeechobee, FL 34974 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE gozp ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD