Certificate of Liability Insurance- Scott's Cleaning� � r ,, ,, � � ;v
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��'�� SCOTT-2 OP ID: N
'4� ��� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
02/26/2021
THIS CERTIFICATE IS IS:cUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES N07' 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 PR�DDUCER, 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 ��f 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 CONTACT
ISU Lawrence Insurence Age:ncy NnMe: Heath Lawrence
Po Box 549 a�" a EM :863-467-0600 F� Na ; 863-067-5142
Okeechobee, FL 34973 E-MAIL
Heath Lawrence ADDRESS:
iNsuReaa:Ohio Casualtv Ins
INSURED Scotts Qualit�r Cleaning, LLC
2344 SR 70 West
Okeechobee, FL 34972
NAIC
INSURER D:
COVERAGE
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT 'fHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTA�IDING 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 CONDITICiNS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR
LTR TYPE OF INSURAMCE POLICYNUMBER MM/DDY EFF MMIDDlYYExP LIMITS
A X COMMERCIAL 6ENER.4L LIABILITY EACH OCCURRENCE S 'I �OOO,OOO
CLAIMS-MADE C� OccUR X BKS58632595 02/23/2021 02/23/2022 pREMISES Ea occurrence S 200,00
MED EXP (Anyone person) S �����0
PERSONAL & ADV INJURY S 'I �OOO�OOO
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S Y�OOO,OOO
X POLICY � PRO- r�
JECT L LOC PRODUCTS - COMPlOP AGG S i�000,000
OTHER: y
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a
Ea accident
ANY AUTO BODILY INJURY (Per person) S
ALLOWNED S��HEDUI.ED
AUTOS AUTOS BODILYINJURY(Peraccident) S
HIRED AUTOS Ai�OSWNED PROPERTY DAMAGE S
Per accident
$
UMBRELLA LIAB pCCUR EACH OCCURRENCE E
EXCESS LIAB CLAIMS-MADE AGGREGATE S
DED RETENTION :6 $
WORKERSCOMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY y � N STATUTE ER
ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED7 , ❑ N / A
(Mandatory In NH) - E.L. DISEASE �- EA EMPLOYE S -
If yes, describe under
DESCRIPTION OF OPERA710NS below E.L. DISEASE - POLICY LIMIT S
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 701, Additional Remarks Schedule, may be attached if more space Is requtred)
JANITORIAL SERVICES
CERTIFICATE HOLDER /�A�I/�CI � w�r����
City of Okeechobee
55 S.E. 3rd Awenue
Okeechobee, FL 34974
CTYOKEE
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
�����i�� i���
O 1988-2014 ACORD CORPORATION. All righks reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
C:ERTIFICATE OF LTABILTTY INSURANCE 1i4i2o22
Producer: P�YrT10Uti1 �I1S�urance Agency This CertiFcate is tssued as a matter of information only and confers no
Z%3J U.S. HIC�IIWay 'I J N. rightr upon the Certfficate Holder. Thfs Certlficate does not amend, extend
Holiday, FL �i46J� or alter the coverage afforded by the policies below.
(727) 938-55Ei2 Insurers Affording Coverage NAIC #
Insured: SoUth EaSt PE;rsonnel Leasing, Inc. & Subsidiaries InsurerA: uon Insurence Company 11075
2739 U.S. Hlg�hway 19 N. �nsurere:
Hollday, FL 34691 Insurer C:
Insurer D:
insurer E:
Covera es
The poliGes of insurence Ifsted belaw have been Issued to lhe insured named above for lhe poliq periad indcated. Notwithslanding any requfrement, tertn ar condition of any conlraM u other document
with respeU to which Uils cerU6cate may be (ssued or may pertain, fhe Insurance afforded by �e polides described herein Is subjed to all the terms, exdustans, and conditlons ot such polides. Aggregate
�Imits shown may have been reduced by Fraid claims.
INSR ADDL Policy EfFedive Policy Expirafion
LTR INSRD Type ��f Insurance Policy Number Date (MM/DDlYY) Date(MM/DDiYY) Limits
GENERAL LIABfLITY
Each Occurrence
Commercial �General l.iability
Damage to rented premises (EA
Claims M,ade Occur oc«,rre��e►
�—� Med Exp
���
eneral aggregate limit appties per: Personat Adv Injury
Palicy ❑ F'roJect ❑ LOC General Aggregate
ProduGs - ComProP A99
UTOMOBILE LI.ABILITY Combinod Singto Llrtdt
Any Auto (EA AcGdent)
All Owned Autos Badily Injury
Scheduled Aulos (Per Person)
Hired Autos
Bodily Injury
Non-0wned Autos (Per Accident)
�_ Praperty Damege
(Per AcGdent)
EXCESS/UMBRE:LLA LIABILITY Each Ocwnence
Occur � i;�alms Made A��ragate
Deductlble
A Workers Compensation and X WC Statu- OTH-
Employers' Llability WC 71949 01/01/2022 01/01/2023 to Limits ER
Any proprietor/partneNexecuUve officedmember E.L. Each Accident 51,000,000
excluded? N�
If Yes, describe under special prov(sions below.
E.L. Disease - Ea Employee St,000,000
E.L. Disease - Policy Limits S1,000,000
other Lion Insurance Company is A.M. Best Company rated A(Excellent). AMB # 12616
Descriptions of Operations/Loc;�tionsNehicies/Exclusions added by EndorsemenUSpecial Provisions: Cllent ID: 12-57-152
Coverage only appltes to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to tfie following "Gfent Company":
Scott's Quality Cleaning
Coverage only appiies to Injurfes Incurre�d by South East Personnel Leasing, Inc. & Subsidiaries acUve emptoyee(s), while working in: FL.
Coverage does not apply to statutory ennployee(s) or independent conhactor(s) of the Cltent Company or any other entity.
A Iist of the acGve employee(s) leased d� the Gient Company can be obtained by faxing a request to (727) 937-2138 or email certiFlcates@Iloninsurancecomparry.com
Pwject Name:
ISSUE 70-16-14 (AF). REISUE 07-28-1�6 (PH) REISSUE OB-17-17 (RK) REISSUE 09-15-20 (AR). REISSUE 01-20-21 (KLT). REISSUE 04-07-21(BP). REISSUE 01-0422 (KLT)
CERTIFICATE HOLDER Be in Date: 10 26 1998
CANCELLATION
CITY OF OKEECHOBEE Should any of tlie above desuibed polides be pncelled before the expiration date thereot, the Issuing
insurer wlll endeavor to ma1130 days written ratice lo the ceNflcate holder named to the lefl, but taUure to
do so shall impose no obliga8on or IlaWllty of any kind upon fhe tnsurer, its agents or represeMatives.
55 SE 3RD AVE.
..-�—.
OKEECHOBEE, FL 34974 � �
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