CY 10/1/2019-20A Q® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
10/10/2019
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
Celedinas Insurance Group
A Marsh & McLennan Agency
4400 PGA Blvd, Suite 1000
CONTACT
NAME:
PHONE FAX
Ext): 561.622.2550 'C'No
E AAA Lo
ADDRESS: celedinascerts@mma-fl.com
INSURERS AFFORDING COVERAGE NAIC #
Palm Beach Gardens FL 33410
INSURER A: Allied Insurance Co. of America 10127
EACH OCCURRENCE $1,000,000
INSURED NASOYEA-01
INSURER B: Depositors Insurance Company 42587
Nason Yeager Gerson Harris & Fumero, PA
3001 PGA Blvd #305
INSURERC:
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICYF—] PRO- JECT ❑ LOC
OTHER:
Palm Beach Gardens FL 33410
INSURER D :
INSURER E
A
INSURER F :
r_nvl=Rer_Fc CFRTIFICATF NHMRFR-479R75RRR 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
LTR
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
Y
ACPBPOL3037929813
10/1/2019
10/1/2020
EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED
PREMISES Eaoccurrence $300,000
MED EXP (Any one person) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICYF—] PRO- JECT ❑ LOC
OTHER:
GENERAL AGGREGATE $2,000,000
PRODUCTS - COMP/OP AGG $ 2,000,000
A
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
X AUTOS ONLY X AUTOS ONLY
ACPBPOL3037929813
10/1/2019
10/1/2020
COMBINED SINGLE LIMIT $1,000,000
Ea accident
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
Per accident
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
ACPCAP3037929813
10/1/2019
10/1/2020
EACH OCCURRENCE $4,000,000
AGGREGATE $ 4,000,000
DED–F7 RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
ACPWCD3037929813
10/1/2019
10/1/2020
1 PER OTH-
STATUTE ER
E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE -EA EMPLOYEE $ 1,000,000
E.L. DISEASE -POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Proof of Insurance Only.
CERTIFICATE HOLDER UArvI:tLL.A I IUN
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
u All - .-r.a.. .. ...1
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD