Scott's Quality Cleaning, WC 1/1/2024 - 1/1/2025 Date
CERTIFICATE OF LIABILITY INSURANCE 1/11/2024
Producer: Plymouth Insurance Agency This Certificate is issued as a matter of information only and confers no
2739 U.S. Highway 19 N. rights upon the Certificate Holder. This Certificate does not amend,extend
Holiday, FL 34691 or alter the coverage afforded by the policies below.
(727) 938-5562 Insurers Affording Coverage NAIC u
Insured: South East Personnel Leasing. Inc. & Subsidiaries Insurer Lion Insurance Company 11075
2739 U.S. Highway 19 N. Insurer B
Holiday, FL 34691 Insurer C.
Insurer D:
Insurer E
Coverages
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. Aggregate
limits shown may have been reduced by paid claims.
INSR ADDL Policy Effective Policy Expiration Limits
LTR INSRD Type of Insurance Policy Number Date(MM/DD/YY) Date(MM/DD/YY)
GENERAL LIABILITY Each Occurrence $
Commercial General Liability
Damage to rented premises(EA
Claims Made ❑ Occur occurrence) S
Med Exp 3
General aggregate limit applies per Personal Adv Injury S
General Aggregate S
Policy ❑Project ❑ LOC
Products-Comp/Op Agg $
AUTOMOBILE LIABILITY Combined Single Limit
(EA Accident) 5
Any Auto
Bodily Injury
All Owned Autos
(Per Person)
Scheduled Autos
Hired Autos Bodily Injury
Non-Owned Autos (Per Accident)
Property Damage
(Per Accident) •
EXCESS/UMBRELLA LIABILITY Each Occurrence
ROccur ❑Claims Made Aggregate
Deductible
A Workers Compensation and x I WC Statu- OTH-
Employers'Liability WC 71949 01/01/2024 01/01/2025 tory Limits ER
Any proprietor/partner/executive officer/member E.L.Each Accident Si 000.000
excluded? NO
E.L.Disease-Ea Employee Sr000,000
If Yes,describe under special provisions below.
E.L.Disease-Policy Limits Sr 000,000
Other Lion Insurance Company is A.M. Best Company rated A(Excellent). AMB# 12616
Descriptions of Operations/LocationsNehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 12-57-152
Coverage only applies to active employee(s)of South East Personnel Leasing,Inc.&Subsidiaries that are leased to the following"Client Company":
Scott's Quality Cleaning
Coverage only applies to injuries incurred by South East Personnel Leasing,Inc.&Subsidiaries active employee(s) ,while working in:FL.
Coverage does not apply to statutory employee(s)or independent contractor(s)of the Client Company or any other entity.
A list of the active employee(s)leased to the Client Company can be obtained by emailing a request to certificates@lioninsurancecompany.com
Project Name:
ISSUE 10-16-14(AF). REISUE 07-28-16(PH)REISSUE 08-17-17(RK)REISSUE 09-15-20(AR).REISSUE 01-20-21 (KLT).REISSUE 04-07-21(BP).REISSUE 01-04-22(KLT)
REISSUE 01-11-24(KLT)
Begin Date:10/26/1998
CERTIFICATE HOLDER CANCELLATION
CITY OF OKEECHOBEE Should any of the above described policies be cancelled before the expiration date thereof,the issuing
insurer will endeavor to mail 30 days written notice to the certificate holder named to the left but failure to
do so shall impose no obligation or liability of any kind upon the insurer.its agents or representatives.
55 SE 3RD AVE. -
OKEECHOBEE. FL 34974 ses ) ' & _