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HomeMy WebLinkAboutCOI - South East Employee Leasing Services, Inc. - Expires 2025-01-01CERTIFICATE OF LIABILITY INSURANCE DATE (MM/OD/YYYY) 12/12/2023 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(les) must be endorsed. IF SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on the certificate does not confer rights to the certificate holder in lieu of such endorsement(s). _ PRODUCER Plymouth Insurance Agency, Inc. 2739 US Highway 19 North Holiday, FL 34691 INSURED South East Employee Leasing Services, Inc. (LCF) SVG Contractors, Inc. 2739 Us Highway 19 North Holiday, FL :34691 CONTAcr NAME: PHONE 1-800-966-5562 IA/C, NO EXTI: EMAIL ADDRESS: INSURERS) AFFORDING COVERAGE INSURER A: State National Insurance Company, Inc INSURER B: INSURER C: INSURER D: INSURER E: INSURER F. N NUMBER: NAIC 12831 V 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 ADUL INSR SU13R WVO POLICY NUMBER POLICY EFF IMM/DD/YYYYI POLICY EXP IMM/DD/YYYYI LIMITS GENERAL LIABILITY EACH OCCURENCE $ COMMERCIAL GENERAL LIABILITY PREMISES (ERENTED o cu Bence) $ 1 CLAIMS -MADE [ I OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PIIODUC'r5 - COMP/OP AGCE $ 1 _. ..,: PRO- I POLICY JECi, l I LOC $ AUTOMOBILE LIABILITY I FpMBCNdeD�$INGLE LIMIT (BODILY $ ANY AUTO INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS BODILY INJURY (Per accident $ --- AUTOS HIRED AUTO NON -OWNED P(PROPer acRTdeYD DAMAGE $ - L-- AUTOS ICI UMBRELLA LIAR OCCUR EACH OCCURRENCE .. EXCESS LIAR CLAIMS -MADE AGGREGATE $ DED I ! RETENTION $ $ WO 1KERS COMPENSATION X TORYTLMITS TH- OER A AND EMPLOYERS' LIABILITY Y/N ANY'PROPRIETOR/PARTNER/EXECUTIVE FT, 1 CWC71949-1473 1/1/2024 J./1/2025 E.L. EACH ACCIDENT $ $1 rOOO rOOO I OFFICER/MEMBER EXCLUDED? L,j1 N/A EL DISEASE -EA EMPLOYEE $ $1,000,000 (Mandatory In Nil) Illves, describe under E.L. DISEASE- POLICY LIMIT $ $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101, Additional Remarks Schedule, If more space is required) (California Operations Only) Coverage is extended to leased employees as approved and assigned by South East Employee Leasing Services, Inc. but not subcontractors or nonleased employees of: SVG Contractors, Inc. Project Name: ISSUE 07-21-23 (PH) .. .. CERTIFICATE HOLDER ..,.... ..._.. .__.. .. - CANCELLATION CITY OF GILROY 7351 ROSANNA ST GILROY, CA 95020 SHOULD ANY OF THE ABOVE DESCRIBE() POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE SHALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,—, "�-=--s ~^� y�ei. © 1988-2010 ACORD Corporation, All rights reserved. ACORD2S(2010/05)