HomeMy WebLinkAboutGrubbs Emergency Services Certificate of Insurance
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CERTIFICATE OF INSURANCE
DATE: Oct. 31, 2005
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURED
Grubbs Emergency Services, Inc.
Grubbs Emergency Services, LLC
Grubbs Construction Company
P.O. Box 12113
Brooksville, FL 34603
Darien Casualty and Surety SPC
THIS IS TO CERTIFY THAT THE POLICIES LISTED BELOW HAVE BEEN ISSUED TO THE NAMED INSURED 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.
TYPE OF POLICY POLICY
INSURANCE NUMBER EFFECTIVE
DATE
POLICY
EXPIRATION
DATE
LIMITS
GENERAL GENERAL AGGREGATE $1,000,000 per
LlAIBLlTY ro' ect
X COMMERCIAL POLICY AGGREGATE $2,000,000
GENERAL
LIABILITY
CLAIMS MADE DCS 001-05 10/31/05 10/3 1/06 PRODUCTS-COMP/OP $1,000,000
AGGREGATE
X OCCURRENCE PERSONAL & ADV INJURY $1,000,000
RETRO DATE EACH OCCURRENCE $1,000,000
S.I.R. FIRE DAMAGE (Anyone fire) $100,000
DESCRIPTION OF OPERA TIONSILOCA TIONSNEHICLES/SPECIAL ITEMS (LIMITS MAY BE SUBJECT TO RETENTIONS)
The Certificate Holder is an additional insured under policy DCS 001-05 only as relates to the Certificate Holder's contract with Grubbs Emergency
Services, Inc., Grubbs Emergency Services, LLC or Grubbs Construction Company and only until the contractual operations for the Certificate
Holder are completed.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE INSURANCE COMPANY
WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH
NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON
THE COMPANY, ITS AGENTS OR REPRESENTATAIVES.
AUTHORIZED REPRESENT A TrVE
City of Winter Springs
A TTN: Ronald McJ erome
1126 E. SR 434
Winter Springs, FI 32708
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