COMPLIANCE INFO - Laserfiche WebLink

Home Browse Search

Client#: 253b I GEVSCONS ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/22/2018 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Carly Underwood Greyling Ins. Brokerage/EPIC PHONE 770.552.4225 FAX 8 A/C,No,Ext): 66.550.4082 3780 Mansell Road,Suite 370 E-MAIL ADDREss: carly.underwood@greyling.com Alpharetta,GA 30022 INSURERS)AFFORDING COVERAGE NAIC# INSURER A;National Union Fire Ins.Co. 19445 INSURED INSURER B:New Hampshire Ins.Co. 23841 Geosyntec Consultants, Inc. 900 Broken Sound Parkway NW,Suite 200 Allianz Underwriters Insurance 36420 INSURER C INSURER D: Boca Raton, FL 33487 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 18-19 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 CONTRACTOR 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. LTRR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 5268179 4/01/2018 04/01/2019 EACH OCCURRENCE $1,000,000 CLAIMS-MADE a OCCUR DAMAGE OEaoccurrencs $500,000 MED EXP(Any one person) s25,000 PERSONAL&ADV INJURY $11,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY II ECOT FX LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 4489673(AOS) 4/01/2018 04/01/201 EaMaad.ri) NGLELIMIT 1,000,000 A X ANY AUTO 4489674(MA) 04/01/2018 04/01/2019 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED X AUTOS ONLY �( NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 015893709 AOS 4/01/2018 04/01/201 PER OTH- AND EMPLOYERS'LIABILITY Y/N ( ) X T T A ANY PROPRIETOR/PARTNER/EXECUTIVE 015893710(CA) 4/01/2018 04/01/201 E.L.EACH ACCIDENT $1 000 000 OFFICERIMEMBER EXCLUDED? a N/A B (Mandatory in NH) 015893711 (ME) 4/01/2018 04/01/201 E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Professional Liab U51L00010218 4/01/2018 04/01/201 Each /Contractors Incident $2,000,000 Pollution Liab Aggregate$2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Glenn Springs Holdings, Inc. ,342 Sycanda LLC and Melvin Kauffman are named as Additional Insureds on the above referenced liability policies with the exception of workers compensation&professional liability where required by written contract. Waiver of Subrogation is applicable where required by written contract&allowed by law. Should any of the above described policies be cancelled by the issuing insurer before the expiration date (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Glenn Springs Holdings, Inc. THE 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 @ 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S 1260999/M 1056601 KKRE 1