Loading...
HomeMy WebLinkAboutA1A BR Ins 2019 ACC?R" CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DD/YYYY) 11/07/2018 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 rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME: Seth ISCh K&K Insurance Group, Inc. PHONE FAX 877-783-1161 800-363-3694 1712 Magnavox Way (A/C,No,Ext): (A/c,No): Fort Wayne IN 46804 ADDRESS: OandG@kandkinsurance.com PRODUCER CUSTOMER ID: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Nationwide Mutual Insurance Company 23787 A1A Management, LLC INSURER B: DBA:A1A Beach Rentals,A1A Outfitters INSURER C: 6811 N Atlantic Ave,Suite C Cape Canaveral, FL 32920 INSURER D: A Member of the Sports, Leisure&Entertainment RPG INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: W01338800 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM/DD MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY X 6BRPA0000028802500 11/07/2018 11/07/2019 EACH OCCURRENCE $1,000,000 CLAIMS- Fx]OCCUR 10:21 AM EDT 12:01 AM DAMAGE TO RENTED $300 000 MADE PREMISES Ea Occurrence MED EXP(Any one person) EXCLUDED PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $5,000,000 NGEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS—COMP/OPAGG $1,000,000 POLICY ❑PRO- ElLOCPROFESSIONAL LIABILITY JECT X OTHER: MEMBER LEGAL LIAB TO PARTICIPANTS AUTOMOBILE LIABILITY (Ea accident) ANY AUTO BODILY INJURY(Per person) OWN ONLY ED AUTOS e AUTOS SCHEDULED BODILY INJURY(Per accident) HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident NOT PROVIDED WHILE IN HAWAII UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION WORKERS COMPENSATION AND NSA PER OTHER EMPLOYERS'LIABILITY STATUTE ANY PROPRIETOR/PARTNER/ Y/N E.L.EACH ACCIDENT EXECUTIVE OFFICER/MEMBER ❑ EXCLUDED?(Mandatory in NH) E.L.DISEASE—EA EMPLOYEE If yes,describe under DESCRIPTION E.L.DISEASE—POLICY LIMIT OF OPERATIONS below MEDICAL PAYMENTS FOR PARTICIPANTS PRIMARY MEDICAL EXCESS MEDICAL DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Bicycling Tours(guided, less than 50 miles), Kayak/Canoe/Raft/Tube/Paddle&Surf Board Rental Operations Class I, II, III rivers,flatwater (non-guided/guided), Paddling/Paddleboarding(includes stand-up paddle boarding),Surfing Certificate holder is added as an additional insured, but only for liability caused,in whole or in part, by the acts or omissions of the named insured. Coverage does not extend to the negligence or errors&omissions of the additional insured. CERTIFICATE HOLDER CANCELLATION City of Cape Canaveral SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 105 Polk Ave, PO Box 326 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Canaveral, FL 32920 ACCORDANCE WITH THE POLICY PROVISIONS. (Permit Grantor) AUTHORIZED REPRESENTATIVE Coverage is only extended to U.S.events and activities. ""NOTICE TO TEXAS INSUREDS:The Insurer for the purchasing group may not be subject to all the insurance laws and regulations of the State of Texas ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 6BRPA0000028802500 COMMERCIAL GENERAL LIABILITY CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: The State, Political or Governmental Subdivision for which a Certificate of Insurance has been issued and is on file with K&K Insurance Group. Per USDA Forest Service assigned National ID Number. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to 2. This insurance does not apply to: include as an additional insured any state or a. "Bodily injury", "property damage" or governmental agency or subdivision or political "personal and advertising injury" arising out subdivision shown in the Schedule, subject to the of operations performed for the federal following provisions: government, state or municipality; or 1. This insurance applies only with respect to b. "Bodily injury" or "property damage" included operations performed by you or on your behalf for which the state or governmental agency or within the "products-completed operations subdivision or political subdivision has issued a hazard". permit or authorization. B. With respect to the insurance afforded to these However: additional insureds, the following is added to Section III— Limits Of Insurance: a. The insurance afforded to such additional If coverage provided to the additional insured is insured only applies to the extent permitted required by a contract or agreement, the most we will by law; and pay on behalf of the additional insured is the amount b. If coverage provided to the additional insured of insurance: is required by a contract or agreement, the 1. Required by the contract or agreement; or insurance afforded to such additional insured will not be broader than that which you are 2. Available under the applicable Limits of required by the contract or agreement to Insurance shown in the Declarations; provide for such additional insured. whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 12 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 6BRPA0000028802500 COMMERCIAL GENERAL LIABILITY CG 02 24 10 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Number of Days' Notice Minimum 30 Days or Days per Certificate on file with K&K Insurance Group. (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. Named Insured: Al Management, LLC DBA:Al Beach Rentals,Al Outfitters Effective Date: 11/07/2018 Applies only to permit grantors and/or governmental entities per CG2012 for which a Certificate of Insurance has been issued and is on file with K&K Insurance Group. Per USDA Forest Service assigned National ID Number. CG 02 24 10 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1