HomeMy WebLinkAboutcocc_prca_COI- Aero Space Workers Inc_ CERTIFICATE OF COVERAGE ISSUED ON: 12/01/2023
COVERAGE PROVIDED BY:PREFERRED GOVERNMENTAL INSURANCE TRUST
PACKAGE AGREEMENT NUMBER: PK FL1 0052702 23-07 COVERAGE PERIOD: 10/01/2023 TO 10/01/2024 12:01 AM
COVERAGES:This is to certify that the agreement below has been issued to the designated member for the coverage 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 coverage afforded by the
agreement described herein subject to all the terms,exclusions and conditions of such agreement.
Mail to:Certificate Holder Designated Member
Aero Space Workers,Inc. City of Cape Canaveral
271 Taylor Avenue 100 Polk Ave.
Cape Canaveral,FL 32920 Cape Canaveral,FL 32920
LIABILITY COVERAGE WORKERS'COMPENSATION COVERAGE
X Comprehensive General Liability,Bodily Injury,Property Damage WC AGREEMENT NUMBER:
and Personal Injury:
Limit $1,000,000 $0 Deductible
Self Insured Workers'Compensation
X Employee Benefits Liability
Limit $1,000,000 $0 Deductible
X Employment Practices Liability Statutory Workers'Compensation
Limit $2,000,000 $0 Deductible
X Public Officials Liability Employers Liability
Each Accident
Limit $2,000,000 $0 Deductible $
$ By Disease
Law Enforcement Liability $ Aggregate Disease
Limit Deductible
PROPERTY COVERAGE AUTOMOBILE COVERAGE
X Buildings&Personal Property X Automobile Liability
Limit:Per schedule on file with Trust $5,000 Deductible Limit $1,000,000 $0 Deductible
Note:See coverage agreement for wind,flood,and other deductibles. X All Owned
Rented,Borrowed and Leased Equipment Specifically Described Autos
Limit:$0 TIV See Schedule for Deductible X Hired Autos
X Total All other Inland Marine X Non-Owned Autos
Limit:$1,998,296 TIV See Schedule for Deductible
X Automobile Physical Damage
CRIME COVERAGE X Comprehensive See Schedule for Deductible
X Employee Dishonesty X Collision See Schedule for Deductible
Limit$50,000 $1,000 Deductible X Hired Auto with limit of$35,000
X Forgery or Alteration
Limit$50,000 $1,000 Deductible Garage Keepers
X Theft Disappearance&Destruction Liability Limit
Limit$50,000 $1,000 Deductible Liability Deductible
X Computer Fraud Comprehensive Deductible
Limit$100,000 $1,000 Deductible Collision Deductible
NOTE:Additional Covered Party status is excluded for non-governmental entities. The most we will pay is further limited by the limitations set forth in Section
768.28(5),Florida Statutes(2010)or the equivalent limitations of successor law which are applicable at the time of loss.
Description of Operations/Locations/Vehicles/Special items-(This section completed by member's agent,who bears complete responsibility and liability for its accuracy):
Date of event: 1st Friday of every month(excluding January&July)
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 agreement above.
Administrator CANCELLATIONS
Public Risk Underwriters® SHOULD ANY OF THE ABOVE DESCRIBED AGREEMENT BE CANCELLED BEFORE THE
P.O.Box 958455 EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
Lake Mary,FL 32795-8455 COVERAGE AGREEMENT PROVISIONS.
Producer
Brown&Brown,Inc.-Maitland /.
2290 Lucien Way,Suite 400,
Maitland,FL 32751 AUTHORIZED REPRESENTATIVE
PGIT-CERT(1/19)PRINT FORM 12/01/2023
Print Date:12/1/2023
Preferred
12/01/2023
Aero Space Workers,Inc.
271 Taylor Avenue
Cape Canaveral , FL , 32920
Re: Coverage Agreement - PK FL1 0052702 23-07
City of Cape Canaveral
Effective Date: 10/01/2023 TO 10/01/2024
To Whom It May Concern:
Preferred Governmental Insurance Trust is unable to name non-governmental entities
as an additional covered party due to Florida Statute 768.28.
Non-governmental entities do not enjoy sovereign immunity protection under Florida
law. Coverage through the Preferred Governmental Insurance Trust is predicated upon
the conceptof sovereign immunity among all its members.Accordingly, entities which
are not eligible for sovereign immunity protection under F.S. 768.28 may not be an
additional covered party under the Preferred coverage agreement.
We appreciate your understanding.
Margaret E. Gross, CPCU
Director of Underwriting
**If Additional Covered Party status was not requested on the attached certificate, the provisions in
this letter do not apply.**
Administered by PUBLIC RISK UNDERWRITERS
P.O.Box 958455 *Lake Mary, FL 32795-8455 *Phone: 321-832-1450•Fax: 321-832-1489
Print Date:12/1/2023