Loading...
PROOF OF INSURANCE (2023 - 2023) CLOSEDDATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 2/28/2022 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 9ELOW. 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 endorsement(s). PRODUCER CT NAME William Haight--- Baldwin Krystyn Sherman PNONE — - -nX 4211 W. Boy Scout Blvd. t tz FxOa 813 387 6839 A/O kq) 813-387-6839 Suite 800 D I ss: Whas ht tics- artnersxom 9 P - — - Tampa FL 33607 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Great Northern Insurance Coma 20303 INSURED INSURERB: „w,Federal Insurance„Gomp,a,ny mm, 20281 Burnham Benefits Insurance Services, LLC 4211 W. Boy Scout Blvd., Suite 800w Tampa FL 33607 INsuRER D t INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:585017176 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. ... AbdU5l1'Si$.. ...... POLICY EFF P0LICY EXP TYPE OF INSURANCE TR V POLICY NUMBER MM/DD M/ D LIMITS A X COMMERCIAL GENERAL LIABILITY 36069302 3/1/2022 3/1/2023 EACH OCCURRENCE$1,000,000 IJAMACLTO RtNTJ. ..... .. CLAIMS -MADE {OCCUR „PIjEMISES.(Eaoccurrence.� $.1000000 MED EXP (Any one person) $ 15,000 PERSONAL 8 ADV INJURY $ 1 000 000 GEN'LAGGREGATE LIMIT APPLIES PER: '.' GENERAL AGGREGATE $2,000,000 ❑ PE Q � LOC POO ' PRODUCTS COMP/OP AGG $ I,nduded ..,,, �IECRY 4 AUTOMOBILE LIABILITY ............. 73620127 3/1 /2022 3/1/2023 COMWNEO SINGLE LIMIT $ 1 000 000 t� p u�Ihl X ANY AUTO BODILY INJURY (Per person) $ OWNED .... SCHEDULED ...BODILY .INJURY .(Per accident) ...$...................................................... --- AUTOS ONLY ..—_..' AUTOS ... ............. ............ HIRED 0)AMAGE '. AUTOS ONLY AUTOS ONLY ...,....... $,,. Eff ctle B X UMBRELLA LIAB X I OCCUR 78186562 3/1/2022 3/1/2023 EACH OCCURRENCE $25,000.000 EXCESS LIAB CLAIMS -MADE AGGREGATE $ 25,000,000 ,..,...�.....�� .............................................. X � -...........__......�,�,__.................................................._$.__...�,__...�,........................................... DED RETENTION.$ WORKERS COMPENSATION PER AND EMPLOYERS' LIABILITY Y I N ..,.. $TA„TUTE ,,,,,,,„ER ........... ,-,-,,.,.,.,.- ... O ICERtMEMNEFIREXCLU EXCLUDED? IL. NIA ...E.L...DISEASECEAEMPLOYEE,..$ ........................................................._.. (Manatory in ESCRIPTION DIf OF OPERATIONS below E.L. DISEASE.. POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Burnham Benefits Insurance Services, LLC ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE (MM/DD/YYYY) AC6RE) CERTIFICATE OF LIABILITY INSURANCE 1, .. 1 6/13/2022 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 endorsement(s). PRODUCER CONTACT NAME � Baldwin Krystyn Sherman PHONE $13-387 683 FAX 4211 W. Boy Scout Blvd.E1aa._E1ct� l.(?!cse1 39 Suite 800 _App aNa.mWPialghtP Pkl _l_A!tflr rs,com 81 7 Tampa FL 33607 - IN SURERJ§)AFFORDINGCOVERAGE NAIC# --_. INsuRER e . mnity Company .... 0346 - INSURER A: Pacific Inde INSURED BRP Colleague Inc. BRP Colleague II Inc. wsuRERc 4211 W. Boy Scout Blvd., Suite 800 INSURER D r Tampa FL 33607 INSURER E COVERAGES CERTIFICATE NUMBER. 1053339517 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. .... ..-.-......... r ._ __..... ... ................._. CYEF, .._...... ............ .. .......,....,,. _ ._ ......... ....... IIYSR ADC1L't,(B'R" pOLIOYEFF POLICYEXP TYPE OF INSURANCE FOLICXNUMBER LIMITS LTR _. MMIDD/YYYY MM/D COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ ...... ..... 0AMAVE t RENfE'b ,...- ,....... -..� CLAIMS -MADE OCCUR PREMISES,_,(Ea occurrenoe $,,,,,,,,,,,,,,,,,_ D y ..„.... n one person _ $ ....................... .. .. PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE ....__ POLICYPRO* LOC � JFCT � PRODUCTS COMP/OP AGG $ OTHER; $ AUTOMOBILE LIABILITY SINGLE LIMIT ( I.. .B e AA90INJURY $ ....... ,._ .. ANY AUTO Per person) ILL INN (Per ) V $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNEDPROPEfGYDAMFIGP' $ AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR � UE RENCE $ ... EXCESS LIAB CLAIMS-MMADE, _ �....__... ---- ...........- _AGGREGATE ... ........._.__ DED RETENTION $ $ A WORKERS COMPENSATION 71740952 1/1/2022 1/1/2023 X S AT,I,JTE �w„ER AND EMOTH- PLOYERS' LIABILITY Y� _ �'" PRIET E L EACH ACCIDENT $ 1, 00----- OFFI R ER EXCLUDEDXECUTIVE N / A _ (Mandatory in NH) E,L, DISEASE EA EMPLOYEE — ...................... L 1 $ ,000,000 ...... If yes, describe under DESCRIPTION OF OPERATIONS below I E.L, DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Burnham Benefits Insurance Services 2211 Michelson Drive, Suite 1200 Irvine CA 92612 AR4RZEDRFPRETVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 2/25/2022 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 3ELOW. 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 endorsement(s)• PRODUCER NAME. William Halgiat Baldwin Krystyn Sherman PHONE" FAX 4211 W. Boy Scout Blvd. .1(AlG.,"9 9xt) 813 387 6839 ( _t? �.:813 574-6167 E MAIL . Suite 800 ADmRE°ss avhIghttrksartnrs cOan .m_ ... Tampa FL 33607 NAI INsuRERA Arch S ecial( ) ���� I n$urance Coma w w 211 AFF RAIN 1/ERA INSURED INSURER SURE.R�.C� m....-..---........ E 4211 Tampa W. B 33607 Scout Blvd., SuiBurnham Benefits Insurance te 800 Services, LLC N u y -INSURER D INSURER E : COVERAGES CERTIFICATE NUMBER:717400022 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. INSIi .... ............_,�.--------------- ADDL SUBE O Y EFF Pq�1,6CY Xi' Ty�---------- .........., ..,.,....... ........ LTR TYPE OFINSURANCE POL.ICYNUMBER IMIM D MMlC1 PYYYY q LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ PE _. ...... ..... . CLAIMS -MADE OCCUR PRrMC`GAGGUreurn I$ES a eR1G� $...... .... ................ .. ...................... f MED EXP (Any one person) $ PERSONAL &ADV INJURY $ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ........... JPEQC;. POLICY LOC (.PRODUCTS COMP/OPAGG $ _ OTHER: $ AUTOMOBILE LIABILITY COME] NEDSINGLE.1-1MIT ........ $ '.. ANY AUTO - BODILY INJURY (Per person) $ OWNED SCHEDULED iBODILYINJURY(Peraccident) $- AUTOS ONLY AUTOS '_HIRED NON -OWNED E � PROPERTY DAN%AGE: AUTOS ONLY . AUTOS ONLY ............................. -.....(Pgc'0QpevG) , °... $.,°„ .. $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE - F DED RETENTION S $ WORKERS COMPENSATION C ''. ERH AND EMPLOYERS' LIABILITY YIN STATUTE ... ". ... ..,.'" ......... """.......`-.-...... FFICERIMEMBEREXCLUDE D?ANYPROPRIETORIPARTNER/EXECUTIVE ❑ NIA (Mandatory in NH) E.L.DSEASECEAEMPLOYEE'. $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT A Errors & Omissions SPL004221111 3/1/2022 3/1/2023 Each claim limit $5,000,000 Aggregate limit $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Burnham Benefits Insurance Services, LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD