Laserfiche WebLink
BURDE-1 OP ID: RM <br />Ai410"M "- CERTIFICATE OF LIABILITY INSURANCE <br />DATE09/28D/YYYY) <br />1 09/28/7 8 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER Phone: 904-249-2345 <br />Fletcher & Company <br />Box Fax:904-246-7986 <br />NAME CT Rebekah Muse <br />PyHONE Ell, 904-694-0314 Fa <br />Re): : <br />Jacksonville <br />JacksonVilie Beach, FL 32240.0069 <br />Fletcher &Company <br />E-MAIL <br />DSS: rmuse@fletcherandcompanyfl.com <br />INSURERS AFFORDING COVERAGE NAIC R <br />INSURER A: Old Dominion Insurance Company 40231 <br />INSURED The Burdette Agency Inc <br />DBA North Star Destination <br />INSURER e: Houston Casualty Company <br />----------- <br />INSURERC___ _ <br />Strategies <br />Karen Burdette <br />1023 Kings Ave <br />INSURER D: <br />- <br />Jacksonville, FL 32207 <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INR <br />LTR <br />TYPE OF INSURANCEIUSIL <br />AYMPOLICY <br />NUMBER <br />POLICY <br />`DDD1YYYY MMIOD/YYYY <br />POLICY EXP <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ 1,000,00 <br />_ff <br />PREMISES Eaaocunence S 50.00 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />BPG2264P <br />12/12/17 <br />12/12/18 <br />CLAIMS -MADE O OCCUR <br />MED EXP (Any ane person) $ 5,00 <br />PERSONAL &ADV INJURY $ 1,000,00 <br />GENERAL AGGREGATE $ 2,000,00 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS-COMP/OP AGG $ 2,000,00 <br />1-1 POLICY PRO LOC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT 1,000,00 <br />Ea..Went $ <br />BODILY INJURY (Per person) $ <br />AX <br />ANY AUTO <br />B1G2264P <br />03/21/18 <br />03/21/19 <br />ALL OED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per amidenl) $ <br />PROPERTY DAMAGE $ <br />Paraaldent <br />NOWONMED <br />HIRED AUTOS AUTOS <br />S <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTIONS <br />$ <br />WORKERS COMPENSATION <br />WC STATU- OTH- <br />13yIla ER <br />A <br />AND EMPLOYER$' LIABILITY <br />ANY PROPRIETORIPARTNERIEXECUTIVE YIN <br />OFFICER(MEMBER EXCLUDED? ❑ <br />(Mandatary In NH) <br />NIA <br />WCG2264P <br />12/12/17 <br />12/12/18 <br />E.L. EACH ACCIDENT $ 1,000,00 <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,00 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS tNI.W <br />E. L. DISEASE -POLICY LIMIT $ 1,000,00 <br />B <br />Errors & Omissions <br />H718111082 <br />01/24/18 <br />01/24/19 <br />Per Claim 1,000,00 <br />Deductible- 5,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attmh ACORD 101, Addltion.l Remark. Sah.dela, ll more apa.. ie required) <br />f <br />�V <br />■.Jia <br />FORIN-1 <br />FOR INFORMATIONAL <br />PURPOSES ONLY <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />n 19AA-9010 Ar,nRD CCARPORATION. All rinh}s <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />