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HomeMy WebLinkAboutThe Gray Insurance Co., Certificate of Insurance No. 257 THE INSURANCE COMPANY NO. 257 CERTIFICATE OF INSURANCE CERTIFICATE HOLDER NAMED INSURED City of Miami Beach CrowderGulf Joint Venture 1700 Convection Center Drive 5435 Business Parkway . Miami Beach, FL 33139 Theodore, AL 36582 - 1675 Thi: Certificate of Insurance neither affirmatively nor negatively amends, extends of alters the coverage afforded by the policies listed thereon. CONFIRMATION TYPE OF INSURANCE POLICY POLICY LIMITS OF LIABILITY OF COVERAGE NUMBER PERIOD WORKERS' COMPENSATION & XSWC - 070550 09/01/2008 EMPLOYERS LIABILITY 09/01/2011 © YES fl NO U.S. Longshoremen's and Harbor Workers' WORKERS COMPENSATION Statutory Compensation Act Coverage ® YES U NO Outer Continental Shelf .Land Act EMPLOYERS LIABILITY (]X YES 11 NO Jones Act (including Transportation, Wages, Each Accident 5 1,000,000 Maintenance. and Cure), Death on the High Disease - Policy Limit $ 1,000,000 Seas Act & General Maritime Law Disease - Each Employee $ 1,000,000 ® YES El NO Voluntary Compensation F_ndorseme.nt © YES fl NC) Other States Insurance MARITIME EMPLOYERS ® YES fl NO Alternate Employer /Borrowed Servant Endorsement • LIABILITY S 1,000.000 ® YES El NO "In Rein" Endorsement © YES ED NO Gulf of Mexico Territorial Extension / #24 / 4 GENERAL LIABILITY - Form & Edition Date ISO CG 00 01 11/88 XSGL-073220 09/01/2008 09/01/2011 • 1 X1 YES El NO Broad Form Property Damage Liability General Aggregate Unlimited including X, (2, U Products - Comp /OPS Agg. $ 3,000,000 © YES NO General Aggregate applies per project or equivalent Personal & Advertising Injury $ 1,000,000 ® YES ❑ NO Products /Completed Operations Each Occurrence v $ 1,000,000 Q YES LJ NO Contractual Liability Fire Damage $ 50,000 © YES J NO Sudden and Accidental Pollution Liability (Any one firc) © YES El NO Occurrence Form Medical Expense $ 5,000 © YES [1 NO Personal Injury (Any one person) © YES fl NO "In Rem" Endorsement © YES El] NO Cross Liability ® YES n NO Watercraft exclusion has been modified by the vessels endorsement on scheduled equipment • LDI COI 268 1 11 01 11 CONFIRMATION TYPE OF INSURANCE POLICY POLICY LIMITS OF LIABILITY OF COVERAGE NUMBER PERIOD AUTOMOBILE LIABILITY XSAL - 073018 09/01 /2008 09/01 /2011 Q YES Li NO Any Auto Bodily Injury & Property $ 1,000,000 in YES El NO All Owned Autos Damage Combined © YES NO Hired Autos ® YES [] NO Non -Owned Autos EXCESS LIABILITY GXS- 042561 09/01/2010 � ; 09/01/2011 L_`_1 YES U NO Lxccss Form Each Occurrence $ 4,000,000 Aggregate $ 4.000.000 JOB OR PROJECT DESCRIPTION RFP #29 -05/06 Disaster Recovery Services SPECIAL CON'DIT1ONS The certificate holder is an additional insured on all policies except Workers' Compensation and is provided a Waiver of Subrogation, all if required by written contract. The above insurance policies shall be primary and non contributory to any other insurance polices maintained by the certificate holder, it required by written contract. Should the insurance herein described he cancelled, assigned or changed in such a manner as to affect this certificate, THE GRAY INSURANCE COMPANY will endeavor to give thirty ( 30 ) days written notice to the certificate holder, but failure to do so shall impose no obligation or liability upon THE GRAY INSURANCE COMPANY. • / j TH f RAY LNSURANC COMP I' 311 N. I -10 Service Road West, Metairie, LA 70002 DATE: 3/16/2011 FORM NO.135 REV. 12/30/2010 Performance Bond Bond Number SU1106159 KNOW ALL BY THESE PRESENTS, That we, CROWDERGULF JOINT VENTURE, INC. (hereinafter called the Principal), as Principal, and Arch Insurance Company, a corporation duly organized under the laws of the state of Missouri (hereinafter called the Surety), as Surety, are held and firmly bound unto CITY OF MAIM! BEACH, FLORIDA (hereinafter called the Obligee) in the sum of One Million Dollars ($1,000,000,00) Dollars for the payment of which sum well and truly to be made, we, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. Sealed with our seals and dated this J aT day of ls'[Z()4 , 2011 WHEREAS, said Principal has entered into a Contract with said Obligee, dated 'Emorktiq 1 , . 0011 , for DISASTER DEBRIS RECOVERY SERVICES CONTRACT - RFP NO. 29-05/06 for a 24 month initial contract period to expire on .? a 13 in . accordance with the terms and conditions of said Contract, which is hereby referred to and made a part of hereof as if fully set forth herein: NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, if option is taken to renew the contract for another 12 month period, a new Performance Bond is required. However, should the surety not provide the renewal bond, this is not to be considered a default under the contract. That if the above bounden Principal shall well and truly keep, do and perform each and every, all and singular, the matters and things in said contract set forth and specified to be by said Principal kept, done and performed, at the times and in the manner in said contract specified, or shall pay over, make good and reimburse to the above named Obligee, all loss and damage which said Obligee may sustain by reason of failure or default on the part of said Principal so to do, then this obligation shall be null and void; otherwise shall remain in full force and effect for the contract period. CROWDERGULF JOINT VENTURE, It:C. Principal By..inek Arch J surance Company i /' Surer 41470/ „ 0 Cengelio, Attorney- k.-I:at j. Florida Ref:iart Agei:` In Testimony Whereof, the Company has caused this instrument to be signed and its corporate seal to be affixed by their authorized officers, this 25th day of August , 20 10 . Arch Insurance Company P y Attested and Certified ounce co COMMIE SEAL 1971 L. . SS 111510yI1 t t f If Martin J. Nils!, Secretary J. Mi' ete, ice ., r:! ident STATE OF PENNSYLVANIA SS COUNTY OF PHILADELPHIA SS 1, Brian C. Kuhn, a Notary Public, do hereby certify that Martin J. Nilsen and J. Michael Pete personally known to me to be the sarne persons whose names are respectively as Secretary and Vice President of the Arch insurance Company, a Corporation organized and existing under the laws of the State of Missouri, subscribed to the foregoing instrument, appeared before me this day In person and severally acknowledged that they being thereunto duly authorized signed, sealed with the corporate seal and delivered the said instrument as the free and voluntary act of said corporation and as their own free and voluntary acts for the uses and purposes therein set forth. COMMONWEALTH OP PENNSYLVANIA NOTARIAL `SEAL Brian C. Kuhn, Notary Public Brian C. Kuhn, Notary Public City of Philadelphia, Philadelphia County My commission expires 12 - 2011 CERTIFICATION My commission expires December 06,1011 I, Martin J. Nilsen, Secretary of the Arch Insurance Company, do hereby certify that the attached Power of Attorney dated August 25. 2010 on behalf of the person(s) as listed above is a true and correct copy and that the same has been in full force and effect since the date thereof and is in full force and effect on the date of this certificate; and I do further certify that the said J. Michael Pete, who executed the Power of Attorney as Vice President, was on the date of execution of the attached Power of Attorney the duly elected Vice President of the Arch Insurance Company. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corpor. e s - .1 of the Arch • Insurance Company on this l e day of MA ft C M • , , 20 11 . .k Martin J. N eren, Secretary This Power of Attorney limits the acts of those named therein to the bonds and undertakings specifically named therein and they have no authority to bind the Company except in the manner and to the extent herein stated. PLEASE SEND ALL CLAIM INQUIRIES RELATING TO THIS BOND TO THE FOLLOWING ADDRESS: Arch Surety 3 Parkway, Ste. 1 500 Philadelphia, PA 19102 a lma• C° BEAL 1E eEel 00ML0013 00 03 03 Wad Page 2 of 2 Printed in U.S.A. POWER OF ATTORNEY Know All Men By These Presents: That the Arch Insurance Company, a corporation organized and existing under the laws of the State of Missouri, having its principal office in Kansas City, Missouri (hereinafter referred to as the "'Company ") does hereby appoint James C. Congelio and James N. Congelio of Jacksonville, FL (EACH) its true and lawful Attorriey(s)- in -FFct, to make, execute, seal, and deliver from the date of issuance of this power for and on its behalf as surety, and as its act and deed: Any and all bonds and undertakings EXCEPTION: NO AUTHORITY is granted to make, execute, seal and deliver bonds or undertakings that guarantee the payment or collection of any promissory note, check, draft or letter of credit. This authority does not permit the same obligation to be split into two or more bonds in order to bring each such bond within the dollar &nit of authority as set forth herein. The Company may revoke this appointment at any time. The exe :tk n of such bonds and undertakings in pursuance of these presents :shall be as binding upon the said Company as fully and amply to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at Its principal office In Kansas City, Missouri. • . This Power of Attorney Is executed by authority of resolutions adopted by unanimous consent of the Board of Directors of the Company on March 3, 2003, true and accurate copies of which are hereinafter set forth and are hereby certified to by the undersigned Secretary as being in full force and effect: "VOTED, That the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing and filed with the Secretary, or the Secretary shall have the power ry po and authority to appoint agents and attorneys-in-fact, ys- ct, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, s re nizances contracts � �g racts of indemnity and other writings, obligatory In the nature thereof, and any such officers " y rs of the Company may appoint agents for acceptance of process." This Power of Attomey is signed, sealed and certified by facsimile under and by authority of the following resolution adopted by the unanimous consent of the Board of Directors of the Company on March 3, 2003: . VOTED, That the signature of the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing and filed with the Secretary, and the signature of the Secretary, the seal of the Company, and certifications by the Secretary, may be affixed by facsimile on any power of attorney or bond executed pursuant to the resolution adopted by the Board of Directors on March 3, 2003, and any such power so executed, sealed and certified with respect to any bond or undertaking to which it is attached, shall continue to be valid and binding upon the Company. 001\41.0013 00 03 03 Page 1 of 2 Printed in U.S.A.