AMPHIBIOUS MEDICS (INDUSTRIAL MEDICAL SUPPORT, INC.)

Home Browse Search

DATE ,acoRO� CERTIFICATE OF LIABILITY INSURANCE 03/20/202YYY) 03/20/20Z5 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 Colleen DeWitt SUNZ Insurance Solutions, LLC ID : (Vensure HR) NAME: FAX c/o Vensure HR Inc PHONE (800) 409-89S8 A/C No: E-MAIL cents@vensure.com 1475 S. Price Road, ADDRESS: Chandler, AZ 85286 INSURERS AFFORDING COVERAGE NAIC# INSURERA: SUNZ Insurance Company 34762 INSURED INSURER B: Vensure HR Inc L/C/F Industrial Medical Support Inc INSURERC: DBA Amphibious Medics INSURERD: 1475 S. Price Road INSURERE: Chandler AZ 85286 INSURER F COVERAGES CERTIFICATE NUMBER: 10220168 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDC)= MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE1-1 OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO ❑ JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AJTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTYOAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACHOCCURRENCE $ EXCESS LAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION ✓ . PER ORH AND EMPLOYERS'LIABILITY YIN WC071-00125-025 01/01/2025 01/01/2026 STATUTE E ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1 00,000 CFFICERIMEMBEREXCLUOED? FN—] NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Coverage provided for all leased employees but not subcontractors of: Industrial Medical Support Inc DBA Amphibious Medics. Client Effective: 08/01/2023. Waiver Of Subrogation in favor of certificate holder, as per written contract, while work is performed at or in: CA - California. APPROVED By Tu Tran Nguyen a�7:418 =23,2025 CERTIFICATE HOLDER CANCELLATION CA - California SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana, Attention THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Parks, Recreation, and Community Services Agency ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE Rick Leonard - ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 10220168 I VensureHRInc MCP (CA) WC0710012502S I Karina Rodriguez 1 03/20/2025 12:37:37 PM -05 1 Page 1 of 2