KIDDASS OP ID: TR
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 09/13/2022
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 770-949-0025 CONTACT Kevin White
NAME:
Reeves Insurance Assoc. Inc PHONE 770-949-0025 FAX 770-949-0698
3961 Hwy 5 (A/C, No, Ext): (A/C, No):
Douglasville, GA 30135 E-MAIL
ADDRESS:
kwhite@reeves-ins.com
Kevin White
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : EMC Insurance Companies 002161
INSURED INSURER B : AmTrust North America
Kidd and Associates Flooring
and Contracting LLC INSURER C :
7421 Douglas Blvd Suite N421
Douglasville, GA 30135 INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 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 SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
1,000,000
CLAIMS-MADE X OCCUR
X X 5X93465-23 09/28/2022 09/28/2023 DAMAGE TO RENTED
PREMISES (Ea occurrence) $
500,000
MED EXP (Any one person) $
10,000
PERSONAL & ADV INJURY $
1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
2,000,000
POLICY PRO-
JECT LOC PRODUCTS - COMP/OP AGG $
2,000,000
OTHER: $
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY (Ea accident) $
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident) $
$
A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $
5,000,000
EXCESS LIAB CLAIMS-MADE 5X93465-23 09/28/2022 09/28/2023 AGGREGATE $
5,000,000
DED RETENTION $ $
B WORKERS COMPENSATION PER
STATUTE
OTH-
ER
AND EMPLOYERS' LIABILITY
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE X KWC1295469 09/28/2022 09/28/2023 E.L. EACH ACCIDENT $
1,000,000
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
1,000,000
If yes, describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
DEKALBC
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Dekalb County School District
The Dekalb County Board of
AUTHORIZED REPRESENTATIVE
Education
Kevin White
1780 Montreal Road
Tucker, GA 30084-6705
ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
HOLDER CODE DEKALBC KIDDASS PAGE 2
NOTEPAD: INSURED'S NAME Kidd and Associates Flooring OP ID: TR Date 09/13/2022
Dekalb County School District and The Dekalb County Board of Education,
are listed as additional insured with respect to the general liability
and waiver of subrogation against the Owner and its respective directors,
officers, partners, Board Member, officials, agents, insures,
subcontracotrs, consultants and employees on the general liability and
workers
compensation.