10-04 Licences and Insurance - COI for FL Dept of Ag 9-29-25 Slide.pdf
PDF 211 KB Posted
- Attached to
- Palm Bay Aquatic Center
- Solicitation number
- 01-RFQ-27
- Issued by
- Brevard County, Florida
About this file
This is a Certificate of Insurance issued by the Preferred Governmental Insurance Trust (PGIT) for the City of Palm Bay, designated member, effective October 1, 2025, through October 1, 2026, with coverage period of 12 months. The certificate was issued on September 29, 2025, under Package Agreement Number PX FL1 0052502 25-11 and is administered by Public Risk Underwriters. The certificate holder is the Florida Department of Agriculture and Consumer Services, Bureau of Fair Rides Inspection. The certificate specifically identifies coverage with respect to the Aquatic Center Slide operations and is issued as a matter of information only, conferring no rights upon the certificate holder and not amending, extending, or altering the coverage afforded by the underlying agreement.
The coverage includes comprehensive general liability with a $5,000,000 limit and $200,000 self-insured retention deductible; employee benefits liability, employment practices liability, public officials liability, and law enforcement liability each with $5,000,000 limits and $200,000 SIR deductibles; workers' compensation self-insurance with statutory coverage and employers liability limits of $1,000,000 per accident; property coverage including buildings and personal property with per-schedule limits and a $5,000 deductible; inland marine coverage for rented, borrowed, and leased equipment ($804,000 TIV) and all other equipment ($13,429,743 TIV); crime coverage including employee dishonesty, forgery, theft, and computer fraud each with $100,000 limits and $1,000 deductibles; and automobile liability with a $2,000,000 limit covering owned, hired, and non-owned vehicles. The certificate explicitly notes that additional covered party status is excluded for non-governmental entities due to Florida Statute 768.28, which restricts sovereign immunity protection to governmental entities eligible for such protection.
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Text version
CERTIFICATE OF COVERAGE ISSUED ON: 9/29/2025
COVERAGE PROVIDED BY: PREFERRED GOVERNMENTAL INSURANCE TRUST
PACKAGE AGREEMENT NUMBER: PX FL1 0052502 25-11 COVERAGE PERIOD: 10/01/2025 TO 10/01/2026 12:01 AM
COVERAGES: This is to certify that the agreement below has been issued to the designated member for the coverage 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 coverage afforded by the agreement described herein subject to all the terms, exclusions and conditions of such agreement.
Mail to: Certificate Holder Florida Department of Agriculture and Consumer Services, Bureau of Fair Rides Inspection, The Rhodes Building 2005 Apalachee Pkwy
Tallahassee, Florida 32399
Designated Member City of Palm Bay 120 Malabar Road Palm Bay, Florida 32907
LIABILITY COVERAGE
X Comprehensive General Liability, Bodily Injury, Property Damage and Personal Injury:
Limit: $5,000,000 $200,000 SIR Deductible
X Employee Benefits Liability
Limit: $5,000,000 $200,000 SIR Deductible
X Employment Practices Liability
Limit: $5,000,000 $200,000 SIR Deductible
X Public Officials Liability
Limit: $5,000,000 $200,000 SIR Deductible
X Law Enforcement Liability
Limit: $5,000,000 $200,000 SIR Deductible
WORKERS' COMPENSATION COVERAGE
WC AGREEMENT NUMBER:
X Self Insured Workers’ Compensation $350,000
X Statutory Workers’ Compensation
X Employers Liability $1,000,000 Each Accident $1,000,000 By Disease $1,000,000 Aggregate Disease
PROPERTY COVERAGE
X Buildings & Personal Property
Limit: Per Schedule on file with Trust Note: See coverage agreement for wind, flood, and other deductibles.
$5,000 Deductible
X Inland Marine – Rented, Borrowed and Leased Equipment Limit: $804,000 TIV See Schedule for Deductible
X Inland Marine – All other Limit: $13,429,743 TIV See Schedule for Deductible
CRIME COVERAGE
X Employee Dishonesty
Limit: $100,000 $1,000 Deductible X Forgery or Alteration
Limit: $100,000 $1,000 Deductible X Theft Disappearance & Destruction
Limit: $100,000 $1,000 Deductible X Computer Fraud
Limit: $100,000 $1,000 Deductible
AUTOMOBILE COVERAGE
X Automobile Liability
Limit: $2,000,000 $200,000/300,000 SIR Deductible X All Owned X Specifically Described Autos X Hired Autos X Non-Owned Autos
X Automobile Physical Damage X Comprehensive See Schedule for Deductible X Collision See Schedule for Deductible X Hired Auto with limit of $35,000
Garage Keepers Liability Limit Liability Deductible Comprehensive Deductible Collision Deductible
NOTE: Additional Covered Party status is excluded for non-governmental entities. The most we will pay is further limited by the limitations set forth in Section 768.28(5), Florida Statutes (2010) or the equivalent limitations of successor law which are applicable at the time of loss.
Description of Operations/ Locations/ Vehicles/Special items-(This section completed by member's agent, who bears complete responsibility and liability for its accuracy):
Certificate of Insurance issued as proof of coverage with respect to the Aquatic Center Slide.
This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the agreement above.
Administrator Public Risk Underwriters® P.O. Box 958455 Lake Mary, FL 32795-8455
CANCELLATIONS
SHOULD ANY OF THE ABOVE DESCRIBED AGREEMENT BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE COVERAGE AGREEMENT
PROVISIONS.
Producer Risk Management Associates, Inc.
300 North Beach Street Daytona Beach, Florida, 32114
AUTHORIZED REPRESENTATIVE
PGIT-CERT (1/19) PRINT FORM
9/29/2025
Florida Department of Agriculture and Consumer Services, Bureau of Fair Rides Inspection, The Rhodes Building 2005 Apalachee Pkwy
Tallahassee, Florida 32399
Re: Coverage Agreement - PX FL1 0052502 25-11 City of Palm Bay Effective Date: 10/01/2025 to 10/01/2026
To Whom It May Concern:
Preferred Governmental Insurance Trust is unable to name non-governmental entities as an additional covered party due to Florida Statute 768.28.
Non-governmental entities do not enjoy sovereign immunity protection under Florida law.
Coverage through the Preferred Governmental Insurance Trust is predicated upon the concept of sovereign immunity among all its members. Accordingly, entities which are not eligible for sovereign immunity protection under F.S. 768.28 may not be an additional covered party under the Preferred coverage agreement.
We appreciate your understanding.
Margaret E. Gross, CPCU Director of Underwriting
**If Additional Covered Party status was not requested on the attached certificate, the provisions in this letter do not apply.**
Administered by PUBLIC RISK UNDERWRITERS P.O. Box 958455 Lake Mary, FL 32795-8455 Phone: 321-832-1450 Fax: 321-832-1489
File details come from the government source that posted it. Updated .