ACORD
DATE (MM/DD/YYYY)
07/25/2023
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).
CONTACT
PRODUCER
NAME: Progressive Commercial Lines Customer and Agent Servicing
RICH INSURANCE AGENCY LLC & MTI
PHONE
FAX
5752 NORTH BROADWAY, KANSAS CITY, MO 64118
(A/C, No, Ext): 1-800-444-4487
(A/C. No):
E-MAIL progressivecommercial@email.progressive.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC#
INSURER A : Progressive Express Insurance Company
10193
INSURED
INSURER B :
C2C Auto Transport Inc.
INSURER C :
5604 Silver Sun Dr
Apollo Beach, FL 33572
INSURER D :
INSURER E :
INSURER F :
CERTIFICATE NUMBER: 435064327968669374D072523T190952
COVERAGES
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
TYPE OF INSURANCE
POLICY NUMBER
LIMITS
LT R
INSD WVD
(MM/DD/YYYY) (MM/DD/YYYY)
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
DAMAGE TO RENTED
] CLAIMS-MADE
OCCUR
PREMISES (Ea occurrence) $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO­ □
PRODUCTS - COMP/OP AGG $
__ POLICY
JECT
LOC
OTHER:
$
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY
(Ea accident)_______
1000000
ANY AUTO
BODILY INJURY (Per person) $
OWNED
A
N N
959916747
07/21/2023 07/21/2024 BODILY INJURY (Per accident) $
X ASCUTHOESDULED
AUTOS ONLY
P(PReOr aPcEcRidTeYntD) AMAGE
HIRED
NON-OWNED
$
AUTOS ONLY
AUTOS ONLY
$
EACH OCCURRENCE
UMBRELLA LIAB
OCCUR
$
AGGREGATE
$
EXCESS LIAB
CLAIMS-MADE
RETENTION $
$
DED
WORKERS COMPENSATION
__ I BFRTUTE__ I 2RHY/N
AND EMPLOYERS' LIABILITY
ANYPROPRIETOR/PARTNER/EXECUTIVE □ N/A
E.L. EACH ACCIDENT
$
OFFICER/MEMBEREXCLUDED?
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS below
See ACORD 101 for additional coverage details.
$
959916747
N N
07/21/2023 07/21/2024
A
CERTIFICATE OF LIABILITY INSURANCE
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER
Assure Assist, Inc.
543 Country Club Dr, Unit B338
Unit B338
Simi Valley, CA 93065
ACORD 25 (2016/03)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
© 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
r_ ®
ACORD
AGENCY CUSTOMER ID:
LOC #:
ADDITIONAL REMARKS SCHEDULE
AGENCY
RICH INSURANCE AGENCY LLC & MTI
POLICY NUMBER
959916747
CARRIER
NAIC CODE
Progressive Express Insurance Company
10193
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM TITLE: Certificate of Liability Insurance
FORM NUMBER: 25
Additional Coverages
Insurance coverage(s)
Motor Truck Cargo
Personal Injury Protection
Uninsured Motorist - Nonstacked
Page 1
of 1
NAMED INSURED
C2C Auto Transport Inc.
5604 Silver Sun Dr
Apollo Beach, FL 33572
EFFECTIVE DATE: 07/21/2023
Limits
$250,000 w/$2,500 Ded
$10,000 w/$0 Ded - Named Insured Only
$50,000 Combined Single Limit
Description of Location/Vehicles/Special Items
Scheduled autos only
2017 PETERBILT 389 1NPXD49X9HD357023
Comprehensive
$1,000
Collision
$1,000
2017 Cottrell Trailer 5EOAA1449HG901701
Comprehensive
$1,000
Collision
$1,000
2019 PETERBILT 389 1NPXL49X5KD264672
2022 Wallymo Trailer 1w9g74921kh157517
Ded
Ded
Ded
Ded
Liability coverage may not apply to all scheduled vehicles.
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD