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A� OF CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) <br />09/24/2021 <br />THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT Sandra LaRue <br />NAME: _ <br />Frank H. Furman, Inc. ao° NExt : (954) 943-5050 (AIG No): (954) 942-6310 <br />1314 East Atlantic Blvd. E-MAIL sandra@furmaninsurance.com <br />ADDRESS: _ <br />P. 0. BOX 1927 INSURERS) AFFORDING COVERAGE NAIC M <br />Pompano Beach FL 33061 INSURERA: Admiral Insurance Cc (ri) 24856 <br />INSURED INSURER B: Imperlum Insurance Company 35408 <br />AUM <br />8900 <br />Construction Inc <br />NW 119th St <br />Gardens <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />FL <br />33018 <br />TYPE OF INSURANCE <br />(INSURER F: <br />ME <br />POLICYNUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />INSURER C: National Union Fire Ins Co of Pittsburgh PA <br />19445 <br />WAIURFR n <br />CERTIFICATE <br />I <br />Hialeah <br />Gardens <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />FL <br />33018 <br />TYPE OF INSURANCE <br />(INSURER F: <br />ME <br />POLICYNUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />r.nVFRArFS <br />LIMITS <br />CERTIFICATE <br />NUMBER: <br />B: 21 AU <br />WC/20 GL UM <br />REVISION <br />NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />UPI 1-11=0 <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />ME <br />POLICYNUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />POLICY EXP <br />MMIDDNYYV <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />(2016103) <br />The ACORD <br />name <br />and <br />EACH OCCURRENCE <br />s 13000,000 <br />marks <br />CIAIMS.MADE ❑X OCCUR <br />'TED <br />PREMISES Ea occurrence)$ <br />150,000 <br />MED EXP (Any one person) <br />$ 11000 <br />PERSONAL&ADV INJURY <br />$ 1,000,000 <br />A <br />Y <br />Y <br />CA00003679202 <br />12/01/2020 <br />12/01/2021 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />GENERALAGGREGATE <br />$ 2,000,000 <br />PRODUCTS - COMPIOPAGG <br />S 21000,000 <br />POLICY [g PRO ❑ LOC <br />JECT <br />OTHER' <br />$ <br />AUTOMOBILE LIABILITY <br />OMBINEDtSINGLE LIMIT <br />La acX <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />8 <br />ANYAUTO <br />B <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />Y <br />Y <br />CONIIC0000042200 <br />06/18/2021 <br />06/18/2022 <br />BODILY INJURY(Per orations <br />$ <br />(Per accid nIDAMAGE <br />$ <br />X HIRED NON AUTOS ONLY X AUTOS ONLDV <br />PIP -Basic <br />$ 10,000 <br />X <br />UMBREU_I%UARX <br />OCCUR <br />EACH OCCURRENCE <br />$ 57000,000 <br />AGGREGATE <br />$ 5,000,000 <br />C <br />EXCESS LIAR <br />CIrNMSMADE <br />Y <br />BE018424039 <br />12/01/2020 <br />12/01/2021 <br />DED <br />RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY VIN <br />ANY PROPRIETOREXCL DED? CUTIVE <br />(Mandatoryin NH) EXCLUDED? <br />(Mentlatory In NH) <br />NIA <br />Y <br />CONIIC0000042300 <br />06/18/2021 <br />06/18/2022 <br />X <br />PER <br />ER <br />E.L. EACH ACCIDENT <br />5 11000,000 <br />EL. DISEASE - EA EMPLOYEE <br />$ 11000,000 <br />EL. DISEASE -POLICY LIMIT <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />:1 <br />7 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Re: Golden Shores Park, Sunny Isles Beach, Golden Shores Street Lighting No. 200901. City of Sunny Isles Beach is included as additional insured <br />regarding General Liability & Auto as required by written contract. Waiver of Subrogaton applies to General Liability Auto and Workers Compensation as <br />required by written contract. <br />ceucFll ennN <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />HE EXPIRATION <br />V 1586-2U15 AUUKU I:V KYVKAI IUN. All rights reSBfVeU. <br />ACORD 26 <br />DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Sunny Isles Beach <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />18070 Collins Avenue <br />AUTHORIZED REPRESENTATIVE <br />Sunny isles Beach FL 33160 <br />,�,.:.� A, ?zaoor <br />(2016103) <br />The ACORD <br />name <br />and <br />Togo are <br />registered <br />marks <br />of ACORD <br />