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ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) r `� 9/23/2021 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(les) must 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 NAME: Gina Barra ato Keyes Coverage Insurance PHONEFAX 5900 Hiatus Road ; 954-724-7000 AIC.No): 954-724-7024 nooREss: gbarragato@keyescoverage.com Tamarac FL 33321 INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Continental Insurance Company 35289 INSURED 16117 INSURER B: National Fire Insurance Company of Hartford 20478 Rohl Global Networks LP; Rohl Networks LP 2875 Jupiter Park Drive INSURER C: ValleForge Insurance Company 20508 INSURER D: Suite 900 Jupiter FL 33458 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 53053237 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 6080023478 1/19/2021 1/19/2022 EACH OCCURRENCE _ $ 1,000,000 DAMAGE TO RENTED CLAIMS -MADE � OCCUR PREMISES Ea occurrence $500,000- MED EXP (Any one person) $ 15,000 X Dad 5,000 PerOcc X EBL Dad 1,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 NFGEN'L X POLICY 71 PEa [ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ X OTHER: At Per Wrtn Cont B AUTOMOBILE LIABILITY Y Y 6080023447 1/19/2021 1/19/2022 COMBINED SINGLE LIMIT $1,000,000 Ea accident 1 000 000 BODILY INJURY (Per person) $ ANY AUTO 1X ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ (per a RZtDAMAGE ROPj$ X HIRED AUTOS X AUTOS NO -OWNED $ X Com $1,000 X Coll $1,000 1 A X UMBRELLA LIAB X OCCUR Y Y CUE 6080023464 1/19/2021 1/19/2022 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N Y WC 6 80023450 1/19/2021 1/19/2022X PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED9 ❑NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Job Name: Utility Undergrounding for Golden Shores — ITB No. 21-08-01 City of Sunny Isles Beach is Additional Insured with respect to General Liability per form #CNA74705XX 01/15 and Automobile per form #CNA63359XX 04/12. A Waiver Subrogation is provided in favor of City of Sunny Isles Beach for General Liability per form #CNA74705XX 01/15, Automobile per form #CNA63359XX 04/12 and Workers Compensation per form #WC 00 0313 04/84, as required in written contract. City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach FL 33160 :w aays cancellation- iu tor 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD