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124 SECTION H Forms and Attachments RFQ # 21-11-01 PROFESSIONAL PLANNING AND ZONING CONSULTING SERVICES, CIVIL AND TRAFFIC ENGIEERING Holder Identifier : 7777777707070700077761616045571110767716016204457207453137662516300073641577147321120772414002167111307473150733265512075627230224377710744266357612776607615511701372003076727242035772000777777707000707007 7777777707070700073525677115456000722011417433116407664504160665571077254015313720230712233624216311107022237352062101070333273520631110702333724316201107032236253172000077756163351765540777777707000707007Certificate No : 570090342465 CERTIFICATE OF LIABILITY INSURANCE DATE( MM/DD/YYYY) 11 /18/2021 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).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.PRODUCER Aon Risk Services, Inc of Florida 1001 Brickell Bay Drive Suite 1100 Miami FL 33131 USAPHONE( A/C. No. Ext):E- MAILADDRESS:INSURER(S) AFFORDING COVERAGENAIC #866) 283-7122INSURED34690Property & CasualtyInsCoofHartfordINSURERA: 19682HartfordFireInsuranceCo.INSURER B:29424Hartford Casualty Insurance CoINSURERC:38261Hartford InsuranceCoOfTheSoutheastINSURERD: 13604Starr Surplus Lines Insurance CompanyINSURER E:INSURER F:FAX( A/ C. No.):(800) 363- 0105 CONTACTNAME:The Corradino Group, Inc. 4055 NW 97th Avenue Suite 200 Miami FL 33178 USA COVERAGES CERTIFICATE NUMBER:570090342465 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.Limits shown are as requested POLICY EXP (MM/DD/YYYY)POLICY EFF ( MM/DD/YYYY)SUBRWVDINSR LTR ADDL INSD POLICY NUMBER TYPE OF INSURANCE LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS- MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)MED EXP ( Any one person)PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X GEN'L AGGREGATE LIMIT APPLIES PER: 1, 000,000 300, 000 10,000 1,000, 000 2,000, 000 2,000,000A 05/ 01/ 2021 05/01/ 2022YY21UUNOL5648 PRO- JECT OTHER:AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person)PROPERTY DAMAGE Per accident)XBODILYINJURY (Per accident)1,000,000B05/01/2021 05/01/ 2022YY COMBINED SINGLE LIMIT Ea accident) 21UEN OL5649 EXCESS LIAB X OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED 2,000, 000 2,000,000 10,00005/ 01/ 2021UMBRELLA LIABC 05/01/2022Y21XHUOL5650 RETENTIONX X E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E. L. EACHACCIDENT $1,000,000 X OTH-PER STATUTED05/01/ 2021 05/01/ 2022 See Attached 1,000, 000 Y / N Mandatory in NH)ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/ MEMBER EXCLUDED?N / A Y N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONSbelow1,000,000 21WBOL6H6N Each Claim100060022921107/11/202107/ 11/2022 ClaimsMade $150,000Deductible E& O-PL-PrimaryE $10,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)RE: Request for Qualifications No. 21-11-01. The City of Sunny Isles Beach is included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. A Waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability, Automobile Liability, UmbrellaLiability andWorkersCompensationpolicies.CANCELLATIONCERTIFICATE HOLDER AUTHORIZED REPRESENTATIVECity of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach FL 33160 USA ACORD 25 (2016/03)1988- 2015 ACORD CORPORATION. All rights reserved.The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED