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SRSENGI -01 ZGONZALEZ
<br />A`� ° CERTIFICATE OF LIABILITY INSURANCE
<br />3/310114 n
<br />THIS CERTIFICATE IS ISSUED AS A 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(SSUINGINSURER(S),AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: H the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate do" not confer rights to the
<br />certificate holder in lieu of such endorsements).
<br />raeascER
<br />Collinsworth, Alter, Fowler & French, LLC
<br />8000 Governors Square Blvd
<br />Suite 301
<br />NAME T Zoraida Gonzalez
<br />PHaNE .305 822 -7800 FAx
<br />Nu: 305 362.2443
<br />EaoMOAgaESS: Z90 nzalez@cafflic.com
<br />Miami Lakes, FL 33016
<br />INSURE 5 AFFTlRUN6 C(NEMOE
<br />fMIC4
<br />WSURERA: Hartford Casualty
<br />$ 11000,0
<br />PREMISE ao nxe,v
<br />mSUHFfl
<br />INSURER B:Travelers Casualty and Surety Company of America
<br />$ 10,00
<br />SRS Engineering, Inc.
<br />ws,RPnc:RLI Insurance Company
<br />13086
<br />5001 SW 74th Court
<br />Suite 201
<br />INSURER D:
<br />$ 2,000,0
<br />WSURM E
<br />LLVRAPRIE$FER
<br />PR6 LOC
<br />Miami, FL 33155
<br />INSURER F:
<br />$
<br />Cr1VFRAGFS C.FRTIFICATF NIIMIRFR- RFVISInN NIUARFR.
<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 />INDICATED. NOTKITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBID HEREIN IS SUBJECT TOALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />TYPE OF NSUlUNCE
<br />POLICY MIMBER
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<br />LLURS
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<br />OFINFJULWBnrTY
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<br />21SBAT04463
<br />3/4/2014
<br />314/2015
<br />FAAI OCCIRdENCE
<br />$ 11000,0
<br />PREMISE ao nxe,v
<br />$ 300,00
<br />MTfl IXP orKr IINSC
<br />$ 10,00
<br />PERSdVALAADVVIAMY
<br />s 1,000,0
<br />GEIERAL AGGIEGATE
<br />$ 2,000,0
<br />IiNLAGCREDATE
<br />X iOlf Y
<br />LLVRAPRIE$FER
<br />PR6 LOC
<br />FRDOULTS.CONPQP AGG
<br />s 2,000,00
<br />$
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<br />All DOTED $CIEDULEO
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<br />B3294T108
<br />812112013
<br />8121/2014
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<br />X NC STATLL OTH-
<br />E.L EAOIAIXXDEYT
<br />s 1,000,0
<br />E1015FA5E. EA En
<br />S 1,000,00
<br />EL dSEABE- NIX.I'LeaT
<br />S 1,000,90
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<br />rofesslona(Llab
<br />lalms -Made Basis
<br />IR DP0013445
<br />DPOO13445
<br />111011014
<br />111011014
<br />111012015
<br />1110/2015
<br />Each Claim 1,000,00
<br />Anmral Aggregate 1,000,00
<br />OFSCFIDina Liability etroactiveD te12tC1ES 96; Professional UabiwReoductibfo$ 5.00DEach llaiRWrMi
<br />Professional Llabiliry Retroactive Date 1212011996; Professional Llabi7iry Doducll6b f25,00D Each Claim
<br />"SPECIMEN"
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />®1988 -2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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