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i--"1 SOUTUND-04 NPERERA
<br /> A`R CERTIFICATE OF LIABILITY INSURANCE CY DA /2TE 9/201
<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 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 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 does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER
<br /> CONT
<br /> Wendy Aguayo
<br /> Collinsworth,Alter,Fowler&French,LLC PHONEO ) �A,X No):(305
<br /> 8000 Governors Square Blvd N�:1305 822-7800 )362.2443
<br /> Suite 301 ADDRESS:
<br /> Miami Lakes,FL 33016
<br /> INSURER(S)AFFORDING COVERAGE I NAIC 0
<br /> INSURER A:FCCI Insurance Company 10178
<br /> INSURED INSURER B:Mt Hawley Insurance Company 37974
<br /> Southern Underground Industries,Inc. INSURER C:Federal Insurance Company 20281
<br /> 3453 NW 44 St#205 INSURER D: I
<br /> Fort Lauderdale,FL 33309 INSURER E:
<br /> INSURER F: I
<br /> COVERAGES CERTIFICATE NUMBER: REVISION 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 /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE 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 /> EXP
<br /> LTR TYPE OF INSURANCE NO W
<br /> S_D.VNPOLICY NUMBER I(MDDYW
<br /> /YYYY)( MMDOFFYIYYYYI, LIMIT
<br /> A X I COMMERCIAL GENERALLIABIUTY EACH OCCURRENCE I S 1,000,000
<br /> CLAIMS-WkDAMAGE TO RENTEDDE X OCCUR X GL0017925 06/01/2015 06/0112016 PREMISES(Ea occurrence) I s 100,000
<br /> IMED EXP(Airy one person) I 5 5,000
<br /> I PERSONAL&ADV INJURY 3 1,000,000
<br /> GENT.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000
<br /> POLICY X TE4 LOC PRODUCTS-COMP/OP AGG 5 2,000,000
<br /> I OTHER 15
<br /> AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT I$ 1,000,000
<br /> (Ea amCent)
<br /> A X ANY AUTO X CA0029926 06/01/2015 06/01/2016 BODILY INJURY(Per person) 5
<br /> ALL OWNED EH SCHEDULED BODILY INJURY(Pa acidea)I S
<br /> AUTOS I I AUTOS
<br /> X AUT OWNED PROPERTY DAMAGE 5
<br /> HIRED AUTOS AUTOS (Per ao5dad) I
<br /> I5
<br /> X 1 UMBRELLA UAB X I OCCUR I EACH OCCURRENCE I5 4,000,000
<br /> A EXCESS UAB I CLAIMS-MADE X UMB0021203 06/01/2015 06/01/20161 AGGREGATE S
<br /> I DED X RETENTION5 10,000 Aggregate s 4,000,000
<br /> WORKERS COMPENSATION X PERTUTE 24".II
<br /> AND EMPLOYERS'LIABILITY STA _ _
<br /> A APROPRIETOR/PARTNERJEXECUTIVE YIN
<br /> NY NIA 001 WC15A73720 06/01/2015 06/01/2016 E.L.EACH ACCIDENT Is 1,000,000
<br /> OFFICERJMEMBER EXCLUDED? JJ
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 5 1,000,000
<br /> 0 yes,describe under
<br /> DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT 15 1,000,000
<br /> g Pollution Liability IEGL0003576 07/01/2015 07/01/2016 Pollution 1,000,000
<br /> C IM 145468572 06/01/2015 06/01/2016 Leased/Rented 100,000
<br /> DESCRIPTOR OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached B more space Is required)
<br /> Project:172nd Drainage Repairs Bid No.16-04-01
<br /> The City of Sunny Isles Beach is listed as Additional Insured with respects to the General Liability and Auto Liability.Umbrella Follows Form.
<br /> Thirty(30)day notice of cancellation subject to policy terms and conditions.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Sunny Isles Beach THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City
<br /> City of0 SunCny Avenue ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 180Sunny Isles Beach,FL 33160
<br /> AUTHORIZED REPRESENTATIVE
<br /> gig
<br /> ©1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
<br />
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