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<br />Sen~ By: PJKINS, Inc.;
<br />
<br />ACJ)RD..
<br />
<br />Page 1/2
<br />CERTIFICATE OF LIABILITY INSURANCE caR .If' DA~~MtoVD;V~
<br />THIS CERTIFICATE IS 188USD M A MATTER OF INFOIWATION
<br />ONLY AND CONFERS NO flIGHTS UpON THE CERTIFICATE
<br />HOLDER. THIS CeRTIFICATE DOES NOT AMEND. EXTEND OR
<br />~TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />954 9796788;
<br />
<br />May-27-03
<br />
<br />4:49PM;
<br />
<br />PROO\lCER
<br />
<br />P.J.X. XNSURANCB, INC.
<br />2500 NORTH POWBlLINB ROAD
<br />POMPANO BRACH n. 33069
<br />Phone:gS4-979-S855 rax;'54-979-6788
<br />INSU'Riii'- --' -.- .- _. - _0- ._- -.
<br />
<br />Shenandoah General
<br />ConstructloD CClll1Pafty, :tnc.
<br />1888 N.W. 22 Stre9t
<br />PompaDo Beach PL 33069
<br />
<br />INSURERS AFFORDING COVERAGE HAlC ,
<br />.- ._,'- - '-"--' - -..-
<br />INSU~ ,-!.~%CB J\K1IRXc.AN llitS~B - '-
<br />lNSURER8~ Ohio.J:!.lII~alt~118ur.nce, Co~,+__ _"
<br />INsuRERC: ,HARBOR,sp~r~TY INS. ,co. ,-+._. _
<br />INSUReR 0:
<br />. -..--.---..-..-.-.-----
<br />INSURER E:
<br />
<br />COVERAGES
<br />
<br />THE POLICIES OF t~SURANCE LI$TfD BELOW HAVE Ill:I:N IssueD TO THE INSURED NAMeD ABOvE FOR THE POLICY ~oo INDICATeD. tlOlWlTHSTANDllIIG
<br />At<< flEOUIREMEN1. T5RM OR CONDITION OF ANY CONnw:T OR 0TI1ER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE I4o'Y BE ISSUeo OR
<br />w\Y rEI'TI\IN. nlE INSUAAMCE N'FOIl,DED 8Y THE f'O\.lClfS DESCRIBED HEREIN IS SUaJECT'TO IIlL 1liE lla'lMli. EXCLUSIONS AND COHDITlONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDucED 8Y PAID CI.AIM5.
<br />.'-' .-. --'-' .. - .-.,'-'
<br />TYl"E OF INsuRANCE POLICY NUMBER
<br />OEHERAL I.lA8ILIT'(
<br />A X X COMMfI\CIALGEN~L"'IlII.l'N CP0930830000
<br />'J CLAIMS MADE [i.] OCCUR
<br />
<br />l.TR NSR
<br />
<br />
<br />_._.----.~-
<br />
<br />12/11{02
<br />
<br />LlIfiS
<br />EACH ocouflRENCe S 1, 0 0 0 . O,~L
<br />~!'1.1"'''ICO
<br />~~l/IWItat $ 5Q, 000__
<br />filED EXP (Any~) s 5,009-._
<br />P&R$ONAL~IH.~ ,51, 0.,00, O.~~
<br />G~ERAL AGl'lRE~, . 2, ,~O 0 , O~L
<br />PROOOCU.COMPIOP~GG . ~, OOO~ OO~
<br />
<br />
<br /> cOt.l81NED SINGLE LIMI'T sl,OOO,OOO
<br />A X ANY AUTO BAP930830100 12/31/02 12/31/03 (E;> :JCCkIenI)
<br /> .-....-,..-.- --
<br /> IIlL OWN~P AUTOS BODILY INJURY
<br /> SCH60lJlEO AUTOS (pl:f' peroonl S
<br /> X ,-.,'-'
<br /> HIRED AuTOS IlDDll Y INJURY
<br /> X NON-OWtlEO AUTOS (Per ~nl) S
<br /> ,.-..-."
<br /> .--.,-,'"-'" pKOPERlY OMl/lGE $
<br /> (per accident)
<br /> GAAAOE LIABILITY AUTO ONLY. EA ACClllfNl $
<br /> .,_.'_0' '- -
<br /> AN'! AUTO OTHER~ EA N:,C ~
<br /> -.. -,
<br /> AUTO ONL '(; AGG $
<br /> ExceSSIV~LA LIABILITY EACH OCCURRENCE S S!~OO, OO~
<br />B ~l OCCUR [l CLAIMS MADE 5:10-52806588 12/31/02 12/31/03 AGGRfCATE S5,000,000
<br /> -.-" -'
<br /> - S
<br /> "- n'_' -_.,
<br /> DEDUCTIBLE S
<br /> X -.-.-. ..,-..,..-- -
<br /> RETeNTION sO S
<br /> WOItKERS COMPENSATION AND \99-4501-0
<br />C EMPL.OYERS' L.lAllIU1Y 01/01/03 01/01/04 ..-' '-
<br />ANY PROPRIETOMARTNEAlEXecUTIVE $ 1000000
<br /> OFFICeR/MEMBER EXCLUDED? ..-..'--
<br /> ~~~llM~$below S 1000000
<br /> .-'-
<br /> s 1000000
<br /> OTHeR
<br />
<br />
<br />OElICRlPTION OF OPERATIONS I LOCATIONS I VEHlCLfS I EXCLUSIONS AIlOEO BY EMDOR$EMENT I Spec;lAL. PROVISIONS
<br />CITY or SONNY ISLBS BlACK IS LIS"l'iD ADDITIONAL INStlRBD WITH RB9PlllC'l' TO
<br />GBNBRAL LIABILITY ONLY. 30 DAYS CANCELLATION KXCBPT 10 DAYS FOR NONPAY
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CANCELLATION
<br />
<br />SUNN--l
<br />
<br />SHO\ILD NfY OF THE IIIIOVE Dt$CFll8ED POLIOIE& Ill! CANCIlLLED BEFORE TH15 EXl'IRATIO
<br />PATe THEREOF, TtlE ISSUING INSURat WILL I!NDEAVOft TO MAll. ~ DAYS wRITTEN
<br />'NOTICE TO THE cERTIFICATE HClUlEIt NAMI!D TO Tl4E LEFT, BUT FAILURe TO 00 SO 3HAI.L
<br />IMPOSE NO OBUGATlON OR UABIU'I"Y OF NfY !(INO Ilf'Ot( THE INSURER. ITS AGfHT$ OR
<br />Rlii'R!SQ1'ATlVE3.
<br />AI.IlltOflIUO JU!\lREUNT AlIVE
<br />
<br />Kati_ Jackson
<br />
<br />
<br />,..'
<br />
<br />CITY OF SUNNY ISLE
<br />BUCH
<br />17070 COLLINS AVKNUB
<br />SUNY ISL! FL 33160
<br />
<br />STE-250
<br />
<br />ACORD 25 (2001/08)
<br />
<br />@ACORDCORPORATlON 198
<br />
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