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From: Vanessa Marcano At Brown & Brown, Inc. FaxID: Brown and Brown Insu To: Ms. Julie CoItieryahn Date: 81512004 11:40 AM Page: 2 of 4 ACORD. CERTIFICATE OF LIABILITY INSURANCE OPID '.r~ DAlE (MMIllDIY'M'J CALV:t-2 08/05/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown , Brown, Znc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE . 5900 N. ADd1:ews Ave. '300 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 5727 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ft. Laudexdale r.L 33310-5727 Phone: 954-776-2222 l'ax:9S4-776-4446 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: IIUl;folOd rift _""'0 Co. C'.r INSURER B: ..tional rire J:nsuEmee eo. of C'.r Calvin! GioxdaDo & Assoc, Znc. INSURER C kidptUU IIlIpl0J9n :DI8. co. Ns. .ru ie Col re~m 1800 Eller Dx ve 600 INSURER 0: _1m _1CU1 _""'0 co Ft. Lauderdale B'L 33316 INSURER E. COVERAGES THE POLICIES OF INSIJIWo4CE L1STCD BELOWJiI\VE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA lED. N01WITHST!lKlING I'm REQUIREMENT, lERM OR CONDITION OF N-lY CONTRACT OR OTHER DOClM:NT WflH RESPECT TO WHICH THIS CERTIFICAlE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AfFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE lERMS, EXCLUSIONS!lKl CONDITIONS OF SUCH POLICIES. AGGIlEGAlE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS. ~;!!! T'IPE OF INSURANCE POLICY NUMBER oATiiWm DAlE (IIMIIlDl'l'Y) LIMIT8 GENERAL UABLITV EACH OCCLmENCE $1,000,000 - A X ~ COMIooERCIAL GENERAL LIABILITY 21UUNIdU645 01/01/04 01/01/05 PREMiSES(E';,";;;'~) $ 300,000 b ClAIMS WIDE ~ OCCUR I.ED EX? (Any one person) $ 10 ,000 - PERSONAL 4 !>DV INJURY $1,000,000 - GENERAL AGGREGAlE $2,000,000 - GEl'lL AGGREGAlE LIMlT .oPPLIES PER: PRODUCTS - COMPJOP AGl:, $2,000,000 I POLICY !xl ::& n LOC ZIIIp Ben. 1,000,000 AlJ'l'OM08lLE LIABlLnY COMBINED SINGLE LIMIT - $1,000,000 A ~ N-lY AlITO 21UUNIdU645 01/01/04 01/01/05 (Ea accident) ALL OWNED AlITOS BODILY INJURY - $ SCHEDULED AlITOS 1P9r person) - ~ HIRED AlITOS BODILY INJURY $ ~ NON-OWNED AUTOS (Per accident) ~ CClIIIp : $1,000 oed PROPERTY DAMAGE $ X Coll: $1,000 Oed (Par acoidant) GARAGE LIABILITY AlITO ONl. Y - EA ACCIDENT $ =1 MY AlITO OTHER THAN EAACC $ AlITO ONLY AGl:, $ EXCESSIlJMIlRElLA LIABILITY EACH OCClJlRENCE $ 3,000,000 B ~ OCCUR o CLAiMS M!>DE 2803294525 01/01/04 01/01/05 AGGREGATE $3,000,000 $ ~ DEDUCTIBLE $ X RETENTION $10,000 $ WORKERS COMPENSATION AND X I TORY 'LIMITS I IV ER C EMPlOYERS' UA8lUTY 083030996 01/01/04 01/01/05 EL EACH ACCIDENT $ 500000 N-lY PROPRIETORIPAATNERlEXEClIflVE OFF ICERlMEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 500000 II Ves, describe under E L DISEASE - POLICY LIMIT $ 500000 SPECIAL PROVISIONS below OTHER D Professional Liab J1:OC66915212 08/27/03 08/27/04 pex Claim $1,000,000 Ded: $100,000 U~RO: 8/1/1959 Aqg $2,000,000 oesCRlP11ON OF OPERATIONS' LOCATIONS' VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Project: Margo1is Park-UDderground Drainage system. COnsultant svcs Aqzmt. COntract '0407-20-600-5617A. certificate holder is named as additiona1 ins1U'ed wi tb. xespeats to Genexal Liability insuxanae. ZnS1U'anae covexage is pximaxy & DOD-contxibutoxy to any othex iDsuxance available to the certificate holder. (see attached notes)........ CERTIFICATE HOLDER CANCELLATION CITYSUJ: SHOULD AI<< Of THE ABOVE DESCRIBED POUClES Be CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIl *30 DAYS WRITTEN - Ci ty of SUDDY Isles Beach NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL 17070 Collins Ave, Suite 250 IMPOSE NO OBUGAnON OR LIABILITY OF AI<< KIND UPON THE INSURER, ITS AGENTS OR Sunny Zslea Beach I'L 33160 REPRESENl'ATIYES. ~~T\YE; .- --- ,. ... ACORD 25 (2001108) @ACORD CORPORATION 1988