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<br />ACORDN
<br />
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />
<br />OP IDc4
<br />SOUTH76 01/30/08
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />DATE tMMlDDfYYVYI
<br />
<br />PRODUCER
<br />
<br />BROWN & BROWN OF FLORIDA INC
<br />8000 GOVERNORS SQUARE BLVD 400
<br />MIAMI LAKES FL 33016-1588
<br />Phone: 305-364-7800
<br />
<br />Fax:
<br />
<br />305-822-5687
<br />
<br />J~NSU~~~~~FFORDING COVERAGE
<br />~NS~~=-RA VALLEY FORGE INSURANCE CO
<br />INSURER B TRANSPORTA.TlON INSURANCE co
<br />-"----'-- .---.--------
<br />~~s~~~~~--.,_-.
<br />
<br />I INSURER 0
<br />~ --.- ~-- ~- .------ ._.__._-------~-----
<br />1 INSURER E
<br />
<br />NAIC#
<br />
<br />20508
<br />20494
<br />
<br />INSURED
<br />
<br />SOUTHEASTERN ENGINEERING
<br />CONTRACTORS INC
<br />12054 NW 98TH AVENUE
<br />HIALEAH GARDENS FL 33018
<br />
<br />COVERAGES
<br />
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE fOR THE POLICY PERIOD INDICATED NQTWTHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER OOCUMENTVVlTH RESPECT TO ~ICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS ex.eLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
<br />INSR DD'L ---- POLICY EFFECTIVE POLICY EXPIRATION
<br />LTR NSRD TYPE OF INSURANCE POLICY NUMBER OA TE (MMlDD!YYI DATE (MM'ODIYV) LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE , 1,000,000
<br /> - DAMAGE TO RENTED
<br />A X ~ COMMERCIAL GENERAL LIABILITY TCP2082754511 01/31/08 01/31/09 PREMISES (Ea occurence) , 100,000
<br /> - tJ ClAIMS MADE ~ OCCUR MED EXP (Anyone person) , 5,000
<br /> X WAIVER OF SUBRO PERSONAL & ADV INJURY , 1,000,000
<br /> -
<br /> GENERAL AGGREGATE ,2,000,000
<br /> -
<br /> GENOL AGGREGATE LIMIT APPLIES PER PRODUCTS 0 COMPIOP AGG , 2,000,000
<br /> I POLICY ~PRO- nLOC Empl 1,000,000
<br /> X JECT Ben.
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
<br /> - , 1,000,000
<br />A ~ ANY AUTO C2082754525 01/31/08 01/31/09 (EaacCldenl)
<br /> ALL OWNED AUTOS BODIL Y INJURY
<br /> - ,
<br /> SCHEDULED AUTOS (Perpers.on)
<br /> - t
<br /> ~ HIRED AUTOS BOOIL Y INJURY I,
<br /> X NON-OWNED AUTOS (Per accident) t--
<br /> - I
<br /> - ------. I I PROPERTY DAMAGE
<br /> IIPeraCCldent)
<br /> GARAGE LiABILITY AUTO ONLY. EA ACCIDENT ,
<br /> =1 ANY AUTO ,--.
<br /> OTHER THAN EAACC ,
<br /> --
<br /> AUTO ONLY AGG ,
<br /> EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE , 2,000,000
<br />B U OCCUR D CLAIMS MADE C2081302155 01/31/08 01/31/09 AGGREGATE ,2,000,000
<br /> ,
<br /> ~ ~EDUCTIBLE I ,
<br /> X RETENTION ,10,000 ,
<br /> WORKERS COMPENSAT1ON AND I T~ ~~~~~- I 10TH-
<br /> ER
<br /> EMPLOYERS' LiABILITY
<br /> Am PROPRIETORIPARTNERlEXECUTlVE EL EACH ACCIDENT ,
<br /> OFFICERfMEMBER EXCLUDED? ~: DISEASE.:. EA EMPLOYEE ,
<br /> If yes. de5Cfibe unde'
<br /> SPECIAL PROVISIONS below E L DISEASE. POLICY LIMIT ,
<br /> OTHER I
<br /> I I
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />*10 Days Cancellation applies for non payment
<br />Certificate Holder is Additional Insured with regard to General Liability
<br />when required by written contract Re: Central Island
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CANCELLATION
<br />
<br />CITYl60
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
<br />
<br />30*
<br />
<br />DAYS WRITTEN
<br />
<br />CITY OF SUNNY ISLES BEACH
<br />RICK CONNOR
<br />18070 COLLINS AVENUE
<br />SUNNY ISLES BEACH FL 33160
<br />
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
<br />
<br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />
<br />ACORD 25 (2001/08)
<br />
<br />
<br />@ACORD CORPORATION 1988
<br />
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