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ACU ::::.0 RCERTIFICATE OF" -LIABILITY INSURANCE <br /> •‘-..:-:: - .1 DATE(km101.0)1'1" <br /> (Ii/3/2015 <br /> • • <br /> 'THIS CERTIFICATE IS-.ISSPED.ASAIMATTER prINFORMAT1ON ONLY AND CONFERS NO RIGHTS UPON THE.CERTIFICATE•HOLDER THIS <br /> . • CERTIFICATE ixEs.iicri.A0hFiMAiNtui7oft NEGATIVELY AMEND EXTEND OR ALTER,THE.COVERAGE'AFFORDED.BY THE POUdiEs. <br /> :BELOW. THIS CERTIFICATE OF iNSURANCEsbps.NOT CONSTITUTE A CONTRACT BETWEEN TfE-ISSUING•INSiJFiEN(S), AUTHORIZED <br /> ... <br /> REPRESENTATIVE OR PRODUCER,AND WE CERTIFieWt1HOLDER. <br /> INTORTANT: If the certificate holder Is-anADDMONAL INSURED,'the policy(les)must be endorsed.-!!SUBROGATION IS.WANED,subject to <br /> the terms arAccinaitiiiir of the 011.4y.;certalgipcilLCIes may require an endorsement A statement on this certificate does not confer rtOht to the <br /> certificate holder En Deu of such endorsemeist(i). ... - . _ <br /> PRODUCER - <br /> 'Jo sett°....;Toiiisaint <br /> NAME; <br /> NSI Insurance Group PH°24E . (305)5561:488 rojc,AX No(305)536-3540 <br /> • ., . <br /> 8181 Northwest 154th Suite '230 ... <br /> 3osettetQnsig-roup:org: <br /> ADDRESS; • <br /> - - .....: ..... ....;:: .. <br /> INSURERS)AFtvRDDiu wve.NAGe. . NAM S <br /> Hi Bili. Lakes .FL .33016 tusuaEs A tAamiral Insurance doisPany -24856 . <br /> eisuRES34 <br /> --- —' • • .. - <br /> NtSuRER B ilalpf re Ins.CoC. of. Floridaxa 932 <br /> -.._ . ._. . , <br /> • Jadey •Isii,ds talents, LLC, DELA: Elite Tent Co,. INSURER C:CO=OrCe .5'_Indus:try Ins Co 19411 ' <br /> 2375 SW '58th Avenue ' ,.... ,,._- <br /> INSURER DEIIridgefieeld.Employers;Ins Co 10701 <br /> • <br /> INSURER E: . _.. <br /> 13611:YWOO4 _ .FL 3B623 . <br /> . INSURER F: -.. . .. <br /> COVERAGES— - . :CERTIFICATE NUMBER:15-16'GL, ht-TTOEXCESS,WC- -.. _:REVISION NUMBER: <br /> This IS,TO'CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDMON OF ANY CONTRACT OR OTHER DOCUMENT IMTH.RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED:OR MAY.PERTAIN.-THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREINISSUBJECT 70 ALL THE TOWS, ' <br /> EXCLUSIONS AND CONDITIONS OF;SUCH POLICIES:LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID:CLAIMS.. . . . <br /> uivrFtsR I -- '''iliiOF INSURANCE 1010E Frit POLICY NUMBER PLCYfl . LIMITS <br /> . . <br /> X: COMMERCIAL GENERAL LIARTLITY - • . . . . . <br /> EACH OCOJRRENCE S 1;000;000 <br /> DAMAGE TO RENIE0 S <br /> A cu5fØ 100;Obo' <br /> m:sm.:OE it 1 occit9 PREmIES a osarenoo 3 <br /> - ._ <br /> CA0000171.21.04 .11/1/2015 11/1/2016 MED EXPIArry dna pencil) .5 <br /> . PRHAElidURY $ .1 i(100;0!S0. <br /> ._.... .. .. <br /> • <br /> - . <br /> GENL AGGRE-GATE LIUIT A?FtIES PER. ENEria AGGREGATE S 2,000,000 <br /> • <br /> .]5 POUCY Lan -LI Loc . -Fli6duCTS-COmiNOPAGG. s 2;000,000 <br /> : . OTHER . ' - • " - - .- <br /> S <br /> OMOSILE UABILITY -.• — • CO/A=Sion)S:NED SINGLE UNIT- $ •17900.;000. <br /> —AUTIfEs <br /> ANY AUTO 1BOCIL:Y.IN.IiiRY.(Per perry S <br /> B Ail OWNEO ...-7-sceEnuLao 4150;400 .0E180 •11/1/2015 11/1/2016 ',BOCILY.INX4RY0 $ <br /> AUTOS ---: Amos <br /> 1...• NO&OWNED PROPERTY DAMAGE --, . <br /> S — <br /> X HIRED AUTOS ... AUTOS <br /> I . .. . I il•Siitzsimeno . $ 5,000 <br /> . _ . - <br /> iusesvaist UAB ocatiR I EACH bc:Cuactur....0 $ .1,00'6,000 <br /> - --•'-r- <br /> c -X EXCISS Luka E-I ciAuis-LiAnE AGGREGATE S -1,000,000 <br /> -- - - - <br /> DED 1 I RETENTIONS - -MOE 6678-S773 -11/1/2015 11./1/2016 S <br /> - <br /> WORKERS COMPENSATM ' <br /> I IT- • <br /> AND EMPLOYERS'UABIUTY y IN . . .• <br /> ANY.PROPRSYCIkPTERAEXECLMVE r ..- E.t_.EACH ACCIDENT $ 560•OCio <br /> - OFRCETamEsEER IDLCLUCEDS N i A <br /> D Betendalory bi NH)' 83040216 11/1/2015 11/1/2016• EL_OLSEASE EA EMPLOYEE $ 500,066 <br /> -— tt jar,disate under POLICY WTT $ - <br /> 0.,SCRIPTION OF OPERATIONS Doane . . ... EL DISEASE- I500;000. <br /> . • <br /> 1 - •-- - <br /> . .. . .. -. - -- • - - <br /> . • ._ . . _ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD101,Ade:Iona!Ran:seri Schielide-,awl bre*attached if Mate apace b required) <br /> City of Sunny Isles Beach is aFIdi.4941 l'tiiu-red. <br /> - - - -- <br /> CERIIFIC ATE HOLDER CANCELLATION _ _ _ <br /> SHOULD ANY-OF111E ABOVE DESCRIBED POLICIES BE CANCELLED.BEFORE <br /> CITY OF SUNNY-ISLES BEA6i THE ExPIRATION DATE •THEREOF,-. NOTICE WILL BE OELIVERED IN <br /> 18070 CoLI,±NS AVE . ACCORDANCE WITH THE POLICY PROVISIONS. <br /> SUNNY ISLES -BEACH, FL 3 3i 60 <br /> , AUTHOFICCED REPRESENTATIVE <br /> G Nenezian/JOSETT ---- --!----;-- <. sJI <br /> . . — <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014401) The ACORD name and logo are registered marks of'ACORD <br /> INS025 0014011 0:7,j ''..7.-) <br />