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Client#: 1049182 BELLDAV1 - ACORDr. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY) 7130!2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT • NAME: USI Insurance Services,LLC, PHONE 1715 N.Westshore Blvd.Suite 700 E�aoJi'E'):813 321-7500 (aC Ne); 813 321.7525 Tampa,FL 33607 ADDRESS: INSURER(S)AFFORDING COVERAGE I MAIC 0 INsuRERA:Phoenix Insurance Company 125623 INSURED INSURER :Travelers Indemnity Company 25658 Bell David Planning Group,Inc (1.(stmER Beazley Insurance Company,Inc. 37540 1019 NE 104th Street INSURER D: Miami Shores,FL 33138 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS - CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR IADOL'SUBR' POLICY EFF POLICY EXP LTR TYPE OF INSURANCE HIM IMO I POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY)I UMITS A GENERAL LIABILITY X X 6604057M315 06!29!2015 06129!2016 EAc:-t��ES(OCCURRENCE s 1,000,000 ED X COMMERCIAL GENERAL LIABILITY PREMISEa °rice) 51,000,000 CLAIMS-MADE ( XI OCCUR I MED EXP(Any One person) 510,000 _ I PERSONALE ADV INJURY S 1,000,000 I GENERAL AGGREGATE 52,000,000 GEHL AGGREGATELIMIT APPLIES PER: I PRODUCTS-COMP/OP AGG S 2,000,000 • 7 POLICY fO- n LOC I S A AUTOMOBILE LIABILITY X X 6604057M315 11612912015 06129(2016.(E°M Ez1tNGLELLu1 s1,000,000 ANY AUTO I BODILY INJURY(Per person) 5 ALL OWNED SCHEDULED BOOILY INJURY(Per accident) S AUTOS AUTOS NON -OWNED PROPERTeen Y DAMAGE X HIRED AUTOS X AUTOS 1(Per acden+) Il I $ B [ UMBRELLA LAB [x OCCUR CUP3787T880 06/29/2015 0612912016 EACH OCCURRENCE 151,000,000 •EXCESS L1AB I I CAMS-MADE I AGGREGATE DED I XI RETENTION swoopI 151,000,000 5 WORKERS COMPENSATION I 'TORYTUM 75 I IFORH I AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORJ?ARTNERIEXECUtIVE - I E.L.EACH ACCIDENT I$ OFFICER/MEMBER EXCLUDED? l N/A (Mandatory In NH) I E.L.DISEASE-EA EMPLOYEE'S II yes.describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT I S C Professional V150F8140601 09/2512014 0912512015 51,000,000 per claim Liability 51,000,000 anni aggr. DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(Attach ACORD 101,Addldonai Remarks Schedule.II more space Is required) Professional liability is written on a claims made basis. CERTIFICATE HOLDER CANCELLATION Cityof SunnyIsles Beach SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE• THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18070 Collins Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Sunny Isles Beach, FL 33160 AUTHORIZED REPRESENTATIVE ' ©1988.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010!05) 1 of 1 The ACORD name and logo are registered marks of ACORD Q p #s15900117/M15705146 BPKEW U