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~ ~R aD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIVYYY) OP 10 B8 04/13/10 TALLY-1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brown & Brown of Florida, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 15519 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ~pa FL 33684-5519 hone: 813-226-1300 Fax:813-226-1313 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A WESTFIELD INSURANCE COMPANY INSURER B: Bridqefield Employers Ins. 10701 Tally En~ineerin~l Inc INSURER C: 1806 N F amingo d INSURER 0: Pembroke Pines FL 33028 I INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR[ TYPE OF INSURANCE POLICY NUMBER 6~f~1~~IDDiYWYJ 6~~lrTMM/DD~ LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 - 04/01/10 04/01/11 PREMISes (E~~~ncel $ 300000 A X X COMMERCIAL GENERAL LIABILITY TRA5183497 I CLAIMS MADE [i] OCCUR MED EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $ 1000000 - GENERAL AGGREGATE $ 2000000 - $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG I [Xl PRO- n POLICY X JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 - A X ANY AUTO TRA5183497 04/01/10 04/01/11 (Ea accident) f-- X ALL OWNED AUTOS BODILY INJURY r-- (Per person) $ SCHEDULED AUTOS r-- X HIRED AUTOS BODILY INJURY I-- $ X NON-OWNED AUTOS (Per accident) r-- r-- PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ R ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ 4000000 I A [] OCCUR o CLAIMS MADE TRA5183497 04/01/10 04/01/11 AGGREGATE $ 4000000 $ ~ DEDUCTIBLE $ X RETENTION $10000 $ WORKERS COMPENSATION X ITO'~Y"~I~lfs I IUE~- AND EMPLOYERS' LIABILITY Y/N B ANY PROPRIETORlPARTNERlEXECUTI"O 0830-44561 04/01/10 04/01/11 E.L. EACH ACCIDENT $ 1000000 OFFICERlMEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE. EA EMPLOYEE $ 1000000 If yes, describe under $ 1000000 SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT OTHER A Prof. Liability EOOOO010678-02 03/30/10 03/30/11 Limit 1,000,000 Ded 5,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS * 30 days notice of cancellation except 10 days notice of cancellation for non payment of premi urn. Certificate holder is listed as additional insured with respect to the General Liability coverage when required by written contract. Waiver of Subrogation in favor of cert holder on GL, AL & WC policies apply CERTIFICATE HOLDER CANCELLATION CITYSUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABtLITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESE ATlVE of Sunny Isles Beach Collins Avenue Isles Beach FL 33160 09 ACORD CORPORATION. All rights reserved. of ACORD