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- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . () ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYV) TM 07/28/2008 PRODUCER (865)691-4847 FAX (865)694-4847 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION TIS Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1900 Winston Road, Suite 100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 10328 Knoxville, TN 37939-0328 INSURERS AFFORDING COVERAGE NAIC# INSURED Phillips and Jordan, Incorporated INSURER A American Contractors Insurance C RRG A VII: Attention: Steve Thompson INSURER B ACIG Insurance Company A VIII 6621 Wilbanks Rd INSURER C Zurich/American Guarantee/WSRB A V NAIC2624 Knoxville, TN 37912 INSURER D 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 I,N~~ f.R,~~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY GL08000030 06/01/2008 06/01/2009 EACH OCCURRENCE $ 2,000,000 - X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED '"0' $ 100,000 - ~ CLAIMS MADE [8] OCCUR MED EXP (Anyone person) $ 5,000 - A PERSONAL & ADV INJURY $ 2,000,000 - GENERAL AGGREGATE $ 4,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 4,000,000 h POLICY !Xl jr8i n LOC AUTOMOBILE LIABILITY AL08000018 06/01/2008 06/01/2009 COMBINED SINGLE LIMIT f-- (Ea aCCident) $ X ANY AUTO 2,000,000 f-- ALL OWNED AUTOS BODILY INJURY f-- $ SCHEDULED AUTOS (Per person) A l- X HIRED AUTOS BODILY INJURY I- $ X NON-OWNED AUTOS (Per aCCIdent) I- PROPERTY DAMAGE $ (Per aCCident) GARAGE LIABILITY AUTO ONL Y - EA ACCIDENT $ R ANY AUTO OTHER THAN EA ACC $ AUTO ONLY' AGG $ EXCESS/UMBRELLA LIABILITY AUC-9137945-02 06/01/2008 06/01/2009 EACH OCCURRENCE $ 10,000,000 o OCCUR D CLAIMS MADE AGGREGATE $ 10,000,000 C $ ~ DEDUCTIBLE $ X RETENTION S 10,OOC S WORKERS COMPENSATION AND WC08000072 06/01/2008 06/01/2009 X I WC STATU-.I IOJbI- EMPLOYERS' LIABILITY WC08000073 06/01/2008 06/01/2009 500,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under 500,000 SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ OTHER RIESCRIPTION OF OPERA TIONS / LDCA TIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS FP No. 08-07-01 he City of Sunny Isles Beach, Florida shall be named as Additional Insured regarding General L iabil ity and Automobile Liability and this coverage is primary over any insurance the City may maintain. All policies contain a Waiver of Subrogation. Workers Compensation insurance provides statutory coverage n compliance with the Workers Compensation Law of the State of Florida. Policies will not be altered CERTIFICATE HOLDER CANCELLA TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Sunny Isles Beach, Florida 2L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Sunny Isles Beach Government C BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 18070 Collins Avenue OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Sunny Isles Beach, FL 33160 AUTHORIZED REPRESENTATIVE ffIJ~~-- Construction Div./BECHEN ACORD 25 (2001/08) @ACORD CORPORA rlON 1988