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... c ACORD", CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY) 08/08/2008 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION J Smith Lanier & Co of Newnan ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. Box 71429 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Newnan, GA 30271-1429 770683-1000 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:. Employers Mutual 21415 TAG Grinding Services, Inc. INSURER B: Federal Insurance 20281 J W B Leasing Co., Inc. INSURER c: 16418 Highway 22 E INSURER 0: Daviston, AL 36256-6616 INSURER E: Client#: 67108 50T AGGRINDIN COVERAGES c 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 P~}~~Y EFFECTIVE Pg~flIW,b~~N LIMITS A GENERAL UABILITY 3074918 07/27/08 07/27/09 EACH OCCURRENCE $1 000 000 - DAMAGE TO RENTED x.. COMMERCIAL GENERAL LIABILITY $100000 - :=J CLAIMS MADE [!] OCCUR MED EXP (Anyon.. person) $5.000 X PO Ded:500 PERSONAl & ADV INJURY $1.000000 GENERAL AGGREGATE $2.000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $2.000 000 I POLICY fXI '18T n LOC A ~TOMOBILE LIABILITY 3E74918 07/27/08 07/27/09 COMBINED SINGLE LIMIT ~ IWY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY - $ SCHEDULED AUTOS (Per person) - ~ HIRED AUTOS BODILY INJURY $ ~ NON.QWNED AUTOS (Per accident), PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ==1 IWY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ ~ESSlUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR D CLAIMS MADE AGGREGATE $ $ ==1 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I WC STATU-, I IO~ EMPLOYERS' LIABILITY IWY PROPRIETORlPARTNERlEXECUTIVE E.L. EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes. describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below B OTHER Equipment FI 6640674 07/27/08 07/27/09 Limit Per Policy B Leased/Rented 6640674 07/27/08 07/27/09 $100,000 Per Item Limit Equipment $5,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION c City of Sunny Isles Beach Office of the City Clerk - 4th Floor 18070 Collins Avenue Sunny Isles Beach, FL 33160 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ....1Jl... DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE @ ACORD CORPORATION 1988 ACORD 25 (2001/08) 1 of 2 #S507829/M505487