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<br />ACORD. CERTIFICA TE OF LIABILITY INSURANCE DATE tMM'DDlYYYYI <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF" FORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Sample Form HOLDER, THIS CERTIFICATE DOES NOT AMEND. EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> INSURERS AFFORDING COVERAGE NAIC. <br />INSURED -- ---- <br /> INSURER A: <br /> INSURER 8: <br /> Name INSURER c: <br /> and ADDRESS INSURER 0: <br />- INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE F'OR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR COl/OITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 'MilCH THIS CERTifiCATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSIlRANCE AF'F'ORDEO 8Y THE POLICIES OESCRI8EO HEREIN IS SUBJECT TO All THE TERMS, exClUSIOI4S AND CONDITIONS Of SUCH <br />POliCIES. AGGREGATE LIMITS SHOWN MAY HAIlE 8EEN REDUCED BY PAlO CLAIMS. <br />LTRINSR TYPE OF INSURANCE POLICY NUM8ER 'D~Lt~l':~.fcftWIE r DATE IMM'ODIYYT LIMITS <br /> GENERAllIA81l1TY I EACH OCCURRENCE ;11 $1 000 ,000' <br /> ~ <br />A X COMMERCIAL GENERAlllABllI'J NEED GENERAL PREMiSes IEo oJ'encel s <br /> :: tl CLAIMS MADE [!] OCCU \ MEO EXt>.A'"ono porson) $ <br /> LIABILITY: Each Occur. ~~~&~DVI~ $1 ,OQO. 000 <br /> - $1,000,000.00. <br /> ~ GENE~E S 2 000 000 <br /> - , <br /> GEN'l AGGREGATE LIMIT APp~t PER: Personal & Adv. Injury S . COMPIOP AGG $ <br /> II ,nPRO. .-. <br /> POLICY JECT LDC <br /> AUTOMOIllLE LIABILITY $1,000,000.00 and COMBINED SINGLE liMIT <br /> - (EI accidlnl) S <br /> ANY' AUTO <br />.- General Aggregate <br /> ALL OWNED AUTOS 800lL Y INJURY <br /> - $2,000,000.00 (Po, person) S <br /> SCHEDULED AUTOS <br /> - <br /> HIRED AUTOS 800lL Y INJURY . <br /> - (PI' occidlnl) S <br /> lION. OWNED AUTOS <br /> - <br /> PROPERTY DAMAGE S <br /> IP" accidl"') <br /> GARAGE LIABILI.TY AUTO ONLY - EA ACCIDENT $ <br /> R Af4Y AUTO OTHER THAN EAACC S <br /> AUTO ONLY; AGG S <br /> EACH OCCURRENCE. S <br />CERTIFICATE HOLDER NEEDS TO READ AGGREGATE $ <br />AS FOLLOWS: I NEEDED INFORMATION: ~ <br />Florida Department of Transportation Parcel 653 & "- <br />654, FM 2488311 and include FDOT as ~ <br />Right of Way Administration - <br />1000 NW l11th Avenue. Room 6105-B, additional insured. - <br />Miami, FL 33172. - ~ ilf.L. DISeASE. POllCV UMIT I s <br /> --;;7 <br /> ./ <br />"~.,,,.. """""'''''' '7 ""'''''' "~w..,,",..,, ..-.."" '" L PROVISIONS <br />CERTIFICA TE HOLDER 7~ CANCELLA TlON <br />FLORIDA DEPAR~ENT OF TRANSPORTATION SHOUlDAIfY OF THE A80VE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAno~ <br />DATE THEREOF. THE ISSUING INSURER WILL DlDEAVOR TO MAIL DAYS WRITTEN <br />RIGHT OF WAY ADMINISTRATION - <br /> NOTICE TO TilE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT FAILURE TO 00 so SHALL <br />1000 NW 111 th Avenue, Room 6105-8 IMPOSE NO 08L1GATION OR LIABILITY OF ANY KINO UPON THE INSURER. ITS AGENTS OR <br />Miami, FL 33172. REPRESENTATIVES. <br /> AUTHO.8Il!'lI'IFPIJ.ElENTATIVE <br /> <br />ACORD 25 (2001/08) <br /> <br />@ ACORD CORPORATION 1988 <br />