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<br />Sap 25 08 03:22p <br /> <br />TIM E HILL INS AGENCY <br /> <br />9542026300 <br /> <br />p.2 <br /> <br />CERTIFICATE OF INSURANCE <br />SUCH INSURANCE AS RES~ECTS THE INTEREST OF THE CERTIFICATE HOLDER WILL NOT BE CANCELED OR OTHERWISE <br />TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRlnEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT IN NO <br />EVENT SHALL THIS CERTIFICATE BE VAUD MORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE <br />DOES NOT CHANGE THE COVERAGE PROVIDED BY ANY POUCY DESCRIBED BELOW. <br />II <br />This certifieS that: 181 STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY 01 Bloomington, Illinois, or <br />o STATE FARM FIRE AND CASUALTY COMPANY of Blooming ton. I Kino Is <br />has coverage in force for the following Named Insured as shown below: <br />:i <br />Named Insured GREEN CONSTRUCTION TECHNOLOGIES INC <br /> <br />Ii <br />Address of Named Insured 21130 NE 15TH Terrace <br />WILTON MANORS FL 33305 <br /> <br /> li I 043-060t-E1lJ-S9B <br />POLICY NUMBER 159-3995-016-59 674-9969-F12.59 237 5453.A22.59A <br /> \i <br />EFFECTIVE DATE OF 04116108-10116/01 0511 0108.1111 [wB 06/12108.12/1 DIDS 07S22f()U1J,2109 <br />POLICY <br /> 2002 GMC SAVANA 2000 GMC SAVANA EMPLOVEE NON.OWNED 2004 CHEVY <br />DESCRIPTION OF 1GTHG39R821201983 1 GDFG15M5Y1142269 LIABIUTY 3GNEC16Z1-4G32071D <br />VEHICLE <br />LIABIUTY COVERAGE -!><lYES rlNO -~YES DNO !'XIVES flNO ~YES rlNO <br />LIMITS OF LIABILITY i! <br />a. Bod~y Injury <br />Each Person I <br />a. Bodily Injury <br />Each Accident , <br />b. Property Damage " <br />" <br />c. Bodily Injury & il I 51,000,000.00 <br />Property Damage $1,000,000.00 $1,Ooo,OOD.OO $1,QOO,OOO.OO <br />Single LWnit Each Ii <br />Accident '! <br />PHYSiCAl DAMAGE t8!VES ONO I8lYES DNO DYES t8JNO J8JYES DNO <br />COVERAGES 51.000.00 Deductible 51.000.00 Deductible $1.000.00 Deductible <br />a. Comprehen!>ive - <br />II Deductible <br /> 18IYES DNO I8lvES oNO DYES r81NO t8!vES DNO <br />b. Collision $1.000.00 Deductible $1.000.00 _ Deductible $1.000.00 Deductible <br /> Deductible <br />EMPLOYER'S <br />NON.OWNERSHIP I8IvES ONO [giVES DNO [gjVES DNO t8]VES DNO <br />COVERAGE <br />HIRED CAR COVERAGE DYES DNO DYES DNO DyES DNO DYES DNO <br /> ;- ~ <br /> <br />.;;;;l I . <br />. ~. ~/ <br />, <br />Signa'ure of Authorized Representative <br />11 <br />Name and Address of Certificate Holder <br />II <br />ADDITIONAL INSURED <br />Public Services Dept <br />100 N Andrews ave <br />Ft Lauderdale FI33301 <br />Ii <br />d <br />,I <br /> <br />Agenl <br />Title <br /> <br />I <br /> <br />I <br /> <br />6578 <br />Agent's Code Number <br /> <br />Name and Address of Agent <br /> <br />Tim E Hill <br />STATE FARM INSURANCE <br />1505 E COMMERCIAL BLVD <br />FT lAUDERDALE. FL 33334 <br /> <br />L <br /> <br />~ <br /> <br />L 954-202-3516 <br /> <br />09129108 <br />Date <br /> <br />I <br /> <br />~ <br /> <br />--------------------.-------..-.....--------- --.------.-----..-....---..---...------...---.......- <br />Chock if a- permanent Certificate of Insurance for liability coverage is needed: 0 <br />II <br />Check if the Certificate Holder should be added as an Additional Insured: L8l <br />I <br />[ <br />Remarks: i <br />:I <br />I <br />'I <br />:1 <br />