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05/23/2011 08:37 9545775412 RAY PALHEGYI INSURAN PAGE 03 <br />Policy number: 03378709 -5 <br />A&A DRAINAGE AND VAC <br />Page 3 of n <br />3. <br />2009 Ford:F450 Super Doty Stated Amount: $61,500 <br />VIN; 1 FDXF46R38EE63433 <br />Garaging Zip Code: 33028 Radius: 50 <br />(_labliiiyl <br />t;abill[T uMrtNM91 <br />PIP ........................... ............................... <br />Premium <br />$1,142 5666 <br />5107 <br />Physical Damage <br />FTOC FT/CAC <br />Deduaibk P,emlum <br />C0111510 Lofton <br />Deductible Prerttun Auto Total <br />Premium <br />$500............$ 226 ......... *,­i <br />00 5310 $2,451 <br />Premium discounts <br />°°'`! ................... ..............,.....,.................-----....... ..--- .......................... <br />03378709.5 Paid in Full and Renewal <br />Driver <br />........................................................... ............................... . . <br />JAMES SCRIMA CDL ExPahenae <br />VINCENT STAMETS CDL Experience <br />Additional Insured information <br />1 . Additional insured ..... .............................. <br />CITY O'F ViIESTON ... , ...........,................... .,............................. <br />202005AOLKL RD WESTON, FL 33321 <br />2 . Additional Insured <br />CALVIN G10RDAN0 <br />2700 S COMMERCE WESTON, FL 33331 ............................... <br />............................. <br />? , Additional Insured <br />........................................................... <br />TIrARANOVA GORP <br />801 ARTHUR GOOF MIAMI, FL 33140 <br />............................... <br />4. Additional Ir�su►ed <br />............ .................................................. <br />ELSTON. .- .LEET5DAL.E, L <br />801 ARTHUR GOOF MIAMI BEACK FL 33140 <br />............................... <br />5 . Additional Insured <br />....................................................................... <br />WESTFORK TOWER, LLC <br />801 ARTHUR GOOF MIAMI BEACH, R. 33140 <br />..... ............................... ...... <br />6 , Additional Insured <br />GRANITE POLOCLUB <br />801 ARTHUR GOOF MIAMI BEACH, FL 33140 <br />.. ........................... <br />............... ............................... <br />1 . Additional Inwred <br />............................. ................................ <br />GLADES TWIN PLAZA T <br />801 ARTHUR GOOF MIAMI BEACH, FL 39140 <br />8 . Addkional Insured <br />GRANITE MERIDIAN LL <br />801 ARTHUR GODF MIAMI BEACH, FL 33140 <br />. . ...... ................ <br />...'a" I' .................. .......................... <br />9 . Additional Insured <br />"A,A* .................... ............ ....... ., ... .., ..... ........... <br />DEANGELO BROTHERS I <br />1460 SW THIRD S POMPANO BEACH, FL 33069 ............................... <br />10. Addkional Insured <br />.................................................................. <br />WEINGARTEN RLTY INV <br />PO BOX 424133 HOUSTON, TX 77292 <br />Agent signature <br />14 <br />0 <br />Form 6499 it (650) <br />caobw <br />