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<br />m <br /> <br />. ...-- <br /> <br />Illinois Union Insurance Company <br /> <br />TANK SAFE - <br />Storage Tank Liability <br />Insurance Policy <br />Declarations <br /> <br />This Policy is issued by the stock insurance company listed above (herein called the "Insurer"). <br /> <br />COVERAGE A OF THIS POLICY PROVIDES BODILY INJURY AND PROPERTY DAMAGE LIABILITY COVERAGE <br />FOR CLAIMS FIRST MADE AGAINST THE INSURED AND REPORTED TO THE INSURER, IN WRITING, DURING <br />THE POLICY PERIOD. COVERAGE B OF THIS POLICY PROVIDES CORRECTIVE ACTION COSTS COVERAGE ON <br />AN INCIDENT-REPORTED BASIS. <br /> <br />PLEASE READ THIS POLICY CAREFULLY. SOME OF THE PROVISIONS CONTAINED IN THIS POLICY RESTRICT <br />COVERAGE, SPECIFY WHAT IS AND IS NOT COVERED AND DESIGNATE RIGHTS AND DUTIES. LEGAL <br />DEFENSE EXPENSES ARE SUBJECT TO AND WILL ERODE A SEPARATE AGGREGATE LIMIT OF LIABILITY. <br /> <br />THE DECLARATIONS, TOGETHER WITH THE COMPLETED AND SIGNED APPLICATION, THIS POLICY AND ANY <br />ENDORSEMENTS OR SCHEDULES ATTACHED HERETO, CONSTITUTE THE INSURANCE POLICY. <br /> <br />Policy No.: G21828518 007 Renewal of: G21828518 006 <br />Item 1. Named Insured: City of Sunny Isles Beach <br />Principal Address: 18070 Collins Avenue, #250 <br />Sunny Isles Beaeh,FL,33160 <br />Policy Period: <br />From 01/0112011 12:01 A.M. To 01/0112012 12:01 A.M. <br />(Local time at the address shown in lIem 1.) <br /> <br />Item 2. <br /> <br />Item 3. <br />Item 4. <br /> <br />Item 5. <br /> <br />Item 6. <br /> <br />Item 7. <br /> <br />Retroactive Date: <br /> <br />Limits of Liability: <br />a. $ N/A <br />$ 5,000,000 <br /> <br />01/01/2005 <br /> <br />Per Storage Tank Incident Limit (USTs) <br />Per Storage Tank Incident Limit (ASTs) <br /> <br />b. $ N/A <br />$ 5,000,000 <br />$ N/A <br /> <br />Aggregate Limit (USTs) <br />A t L' 't (ASTs) This insumnec issued pursuant 10 Florida Snrplus Lincs Law <br />ggrega e Iml Surplus lincs Agenl: <br />Aggregate Total Limit (UST & ASTs -NtllRl/;ijlil.lfMlfAJe~a1<Defense) <br />Public Risk Underwriters or Florid1 llle. <br />A L I 0 ~ E . . PO "ox 958455 <br />ggregate ega elense xpense lI"1'lke MalY, FL 32795 <br /> <br />c. $ 5,000,000 <br /> <br />Deductible: <br />$ 5,000 <br /> <br /> <br />Premium: <br /> <br />$1 690 Q}J PJ.odu<;ing Agent Address , <br />, '/ 9"t70 AJ/A) '197JJC!f St""..xtY.1 /J}/c.l/I,i k/<,"", 17 <br /> <br />Quarter:_LFSLSO Confl/-Q1!IJ1Jl~$,..!'sLSO Servicc Fec-1f- <br />J . fi~~ r7 <br />$1.6!XH1Qm:.tt,itl,tltJ lax: t2.-0IherFccs: ;(!. <br /> <br />TOTAL AMOUNT DUE: <br /> <br />Notice to Insurer: This 'nsuranc. is issu.d pUl1ulll1llo florida Surplus Lin.s Law. Pmons insured by Surplus <br />" . !.incs ('arrlel1 do no! have lhe prol<cllon nflh< Florid~ Insurance Guaranly Acllo Ih. .xlenl <br />a. Nolree of Claim or Storage Tank InCident: of allY righl ofreool'elY ro.lh. obl/solion of 011 insolvent unlicensed insurer. <br /> <br />Environmental Risk Claims Managef SlIrplu I.~illes enl'. Counlersignalure: <br />ACE USA Claims ~1I~ <br />P.O. Box 5103 ~ ~~ <br /> <br />~~:~~~g~<tWEs INSURERS' <br /> <br /> <br />ARE NOT APPROVED BY ANY <br />ACE TankSafe"'.Dec 4/0'FLORIDA REGUt5f~~ii'Y~'6iE~CY <br /> <br />Page 10f2 <br />