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~ c ACORD@ CERTIFICATE OF LIABILITY INSURANCE Page I DATE (MM/DDIYYYY) ~ 1 of 2 07/12/2011 t THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ... CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES " BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: Ifthe certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ~~N~ACT Willis Insurance Services of California, Inc. :^~,?~~ em I:!:'t. .m 888-467-2378 26 Century Blvd. 877-945-7378 P. O. Box 305191 ~;:,~~12<:<: certificates@Willis,com Nashville, TN 37230-5191 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: National Union Fire Ins Co of Pittsburgh 19445-100 INSURED INSURER B: Zurich American Insurance Company 16535-100 URS Corporation Southern 7800 Congress Avenue, Suite 200 INSURER C: Illinois National Insurance Co. 23817-001 Boca Raton, FL 334B7 Insurance Company of the State of PA 19429-100 INSURER D: INSURER E: I INSURER F: COVERAGES CERTIFICATE NUMBER: 16274225 REVISION NUMBER: ~ THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ~~~; ~~,~ POLICY NUMBER POLICY EFF POLICY EXP LIMITS IT" A GENERAL LIABILITY Y GL4870829 5/1/2011 6/1/2012 EACH OCCURRENCE $ 4,000 000 - ~~~~~H9E~~~J~r~nce \ X COMMERCIAL GENERAL LIABILITY $ 1 000 000 I CLAIMS-MADEW OCCUR MED EXP (Anyone person) $ 10 000 lL XCU, BFPD PERSONAL & ADV INJURY $ 4 000 000 lL Contractual Liabi1itv GENERAL AGGREGATE $ 4 000 000 GEN'L AGGREG~L1MIT APn PER: I PRODUCTS - COMP/OP AGG $ 4 000 000 ... ~. PRO- POLICY X "~~T LOC $ ~ AUTOMOBILE LIABILITY Y BAP938521502 5/1/2011 6/1/2012 COMBINED SINGLE LIMIT 2,000,000 - (Ea accident) $ X ANY AUTO BODILY INJURY(Per person) $ - ALL OWNED - SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ - - NON.OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ - - $ UMBRELLA L1AB H OCCUR EACH OCCURRENCE S - EXCESS L1AB CLAIMS-MADE AGGREGATE S OED I IRETENTION $ $ C WORKERS COMPENSATION WC20635052 1/1/2011 1/1/2012 X TWCSTATU-, I IU~~- AND EMPLOYERS' LIABILITY Y/N A ANY PROPRIETOR/PARTNER/EXECUTIVE D N/A WC20635051 1/1/2011 1/1/2012 E.L. EACH ACCIDENT $ 2,000,000 OFFICER/MEMBER EXCLUDED? C f~~~~~~~~ib"e ~~~er WC20635053 1/1/2011 1/1/2012 EL DISEASE - EA EMPLOYEE S 2,000,000 D DESCRIPTION OF OPERATIONS below WC20635054/WC20635055 1/1/2011 1/1/2012 E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS J LOCATIONS J VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required) Contract/Job Number: RFQ #11-07-01 The Workers' Compensation coverage shown above does not apply in monopolistic states. In the States of ND, OH, WA and WY, Workers' Compensation coverage is provided by the State Fund. In those States, the above-referenced policies provide Stop-Gap Employers' Liability only, SEE ATTACHED '- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ~.... """ AUTHORIZED REPRESENTATIVE City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, FL 33160 ~~ ACORD 25 (2010/05) Coll:3417511 Tpl:1300507 Cert:16274225 @1988-2010ACORD ORPORATION.AII rights reserved. The ACORD name and logo are registered marks of ACORD