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. ACORD,M CERTIFICATE OF LiABIL~TY INSURANCE I DATE (MMIDDIYYYY) 06/15/2011 PRODUCER (954) 755-8577 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE South Atlantic Insurance Services Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 7551 Wiles Road, Suite 201 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Coral Springs FL 33067- INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: HARTFORD INSURANCE 19682 WINGERTER LABORATORIES INC. INSURER B: MAXUM INDEMNITY 1820 N E 144TH STREET INSURER C: INSURER D: NORTH MIAMI FL 33181- iNSURER E: COVERAGES ) 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, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMIDD/YY) DATE (MMIDD/YV) LIMITS ~NERAL LIABILITY / / / / EACH OCCURRENCE $ 1,000,000 ~ 5MERCIAL GENERAL LIABILITY ~~~~~~J?E~~~J~ri;,nce) $ 300,000 A CLAIMS MADE 0 OCCUR 21UUNKK1190 12/31/2010 12/31/2011 MED EXP (Anyone person) $ 10,000 I- PERSONAL & ADV INJURY $ 1,000,000 / / / / GENERAL AGGREGATE $ 2,000,000 -il'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ X -~ PRO-~ / / / / POLICY JECT LOC ~TOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT 1,000,000 (Ea accident) S - ANY AUTO A - ALL OWNED AUTOS 21UUNKK1190 12/31/1010 12/31/2011 BODILY INJURY (Per person) S ~ SCHEDULED AUTOS ~ HIRED AUTOS / / / / BODILY INJURY S X NON-OWNED AUTOS (Per accident) - ~ PIP 10,000 / / / / PROPERTY DAMAGE S X MEDICAL PAYMTS $2000 (Per accident) ~RAGE LIABILITY AUTO ONLY - EAACCIDENT $ ANY AUTO / / / / OTHER THAN EA ACC S AUTO ONLY: AGG S A EXCESS/UMBRELLA LIABILITY 34XHUKK5725 12/31/2010 12/31/2011 EACH OCCURRENCE S 1,000,000 ::il OCCUR D CLAIMS MADE AGGREGATE S 1,000,000 $ R DEDUCTIBLE / / / / S RETENTION $ $ WORKERS COMPENSATION AND / / / / I WCSTATU-: I IOTH- TORY LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? / / / / E.L. DISEASE - EA EMPLOYEE $ II yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ B OTHER PROFESSIONAL PFP6012382 03/15/2011 03/15/2012 GENERAL AGG LIMIT 1,000,000 LIABILITY / / / / LIMIT PER CLAIM 1,000,000 / / / / DEDUCTIBLE 10,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS VEHICLES: SEE ATTACHED VEHICLE LIST : ) CERTIFICATE HOLDER CANCELLATION ( ) - ( ) - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ADDITIONAL INSURED GL EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL - 030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE .~.~.~ -, -. . .. - - ACORD 25 (2001/08) !!eTM" INS025 (0108).05 ELECTRONIC LASER FORMS, INC, - (800)327-0545 @ACORD CORPORATION 1988 Page 1012 .