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<br />j coo"'~~ ~2Y.! <br /> <br />PHONE & FAX <br /> <br />PROJECT MANAGER I EMAIL <br /> <br />+ 305-221-6100 <br />+ 305-221-6110 <br /> <br />Eddy Gonzales Jr <br />Eddy@zurquis.com <br /> <br />ACORQ" <br /> <br />CERTIFICATE OF LIABILITY INSURANCE <br /> <br />DATE'M/NODIYYYY) <br /> <br />11/15/2011 <br /> <br />THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />~EPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain pOlicies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder In lieu of such endorsement(s). <br />PRODUCER <br /> <br /> <br />Naomi Perez <br /> <br />Keen Battle Moad & Company <br />7850 Northwest 146 Street <br />Suite 200 <br />Miami Lakes, FL 33016 <br />INSUReo <br /> <br />305.558.1101 <br /> <br />ir~.NOI,305.822.4722 <br /> <br />Zurqui Construction Service, <br />9755 SW 40th Terrace <br />Miami, FL 33165 <br /> <br />_c!.!sr.QM~llJOll:.________...._ <br />INSURERJ!). AFFORDING COVeRAGE <br />INSURER A: Travelers Indemni ty Company <br />INSURER B: Trav~,!.er~n .property & Casual ty <br />,,1,~su,!~_~_c: Trave!._~_~~_ Prop Cas Co of Amer <br />,!!:!~URERD: J:nsurance Co of Penna <br /> <br />INSURER e : <br />INSURER F : <br />CERTIFICATE NUMBER' 11-12 GL/BA/UMB/WC <br /> <br />:tnc <br /> <br />UAIC# <br />09490 <br />25674 <br />05590 <br />19429 <br /> <br />1--- <br /> <br />COVERAGES <br /> <br />REVISION NUMBER: <br /> <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> <br />1['1: J TYPE OF INSURANCE <br /> <br />~ERAL UA81l1TY <br /> <br />! X ~ COMMERCIAL GENERAL LIABILITY <br /> <br />. :--1 CLAIMS-MACE 0 OCCUR <br /> <br /> <br /> <br />· r:,^o~~'''"'' ^"= ..~-= - <br /> <br />~ POUCV , X I Wi8i , I LOC <br />AUTOMODlLE LIABILITY <br /> <br />Xl ANY AUTO <br />~ <br />~ ALL O'....NED AUTOS <br />B .---1 SCHEOULED AUTOS <br />~ HIHEO AUTOS . <br />~ NON-OWNED AUTOS <br />X COMP DED $1,000 <br />L UMBRELLA LIAD I X I OCCUR <br />EXCESS L1AB r-l CLAIMS.MADE <br />C <br />~~ OEDUCTIBLE <br />X t RETENTION S 10 ~ QOOi <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y I N <br />o ~~~'~~~:~~i1~~~~~r~~~J:ECUT'VED <br />(Mand3rory In NH) <br />g~S~J~~ir~ O":OPERATIONS oo:OW <br /> <br />AOOLSUOR <br />INSR YNO <br /> <br />POLICY NUMBER ! t~ro-Jg~Mg}J%~~ ! LIMITS <br />DTC0345K9604:tND11i04/10/2011 04/10/2012! EACH OCCURRENCE S 1,000,000 <br />~ -g-~ift<;rr~~n~) S 300,000 <br />~n~~~ED EX..!:.~AnY ono porso~__ S 5 ~ 000 <br />~~~~SO~~.~~~2.~JURY __ _"~.__"__~~..Q..Q.!? <br />j GENERAL AGGREGATE S 2,000.000 <br />~~~~?~~.!~!~~~~.~~PIOP ~~.~I-~~~~~= 2 , Q 0 0:"000 <br />I S <br />DT81034 5K9604COF11' 04/10/20111 04/10/2012 i C?MBINED SINGLE LIMIT I S <br />1 (Eaacadent) 1,000,000 <br /> <br />f:~::~~~~~~~n:~~f~~~~~~lr=-----..- _:= <br />i-~?:~~T~~~~AMAGE-"--...:.I.;.--.__._".."'-'._- <br /> <br />- IS <br />IS <br />T DTSMCUP 3 4 5K9 6 0 4 T:tL 11' 04/10/2011 04/1 0/2012l..EAC" OCCURREN~ S <br />! AGGREGATE I s <br />I S <br />I s <br />00977 414 5 09/08/2011 09/08/2012 _~_!~~jEI~J1.Vi;.LJ~Jftl__'__. _.__ <br />E.l. EACH ACCIDENT m ,"~__._----.!.,~,.2.Q",^.,Q,~_Q <br />~_E~:~~~~~.lOYE~~.....!.~_~_~Q._~_.QQ..~ <br />iLL. DISEASE - POliCY LIMIT I S 1 ~ 000,000 <br /> <br />1,000,000 <br />1,000,000 <br /> <br />N/A <br /> <br />i <br /> <br />! 1 <br /> <br />i i <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS IVEtilCLES (Attllch ACORD 101. Ac1diUon.-t Romarks Sehodulo.1f moro spaco is roqulrod) <br />roject Nama: Design and construction of Canopy Structures at Heritage Park and Golden Shores Park <br />roject Number; RFP No. 11-10-01 <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE OEllVEREO IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br /> <br />AUTHORIZED REPneSENTATIVE <br /> <br />..- <br />~-"''''~:$''' <br /> <br />I <br /> <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny Is1es Beach, FL 33160 <br /> <br />Timothv Batt1e/LXH . <br />@1988-2009 ACORD CORPORATION. <br />The ACORD name and logo are registered marks of ACORD <br /> <br />All rights reserved. <br /> <br />ACORD 25 (2009/09) <br /> <br />'" <br /> <br />City of Sunny Isles Beach RFP No. 11-10-02 Due Date 12/07/2011 @ 1 0:00AM <br />