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r 1 ~ r 1 ACORD@ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY) ~ 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: If the 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 ILEANA CABRERA RODRIGUEZ ~~~~~CT MAGDALENA DETRINIDAD rd~gNJo "vt\. 305-529-9966 I FAX 1925 PONCE DE LEON BLVD. iAfC Nol: 305-529-2856 E-MAIL CORAL GABLES, FL 33134 ADDRESS: ~ INSURERISJ AFFORDING COVERAGE NAIC# 1"'~U...t INSURER A : State Farm Mutual Automobile Insurance Comoanv 25178 INSURED ABC CONSTRUCTION INC INSURER B : 7215 NW 7TH ST INSURER C : MIAMI FL 33126 INSURER D : INSURER E : INSURER F : '1 '1 r I r ] COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: II I I '] I L ~ 1 J 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 AODL ISUBR 11&~Mg~ l&g~~%~1 LTR POLICY NUMBER LIMITS GENERAL LIABILITY D 0 EACH OCCURRENCE $ - ~~~~~~S lEa occurrence) COMMERCIAL GENERAL LIABILITY $ - U CLAIMS-MADE D OCCUR MED EXP (Anyone person) $ - PERSONAL & ADV INJURY $ - GENERAL AGGREGATE $ ~'L AGGREAE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $ POLICY ~WT LOC $ AUTOMOBILE LIABILITY D 0 939 7970-B01 02/01/2012 08/01/2012 ~~~~b~~~t~INGLE LIMIT $ f-- ANY AUTO BODILY INJURY (Per person) $ 1,000,000 I- ALL OWNED X SCHEDULED I AUTOS AUTOS BDDIL Y INJURY (Per accident) $ 1,000,000 l- X NON-OWNED ;p~?~~C~d~i,I~AMAGE X HIRED AUTOS _ AUTOS $ 1,000,000 I- $ UMBRELLA L1AB H OCCUR D D EACH OCCURRENCE $ I - --- EXCESS L1AB CLAIMS-MADE AGGREGATE $ 1 OED I I RETENTION $ $ WORKERS COMPENSATION TWCSTATU-, [ 10Jbl- AND EMPLOYERS' LIABILITY TOQ)- LIMITe: Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE D 0 E,L. EACH ACCIDENT $ I OFFICE/MEMBER EXCLUDED? N/A (Mandatory In NHI E.L. DISEASE - EA EMPLOYEE $ If yes, deSctib~ ~~er '"', E,L. DISEASE - POLICY LIMIT $ , D 0 I J DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) SHOULD ANY OF THE ABOVE POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE STATE FARM WILL PROVIDE 30 DAYS WRITTEN NOTICE ~ 1 I J CERTIFICATE HOLDER CANCELLA TION SUNNY ISLES BEACH 18070 COLLINS AVENUE SUNNY ISLES BEACH, FLORIDA 33160 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2010/05)