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. ) r ) r I I I 1 r] I I ) I 1 . J " l . J -' , Client#. 13062 CRAIGASM .. I ACORD", CERTIFICATE OF LIABILITY INSURANCE DA!E (MMlDUfYYYV) . 12103f2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONf'ERS NO R!GHTS UPON THE CERTIF'C~TEHOLDER THIS CERTIFICATE DOES NOT AFFIRMA TIVEL Y OR NEGA lIVE:.L y' AMEND, EXTEND OR ALTER 'THE COVERAGE AFFORDED By'THE'POLiCIES , BELOW. :THIS CERTIFICATE OF INSUf{AN~E DOtS NOT CONSTITUTE A CONTRACT Bl:,TWEEN THE ISSUING INSURER(S), AUTHORiZED: .' REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER., IMPORT ANT: If the certificate holder is an ADDITIONAL INSURED, the poTicy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject 1<:. the terms and conditions of the policy, certain policies may require an endorsement. A statement on this ce.rtificate does n~'t confer rights to the, certificate holder In lieu of such endorsement(s). ~~r<; I Jeanne B. Bender. . =1 PRODUCER Cypress 'Insurance Group BO-CL ~..1l'~l\: 954 771-0300 --,-~ ~ r..ea. No): ~~ 772 94-2_C P.O. Drawer 9328 E-MAIL Fort Lauderdale, FL 33310.9328 ADDRI;SS: ._~ _ _. "._4_ ___ P!Rl"O'\JCER CUST.JMER ID #: ----..---..-. 954 771-Q300 INSURER(S) AFFOROtNG COV~~G_E__ _-1~!~~_ ---- "---'-'---'- .'--' INSUR!:O IUSURERA: Travelers Indemnity -1--0-' .~-- Craig A. Smith & Associates INSURER B : Ohio Casualty Insurance Company I PO Box 880128 INSURER c: Chartis j-'-- Boca Raton, FL 33488 I -- ~':I~URER D : "--- "- INSURER E : : -f---- INSURER F : I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LlSTED 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. ~~RI TYPEOFINSIJRANCE ~~L~~RI POLICY NUMBER rJ>Mg6~ 1~,Jjg~ I LIMITS A Rl' GENERALUABILlTY ! 660505M2249 112f01/2010I12/01f2011 EACH OCCURRENCE 51000000 ; I I ~~~'::,!v_t<"NI"u L COMMERCIAL GENERAL LIABILITY 'PREMISES (Ea oco.mencel 5300,000 U CLAIMS-MADE ~ OCCUR' I MED EXP (Anyone person) 55,000 U PERSONAL&ADVINJURY 51,000,000 . 1 I GENERAL AGGREGATE 52,000,000 ~N'L AGGREGATE LIMIT AP~S PER: I PRODUCTS - COMP/OP AGG s2,000,000 IpOLlCyn~~f,: IXILOC I i I IS B _AUTOMOBILEUABILITY II BA053319679 r2/01/2, 010 12101/2011 COMBINEDSINGLEUMIT (Ea accident) 51.000 000 - ANY AUTO BODILY INJURY (Per person) 5 _ ALL OWNED AUTOS BODILY INJURY (Per accident) 5 ._.! SCHEDULED AUTOS I.. PROPERTY DAMAGE I 5 ~~~ I ~~ I~I NON-OWNED AUTOS ,: I S XI Drive Other Car 'I 5 B _ UMBRELLA LJAB lxJ OCCUR I I EU054645021 '12101/2010112101/20111 EACH OCCURRENCE 154,000,000 X EXCESS UAB n CLAIMS-MADE I I I AGGREGATE s4.000 000 _ DEDUCTIBLE I I i s 1 X RETENTION 5 0 I I I I s C I WORKERS COMPENSATION I BINDER270599 112101/2010 'I 12101f20111 X If~RSY.\~~Yrs I I~~H-I . AND EMPLOYERS' lJAIijLlTY Y IN' ,-,-- ,-- ANY PROPRIETORlPARTNERlEXECUTlVEr;;lN I I E.L EACH ACCIOENT 151,000,000 I OFFICER/MEMBER EXCLUDED? L!!.I N1A ~ (Mandatory In NH) I l5:b D1SEAl:E - EA EMPL9Y~Ei 51,000,000 I ~~sc~~~~ O~OPEP..ATlONS below 1 l I I E.l. DISEASE. POliCY LIMIT 151,000,000 I I I _ II DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICle,S (A,;;ach ACORD 101. Additional Renwrks Schedule II more .pa<:e is required) Workers Compensation applies to Florida operations and employees only. -- -- I 1 (ERTIFfCA TE HOLqER I Proof of Insurance CANCELLATION ----r ..----.. ..._-"-'--, l:mOlJLD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELi ED BEFC:RE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELlVERl'D IN ACCORDANCE WITH THE POLICY PROVISIONS. - I=':~~ .--] @ 1988-2009 ACORD CORPORATION. All righis l'eserved. The ACORD nclme and logo are registered marks of ACORD ACORD 25 (2009/09) " of 1 #S102237fM102203 Proposer: Craig A. Smith & Associates JBB RFQ No. 11-11-02 4