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<br />~ <br /> <br />ACORD@ CERTIFICATE OF LIABILITY INSURANCE I DA TE (MMIDD/VYYY) <br />~ 3/31/2011 <br />THIS CERTIFICATE IS ISSUED AS A MATTER 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 />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <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 ~2~~~CT Jaclyn Stamper <br />Corporate Insurance Advisors rA~gN~o. Exll: (954) 315-5000 I FAX <br />lAIC No\: (954) 315-5050 <br />100 NE 3rd Avenue E-MAIL <br /> ADDRESS: <br />Suite 1000 ~RODUCER D#00002239 <br />Ft. Lauderdale FL 33301 INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURED INSURER A :New Hampshire Ins CO 23841 <br /> INSURER B :Philadelohia Indemnity Ins Co. 18058 <br />LSJ Corp, DBA: Graph Plex Signs INSURERC :FCCI Insurance Company 10178 <br />2830 N. 28th Terrace INSURER D : <br /> INSURER E : <br />Hollywood FL 33020 INSURER F : <br /> <br />COVERAGES <br /> <br />CERTIFICATE NUMBER:CL1l33106222 <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 />INSR ADDL SUBR ~aM~~1 I r~2T6~M-~1 LIMITS <br />LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER <br /> GENERAL LIABILITY X EACH OCCURRENCE $ 1,000,000 <br /> - ~~~~~~~?E~~~~~?ence) <br /> ~ COMMERCIAL GENERAL LIABILITY $ 100,000 <br />A tJ CLAIMS-MADE [i] OCCUR 01-LX-027561402-0 4/1/2011 4/1/2012 MED EXP (Anyone person) $ 5,000 <br /> ~ <br /> PERSONAL & ADV INJURY $ 1,000,000 <br /> r-- <br /> GENERAL AGGREGATE $ 2,000,000 <br /> ~'L AGGRE@E LIMIT APAS PER: PRODUCTS - COMP/OP AGG $ 2,000,000 <br /> POLICY X ~~8T LOC $ <br /> AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT $ 1,000,000 <br /> - (Ea accident) <br /> X ANY AUTO <br /> - PHPK702321 4/1/2011 4/1/2012 BODILY INJURY (Per person) $ <br />B ALL OWNED AUTOS <br /> - BODILY INJURY (Per accident) $ <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> - $ <br /> - HIRED AUTOS (Per accident) <br /> NON-OWNED AUTOS Uninsured motorist combined $ 1,000,000 <br /> - <br /> Medical payments $ 5,000 <br /> X UMBRELLA L1AB H OCCUR EACH OCCURRENCE $ 3,000,000 <br /> - <br /> EXCESS L1AB CLAIMS-MADE AGGREGATE $ 3,000,000 <br /> - DEDUCTIBLE $ <br />A X RETENTION $ 10 000 01-UD-012856515-0 4/1/2011 4/1/2012 $ <br />C WORKERS COMPENSATION X X I T~~$'ItJI~S I IO~-~- <br /> AND EMPLOYERS' LIABILITY Y/N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE D N/A E.L. EACH ACCIDENT $ 500 000 <br /> OFFICER/MEMBER EXCLUDED? 0001WC10A64507 6/10/2011 6/10/2012 <br /> (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 500 000 <br /> ~m,;~rt-H~~ 'g'~'i)PERATlONS below E.L. DISEASE - POLICY LIMIT $ 500 000 <br />DESGRIPTION OF DPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addlllonal Remarks Schedule, if more space Is required) <br /> <br />CERTIFICA TE HOLDER <br /> <br />CANCELLATION <br /> <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN <br />City of Sunny Isles Beach ACCORDANCE WITH THE POLICY PROVISIONS. <br />18070 Collins Avenue <br />Sunny Isles Beach, FL 33160 AUTHORIZED REPRESENTATIVE <br /> Mark Schwartz/DEBBFL i/ll(u~,I:: /!~ A~AtVr:('~- <br /> <br />ACORD 25 (2009/09) <br />INS025 (200909) <br /> <br />@ 1988-2009 ACORD CORPORATION. All rights reserved <br />The ACORD name and logo are registered marks of ACORD . <br />