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<br />~ <br /> <br />OP 10: CO <br /> <br />ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MI'.t'DDNYYV) <br />'----'" 03/21/12 <br />THIS CERTIFICATE IS ISSUEO AS A MATTER OF INFORMATION ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTENO OR ALTER THE COVERAGE AFFOROED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(Sl, AUTHORIZEO <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: Iflhe certificate holder Is an ADDITIONAL INSURED, Ihe pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, sub]ecllo <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 561-487-6001 CONTACT <br /> NAME:: <br />Global Insurance Services, file 561-451-9825 PA~gr:;O Evt'.; lr~ No\: <br />21301 Powerllne Road #211 <br />Boca Raton, FL 33433 E-MAIL <br /> ADDRESS; <br />Brian Ladd CUSTOMER 10': DESISTU <br /> INSURER{S) Af FORDING COVERAGE NAlC' <br />INSURED OesignSludio Boca, LLC INSURER A ,First Community Ins. Co. <br /> 2300 NW Corporate Blvd Ste 214 INSURER B : <br /> Boca Raton, FL 33431 INSURER c: <br /> INSURER 0: <br /> INSURER E : <br /> INSURER F : <br /> <br />COVERAGES <br /> <br />CERTIFICATE NUMBER: <br /> <br />REVISION NUMBER: <br /> <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BElOW HAVE BEEN ISSUED TO mE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOlWlTHSTANDING ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TliIS <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 />To/~ TYPE OF INSURANCE POLICY NUMBER ,~ MMlODrIYVv) LIMITS <br /> GENERAL LIABILITY 1,000,00 <br /> - EAOi OCQJRRENCE , <br />A ~ 3'MEROAL GENERAl LIABILITY X 090004968751204 04/01111 04/01112 PREMISES Ea occurr",nce\ , 50,00 <br /> _ CLAIMS-MADE [K] OCCUR MEU EXP (Anyone p(l/son) , 5,00 <br /> PERSONAl.& ADV INJURY , INCLUDE[ <br /> GENERAl AGGREGATE , 2,OOO,OOC <br /> ~'LAGG~EnEILlMIT i~:!~tIPER PRODUCTS- COMPtOP AGG , l,OOO,OOC <br /> pOUCY I ~f~i LOC , <br /> AUTDrolOBILE LIABILITY COMBtNED SINGLE LIMIT , 1,000,ODC <br /> - (Eaacddellt) <br />A ANY AUTO 090004968751204 04/01/11 041D1/1Z <br />- BODILY INJURY (Par parson) , <br /> - ALL OWNED AUTOS BODilY INJJRY (Per accident) $ <br /> X SCHEDUlED AUTOS PROPERTY DAMAGE <br /> HIRED AUTOS {Peracrido:lnt} , <br /> X NON-OWNED AUTOS , <br /> f-'-'- <br /> , <br /> UMBRELlA L1AB H OCCUR EAOi OCCURRENCE , <br /> I- <br /> EXCESS LIAS CLAIMS-MADE AGGREGATE , <br /> I- DEDUCTlOlE , <br /> RETENTION , , <br /> WORKERS COMPENSATION I T~~rnllN~~ I IOEW- <br /> AND EMPLOYERS'LIABILlTY Y I N <br /> Am PROPRIETORIPARTNER/E)(ECUTIVE 0 E LEACH ACODENT . <br /> OFFlCERIMEWiBER EXClUDED? N/A <br /> (MllndlllorylnNHl E.l. DISEA~. EA EMPlOYEE t <br /> ~;~~~R~~ ~n~~PERATtONS below E.l. DISEASE - POLICY UMIT , <br />DESCRJPTION OF OPERATIONS I lOCATIONS 1VEHCLES (Attach ACORD 101, Addltlonal Rimal1;liI Schtdur.,lfmorlt spaee Is requIred) <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />SUN ISL E <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE lliEREOF, NOTlCE WILL BE DELIVERED IN <br />Sunny Isles Beach ACCORDANCE WITH TliE POLICY PROVISIONS. <br />Building Department AUTHORIZED REPRESENTATiVE <br />18070 Collins Ave" 3rd Floor ~ <br />Sunny Isles Beach, FL 33160 <br /> <br />ACORD 25 (2009/09) <br /> <br />@ 19B8-2009 ACORD CORPORATION. All rights reserved. <br />The ACORD namo and logo are registered marks of ACORD <br />