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Y2t *� � CN6IN ECNIN6r Iwi . Insurance Client#: 13358 ROSSENG3 Arnon r_FRTiFIc:ATE OF LIABILITY INSURANCE Dgj2312012 AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY OR ALTER THE COVERAGE AFFORDED BY POLICIES CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to this certificate does not confer rights to the the terms and conditions of the policy, certain policies may require an endorsement. A statement on certificate holder in lieu of such endorsement(s). PRODUCER ISU Suncoast Insurance Assoc T EM), 813 2895200 A/C, No : 813 289.4561 S: P.O. BOX 22668 71",M'r.Er ER 102: Tampa, FL 33622 -2668 INSURERS) AFFORDING COVERAGE NAIL# 8132695200 RA :TravelersIndemnityCompanyof 25682 INSU RED Ross Engineering, Inc. RS: XL Specialty Insurance Company 37885 R C: Phoenix Insurance Company 25623 3325 S University Dr. R D: Suite 111 R E: Davie, FL 33328 INSURER REVISION NUMBER: GEN'L AGGREGATE LIMIT APPLIES PER: COVERAGES THIS INDICATED. CERTIFICATE EXCLUSIONS NSR L A CERTIFICATE IS TO CERTIFY THAT THE POLICIES OF INSURANCE NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY PERTAIN, AND CONDITIONS OF SUCH POLICIES. TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMIMADE [� OCCUR THE S TERM INSURANCE LIMITS NUMBER: LISTED BELOW HAVE BEEN ISSUm OR CONDITION OF ANY CONTRACTOR AFFORDED BY THE POLICIES SHOWN MAY HAVE BEEN REDUCED POLICY NUMBER 6601B452576 11130/2011 TO THE INSURED OTHER DESCRIBED BY PAID OLICY EFF MMIDDNWY NAMED DOCUMENT HEREIN IS CLAIMS. POUCY EXP M/DD 1201 71!30(201 ABOVE FOR THE POLICY PERIOD WITH RESPECT TO WHICH THIS SUBJECT TO ALL THE TERMS, LIMITS EACH OCCURRENCE $1 000,000 DAM OR PREMISES E.oavrrence MEDEXP(AnYOneperson) $1,000,000 $10,000 PERSONAL &ADY INJURY $1,000,000 GENERALAGGREGATE $2,000,000 PRODUCTS - GO MP /OPAGG $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: $ C POLICY PRO - LOG AUTOMOBILELIABIUTY X BA3B348387 2!02!2012 021021201 COMBINED SINGLE LIMIT (Eaarcidem) $1 000000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED AUTOS PROPERTY DAMAGE (Peraccidenn $ SCHEOULEDAUTOS X HIREDAUTOS $ X NON -OWNED AUTOS $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS-MADE CLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE $ RETENTION WC STATU- OTH- O L TS R VVORKERSCOMPENSATION AND EMPLOYERS' LIABIUTY Y f N ANY PROPRIETOR/PARTNER(EXECUTIVE❑ OFFICER(MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ EL. DISEASE- EAEMPLOYEE $ E.L. DISEASE- POLICY LIMIT (Mandatory In NH) IF yes, desenbe under B DESCRIPTION OF OPERATIONS below Professional DPS9698032 11130120`11 111301201 $1,000,000 $1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mare space is required) The City of Sunny Isles Beach is listed as an Additional Insured as respects the Commercial General Liability, including Automobile Liability, where required by a written contract prior to a loss per policy (See Attached Descriptions) CERTIFICATE HOLDErc - _ -- City of Sunny Isles Beach SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Office of the City Clerk ACCORDANCE WITH THE POLICY PROVISIONS. 18070 Collins Avenue Sunny Isles Beach, FL 33160 AUTHORIZED REPRESENTATIVE (1L0.J� 0&-W- Aa — redoRR.'?nnn ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) 1 of 2 The ACORD name and logo are registered marks of ACORD LWA #S3801311M365176 City of Sunny Isles Beach RFQ 12 -04 -01 Continuing Professional Architectural & Engineering Services Individuals Only (CCNA)