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Clienf#- 13590 CALTENG3 ACORDT., CERTIFICATE OF LIABILITY INSURANCE D4/26/2012YYV) 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. 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 CONTACT NAME: ISU Suncoast Insurance Assoc PHONE 813 289 -5200 FAX A/C No Ext : A/c, No): 8132894561 P.O. Box 22668 E -MAIL Tampa, FL 33622 -2668 ADDRESS: PRODUCER 813 289 -5200 CUSTOMER ID M X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 4 OCCUR INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Hartford Casualty Ins. Co. 29424 Caltran Engineering Group INSURER B: Travelers Casualty & Surety CID 31194 1400 NW 107th Avenue, Suite 209 INSURER C: XL Specialty Insurance Company 37885 Miami, FL 33172 Phoenix Insurance Company INSURER D : p y 25623 INSURER E: INSURER F: GENERAL AGGREGATE $2,000,000 COVERAGES CERTIFICATE NLIMRF_R- REVISION NLIMRER- 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. IN SR LTR TYPE OF INSURANCE DD IN SR BR D POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS A GENERAL LIABILITY 21SBMZJ3000 1/1112012 01/11/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 4 OCCUR DAMAGE TO PRE M SES Ea occurrence) $300,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY I PRO F LOC $ D AUTOMOBILE X LIABILITY ANY AUTO BA21B867048 01/20/2012 01/20/2013 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ X X $ NON -OWNED AUTOS _ _ UMBRELLA LIAB EACH OCCURRENCE $ HOCCUR AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE Y1 UB3857T364 1/20/2012 01/20/201 WC X TORYLI IT OTH- S ER E.L. EACH ACCIDENT $1,000,000 OFFICER /MEMBER EXCLUDED? (Mandatory In NH) N/A E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $1,000,000 C Professional DPS9690874 1/11/2012 01/11/2013 $1,000,000 per claim Liability $1,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Professional liability is written on a claims made and reported basis. RE: RFQ 12 -04 -01 l.tK I Irl%,A I t 11ULUCK t ANN r_LLA 1 IUIN Sunny Isles Beach Government SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Center ACCORDANCE WITH THE POLICY PROVISIONS. 18070 Collins Ave. 4th Floor AUTHORIZED REPRESENTATIVE Sunny Isles Beach, FL 33160 ©1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD #S381001 /M364098 JMB