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aG. BATISTA ASSOCIATES INSURANCE INFORMATION GENERAL LIABILITY INSURANCE OP ID: CM A osz° CERTIFICATE OF LIABILITY INSURANCE ° "';'; Aa1;;YYl 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 954 467.8738 CONTACT AME: Premier Protection Insurance g54- 944.1881 PHONE 409 SE 7th St Fort Lauderdale, FL 33301 (AIC, No Ec): (AfC, No). EMAIL Douglas A. Levy A OGRESS: PRODUCER REALE 100,00 CUSTOMER ID a: -1 MEDEXPIAnyo- r-sall S INSURER(S) AFFORDING COVERAGE NAICA INSURED G. Batista & Associates INSURER A: United Specialty Ins. CO. 10400 Griffin Road Suite 201 INSURER e: Evanston Insurance Co. Cooper City, FL 33328 _ -- GEN L AGGREGATE LIMIT APPLIES PER INSURER C 2,000,00 INSURER D: S INSURER E: AUTOMOBILE LIABILITY INSURER F: 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN - -- INSURED COPY — *— INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER M d)DIYYYY PMMo YVY LTR LIMITS GENERAL LIABILITY EACH OCCURRENCE S 11000,00 A X COMMERCIAL GENERAL LIABILITY NS1211 055 10127/11 10127112 TO ED 5 DPRAEMISES(ENT MAGE RENT rrencoi 100,00 CLAIMS MADE. X OCCUR MEDEXPIAnyo- r-sall S 6,00 PERSONAL S ADV INJURY 5 1,000,00 GENERAL AGGREGATE 5 2,000,00 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG S 2,000,00 X POLICY PRO OC IICT S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S (Ea ac4 I) . ANY AUTO BODILY INJURY I Per gr5orll 3 ALL OWNED AUTOS BODILY INJURY IPer actvdentl $ SCHEDULED AUTOS PROPERTY DAMAGE AIRED AUTOS S I Par acWanp NON OWNED AUTOS S S UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS MADE AGGREGATE S DEDUCTIBLE S REIENHON S S WORKERS COMPENSATION STATU- OTH- ANDEMPLOYERS'LIABILEEY YIN ANYPROPRAIIETORNARiNERJEXECUEIVE OW TORY LIMITS. ER , EL EACH ACCIDENT S OF FICEREMBER EXCLUDED' ❑NIA (Mandatory In NH) E L DISEASE - EA EMPLOYEE S Uy RIPTION OFF DESCRIPTION Of OPERATIONS Uebv EL DISEASE - POLICY LIMIT 9 ESCRIPTI N OF OPERATIONS/ LOCATIONS I VEMICLES (ALUch ACORO I01, Ad ,lional RemarLa Bchadulo.11 more apace Ia required) (Qaeneral oContractor n' } I- ) CERTIFICATE HOLDER CANCELLATION , INSURED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN - -- INSURED COPY — *— ACCORDANCE WITH THE POLICY PROVISIONS. - FOR YOUR RECORDS ONLY AUTHORIZED REPRESENTATIVE �J Q ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD 4@ CITY OF SUNNY ISLES BEACH RFQ No. 12 -04 -01