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G. OCIIATTE PROFESSIONAL LIABILITY INSURANCE i ^—"N REECONS -01 ANGIEY A` ORO CERTIFICATE OF LIABILITY INSURANCE ° "2129no ZYY' 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(les) 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 NAME: Zoraida Gonzalez Collinsworth, Alter, Fowler & French, LLC PHONE (305) 822 -7800 jac, No): (305) 362.2443 8000 Governors Square Blvd WC, No, Eat): Suite 301 ADDRRess: zonzalez@caffllc.com Miami Lakes, FL 33018 INSURERS) AFFORDING COVERAGE NAIC0 A Claims -Made Basis 000152202 2125/2012 2/2512013 Annual Aggregate 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anach ACORD 101, Additional Remarks Schedule, It more space Is mquiredl Professional Liability Deductible $10,000 Each Claim; Professional Liability Retroactive Date 212 512 01 0 CERTIFICATE HOLDER CANCELLATION INSURER A: Ironshore Specialty Ins Co INSURED INSURER S! G Batista S Assoc. INSURER C: 10400 Griffin Road Suite 201 INSURER D Cooper City, FL 33328 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 INSR ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSR INVO POLICY NUMBER lMMMDIYYYY) (MwDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENFRAL LIABILITY DAMAGE TO RENTED PREMISES (Ea oCC 0-01 5 CLAIMS MADE OCCUR MEO EXP (Any one personl 5 PERSONAL S ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMPIOP AGG S POLICY PRP JECT LC IC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea OCY4en1) $ ANY AUTO BODILY INJURY (Per person) S ALOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per acct m) S NON ON14ED PROPERTY DAMAGE S HIRED AUTOS AUTOS (Par accWOnl) S UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LULB CLAIM"ADE AGGREGATE S DED RETENTIONS S WORKERS COMPENSATION WC STATLI OTH AND EMPLOYERS' LIABILITY YIN TORY LIMITS ER ANY PROPRIETORMARTNERIEXECUTIVE NIA OFFICERIMEMSER EXCLUDED EL EACHACCIDENT 5 !Mandatory In NH) EL DISEASE EA EMPLOYEE S DESCRIPTION OF OPERATIONS OeloY, E L DISEASE POLICY LIMIT $ A Professional Liab. 000152202 2126/2012 212512013 Each Claim 1,000,000 A Claims -Made Basis 000152202 2125/2012 2/2512013 Annual Aggregate 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anach ACORD 101, Additional Remarks Schedule, It more space Is mquiredl Professional Liability Deductible $10,000 Each Claim; Professional Liability Retroactive Date 212 512 01 0 CERTIFICATE HOLDER CANCELLATION 50 CITY OF SUNNY ISLES BEACH RFQ No. 12 -04 -01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE '• "' SPECIMEN " "„ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 'SPECIMEN "'••• ACCORDANCE WITH THE POLICY PROVISIONS.- 'SPECIMEN '• AUTHORIZED REPRESENTATIVE I 01988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 50 CITY OF SUNNY ISLES BEACH RFQ No. 12 -04 -01