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rl G. BA71STA & ASSOCIATES 5OO PROFESSIONAL LIABILITY INSURANCE REECONS -01 ANGIEY AC4t7KO DATE (MMND/YYYY) CERTIFICATE OF LIABILITY INSURANCE 2129/'2012 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 pol(cy(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 CONTACT Zoraida Gonzalez Collinsworth, Alter, Fowler 8 French, LLC PHONE 305 822.7800 FAX 8000 Governors Square Blvd (A/C, No, Fall: ( ) (AIc, No): (305) 362.2443 Suite 301 EMAIL z onzalez caffllc.com ADORES g Miami Lakes, FL 33016 INSURER(S)AFFORDING COVERAGE NAICp 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 ADDLSUBR POLICY EFF POLICY E %P LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MMMD/YYYY) LIMITS GENERAL LIABILITY FACHOCCURRENCE S COMMERCIAL GENERAL LABILITY DAMAGE TO RENTED PREMISES(Eaawue M S CLAIMS-MADE OCCUR MEOEXPtMY— Pe,FOnl S GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOSWNED UMBRELLA LIAR OCCUR EXCESS LIAR CLAIMS4AAOE DED RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YON ANY PROPRIETOR/ ARTNERIEXECUTIVE NIA OFFICERIMEMBER EXCLUDED? IMantlatory In NH) II y tle—be —le, DESCRIPTION OF OPERATIONS aeb� A Professional Liab. 000152202 A Claims-Made Basis 000152202 PERSONAL 8 ADV INJURY S 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: BODILY INJURY (Per Person) S 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 ADDLSUBR POLICY EFF POLICY E %P LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MMMD/YYYY) LIMITS GENERAL LIABILITY FACHOCCURRENCE S COMMERCIAL GENERAL LABILITY DAMAGE TO RENTED PREMISES(Eaawue M S CLAIMS-MADE OCCUR MEOEXPtMY— Pe,FOnl S GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOSWNED UMBRELLA LIAR OCCUR EXCESS LIAR CLAIMS4AAOE DED RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YON ANY PROPRIETOR/ ARTNERIEXECUTIVE NIA OFFICERIMEMBER EXCLUDED? IMantlatory In NH) II y tle—be —le, DESCRIPTION OF OPERATIONS aeb� A Professional Liab. 000152202 A Claims-Made Basis 000152202 PERSONAL 8 ADV INJURY S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE GENERAL AGGREGATE 5 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PRODUCTS - COMP /OP AGG S ACCORDANCE WITH THE POLICY PROVISIONS. S COMBINED SINGLE LIMIT AUTHORIZED REPRESENTATIVE (En —A.M) $ 1/'7 / BODILY INJURY (Per Person) S ©1988.2010 ACORD CORPORATION. All rights reserved. BODILY INJURY (Per den) $ The ACORD name and logo are registered marks of ACORD PROPERTY DAMAGE S (Pet accMeNl S EACH OCCURRENCE S AGGREGATE $ 5 WC STATV OTH TORY LIMITS ER EL EACH ACCIDENT S EL DISEASE - EA EMPLOYEE S E L DISEASE - POLICY LIMIT S 2/2612012 2/2512013 Each Claim 1,000,000 212612012 2/2612013 Annual Aggregate 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Ahach ACORD 101, AddRI al Remalhe SEKetlule, 11 more space M qulretll Professional Liability Deductible $10,000 Each Claim; Professional Liability Retroactive Date 2/2512010 CERTIFICATE HOLDER CANCELLATION 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 1/'7 / ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CITY OF SUNNY ISLES BEACH RFQ No. 12 -04 -01