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(12-07-01) Fleet Bus Maintenance and Repair Services
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Beta Trucks LLC
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Entry Properties
Last modified
8/1/2012 11:16:07 AM
Creation date
8/1/2012 11:13:06 AM
Metadata
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Fleet Bus Maint. and Repair Svcs
Bid No. (xx-xx-xx)
12-07-01
Project Type (Bid, RFP, RFQ)
Bid
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�N DATE (MW0D/YYYy) <br />CERTIFICATE OF LIABILITY INSURANCE 09!291 10 <br />................. ... <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />....._.__.__.._. ............ . ..... ........ __ . . . .............. . . ............. - .... . .... .. 11 . ..... .. . . . . . ............... <br />IMPORTANT. It the certificate holder Is an ADDITIONAL INSURED, the poricy(les) Must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). CONTACT . . . . ....... . ....... . ..... . ...... ............ <br />NAME: Patricia Fernandez <br />PRODUCER. ... . .... ..... . ............ . ................ . -5946 <br />PHONE f , (305)956 <br />fissure -US, Inc. . ..... - W,.N - . , - <br />__lp <br />E-MAIL alriciaQassureus-us <br />1880 NE 163rd Street ...ADDR9S§,;_ ........ ... —,--P .............. __ . ......................... ... ......... .............. <br />PRODUCER <br />Vorth Miami Beach, FL 33162 M ... ... . . . . . ........ .... ......... ....... . . ._ ....... .. <br />Phone (305) 956-7818 Fax (305) 956-5946 iNwRkf AFFORD! G COVERAGE MAIC 9 <br />ompany. <br />INSURED INSURER GranadajnsuranceC ... . ....... <br />... ... . . ........... . . ........... <br />Betatrucks, LLC. '_ENSURER _9..; ........ . . . . ........ ................ —1 . ......... .. <br />IN............... . .... _111".-._ .......... <br />15151 West Dixie Highway ...... <br />. .......... . .................. <br />Miami, Ft. 33162 .............. . ....... <br />. . . . ........ .......... . .................. <br />€(05949 =9499 — <br />. . .......... .. . .. . ....... . . ................... ..... . . . . ................. <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER* <br />..... .... ... . . ................... ............. ... .......... .......... . ..... . . . ............ . <br />THIS IS TO CERTIFY THAI- THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH I HIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . . ............. <br />'11Fr L . <br />. . . ... ............ - ............... . ..... . ..... .......... ........... .......... 00D67 I'm y Exp LIMITS <br />I R. POLJCYNUMBER IMM!DOrVYYY ..I <br />-IyfPO.OF INSURANCE . .. ... ...................... - <br />. . ......... <br />......... .... ... . . ... . INSR.im . . .......... <br />GENERAL LIASILITY EACH OCCURRENCE <br />commERciAL GENERAL LIABILITY FLRER <br />7 <br />MED E,)(P iAny one person) <br />CLAIMS.mAor OCCUR <br />PC RSONAL & A. INJURY <br />... ..... . . ....... ... . . <br />.. ... ......... ...... . <br />.......... 'T <br />GENERAL AGGREGA E_ <br />...... ..... <br />............ . ....... <br />GEN't- AGGREGATE I..JMrTAPPJ.IES PER PRODUCTS <br />. ... ... ... .. .. <br />PR. .... . ...... <br />POLICY.._ I COT- LOC . . .. . ............. <br />Lw_ . <br />... .... .. Lo COMBINED SINGLE LIMII <br />AUTOMOBILE LIABILITY <br />(Es accident) <br />mji BODILY INJURY (Per person) $ <br />ANYAUIO <br />.t J ALL. OWNED AUTOS "0185FI_00021732. BODILY INJURY Wel 130660nli S <br />z <br />A <br />SCHEDULED AUTOS <br />y n i PROPERTY DAMAGE <br />$ <br />(Per accident) <br />. . .... ..... <br />HIREDAUrOS <br />S 50,000 AN <br />I !Auto Only <br />NON•OWNED AUTOS <br />T. ......... .......... ... . ..... . . . . . . ....................... . . ...... . ... ................... .... .... . ....... ... . ............ - . . . . ......... <br />S <br />1. ACH OICCURM N <br />UMBRELLALIA13 <br />OCCUR <br />AGGREGATIL <br />EXCESS LIAS CLAIM S-MADE. <br />DEDUCTIBLE <br />. . . ...................... . . .......... <br />.............. ........... WC STATU- <br />WORKERS COMPENSATION <br />-NT <br />AND EMPLOYERS' LIABILITY Yl <br />...... E.L EACH ACCIDf <br />ANY PROPRIETORfPARI'NEPJEXr.CUTrVE', <br />OFFICERMEMBER EXC' LUDED? INIA <br />L. DIS (.ASF - EA LMPLOYFE $ <br />(Mandatory in NH) <br />If as. describe under r $ <br />E.L. DISEASE PO! <br />.... . ... ---- ------ .... . ....... . . . ........ ...... <br />-SCRIPTION OF OPERATIONS below . . ..... <br />. . . . I ............. . . . . . .......... <br />0185FL00021732. <br />$50. <br />.000 00 <br />A Garage Keepers y <br />.. . . ........ ......... ------ . . ....... . .... <br />DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />CERTIFICATE HOLDER <br />MIAMI DADE COUNTY <br />CONSUMER SERVICE <br />140 WEST FLAGLER STREET STE#902 <br />MIAMI, FL, 33130 <br />ACORD 25 (2009109) CIF <br />..... . ......... . .. . ........ ........... . . . . . . . ............ ... - <br />CANCELLATION <br />................. . _., . ..... /-. <br />SHOULD ANY O THE AJOVE DESCRIBED POLICIES 13E CANCELLED BEFORE <br />THE EXPIRATI NDATE HEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANC WITH TAE POLICY PROVISIONS. <br />W <br />1988-2009 ACORD CORPORATION. All rights reserved. <br />/the'-ACORD name and logo are registered marks of ACORD <br />
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