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A G1 d® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
<br /> 2/21/2017
<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 /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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).
<br /> PRODUCER CONTACT Holl Buzen
<br /> NAME: y
<br /> Frank H. Furman, Inc. PHONEc . o.Ext): (954)943-5050 943-5050 (ac,No):(954)942-6310
<br /> 1314 East Atlantic Blvd. E-MAIL
<br /> ADDRESS:bolly @furmaninsurance.com
<br /> P. O. Box 1927 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Pompano Beach FL 33061 INsuRERAFIDI—Gerling America Insurance 41343
<br /> INSURED INSURER B:Travelers/St Paul Companies 40967
<br /> Cool Breeze Air Conditioning Corp. INSURERC:
<br /> 13120 SW 130th Terrace INSURERD:
<br /> INSURER E:
<br /> Miami FL 33186 INSURER F: I
<br /> COVERAGES CERTIFICATE NUMBER:16-17 Master w/Out Forms REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT 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 THIS
<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 /> IXP
<br /> LTR R I TYPE OF INSURANCE IN D IS(M/D I POLICY NUMBER I(MMJDDY/YYYY) (FF MM/DD/YLICY YYY) LIMITS
<br /> X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE Is 1,000,000
<br /> A CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES
<br /> 100,000
<br /> PREMISES(Ea occurrence)
<br /> X EGGCC000200316 4/6/2016 4/6/2017 MED EXP(Any one person) I S Excluded
<br /> PERSONAL 8 ADV INJURY 5 1,000,000
<br /> GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000
<br /> POLICY X 57 8, LOC PRODUCTS-COMP/OP AGG 5 2,000,000
<br /> OTHER: Employee Benefits - 5 1,000,000
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000
<br /> (Ea accident)
<br /> A X ANY AUTO BODILY INJURY(Per person) 5
<br /> ALLOWNED SCHEDULED
<br /> AUTOS AUTOS x EAGCC000200316 4/6/2016 4/6/2017 BODILY INJURY(Per accident) 5
<br /> NON-OWNED PROPERTY DAMAGE S
<br /> X HIRED AUTOS X AUTOS (Per accident)
<br /> Unisured Motorist Limits S 20,000
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 5 5,000,000
<br /> B EXCESS LIAB CLAIMS-MADE AGGREGATE 5 5,000,000
<br /> I DED I X I RETENTIONS 10,000 ZOP71M2852116NF 4/6/2016 4/6/2017 5
<br /> WORKERS COMPENSATION I
<br /> PER STATUTE I I EOTH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 5
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT I 5
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Re. :Invitation to Bid No. 16-12-02 for the New HVAC Chiller Systems for Pelican Community Park
<br /> City of Sunny Isles Beach is listed as additional insured for general liability, auto liability when
<br /> required by written contract.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Sunny Isles Beach THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Capital Projects Manager ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 18070 Collins Avenue
<br /> 3rd Floor AUTHORIZED REPRESENTATIVE
<br /> Sunny Isles Beach, FL 33106 ��
<br /> Dirk DeJong/HB ^&.^-a/ . .,e2..,,, ,,,------
<br /> ©1988-2014
<br /> ,e2 ,,,-----©1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
<br /> INS025(2014011
<br />
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