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CERTIFICATE OF COVERAGE ISSUED ON: 2/20/2012
<br />covrmw PROVIDW BY: PREFERRED GOVERNMENTAL INSURANCE TRUST
<br />PACKAGE AGREEMENT NUMBER:PK FLl 013202611 -09 COVERAGE PERIOD: 10/1/2011 TO 10/1/201212:01 AM
<br />C01 /ERAGES:This is to certfy that the agreement below has been issued to the designated member for the coverage period Indicated. Notwithstanding any
<br />requirement, term or condition of any contractor other document with respect to which this certificate maybe Issued or may pertain, the coverage afforded by the
<br />agreement described herein subject to all the terms, exclusions and conditions of such agreement.
<br />Mail to: Certificate Holder
<br />afforded by the agreement above.
<br />Florida Department of Transportation
<br />Administrator
<br />Public Risk Underwriters@
<br />Right of Way Administration
<br />P.O. Box 958455
<br />1000 N W 111 Ave RmN6105B
<br />Lake Mary, P! 32795 -8455
<br />Miami, FL 33172
<br />-........._ ... ...............................
<br />Producer
<br />_._..__....__._._....
<br />LIABILITY COVERAGE
<br />Brown & Brown, Inc.
<br />X Comprehensive General Liability, Bodily Injury, Property Damage
<br />and Personal Injury
<br />Limit $5,000,000 / $5,000,000
<br />$0 Deductible
<br />X Public Officials Liability
<br />AUMORt7_ED 91.31RESENTAT1W.
<br />Limit $5,000,000
<br />$0 Deductible
<br />X Employment Practices Liability
<br />Limit $5,000,000
<br />$0 Deductible
<br />X Employee Benefits Liability
<br />Limit $5,000,000 / $5,000,000
<br />$0 Deductible
<br />X Law Enforcement Liability
<br />Limit $5,000,000
<br />$0 Deductible
<br />PROPERTY COVERAGE
<br />X Buildings & Personal Property
<br />Per schedule on file with $5,000 Deductible
<br />TrustLimit
<br />Nor: Ser coverage agreement for elerails al i+vxd flood and other
<br />deductibles.
<br />X Rented, Borrowed and Leased Equipment
<br />Limit $50,000 TIV See Schedule for Deductible
<br />X All other Inland Marine
<br />Limit $3,314,156 TIV See Schedule for Deductible
<br />Dealgnated Member
<br />City of Sunny Isles Beach
<br />18070 Collins Avenue
<br />Sunny Isles Beach, FL 33160
<br />WORKERS' COMPENSATION COVERAGE
<br />WC AGREEMEN'r NUMBER: WC FLI 01320261142
<br />Selflnsured Workers' Compensation
<br />X Statutory Workers' Compensation
<br />2,500 Deductible
<br />X Employers Liability
<br />$1,000,000 Each Accident
<br />$1,000,000 By Disease
<br />$1,000,000 Aggregate Disease
<br />AUTOMOBILE COVERAGE
<br />Automobile Liability
<br />Limit $5,000,000 $0 Deductible
<br />X All Owned
<br />Specifically Described Autos
<br />X Hired Autos
<br />X Non -Owned Autos
<br />Automobile Physical Damage
<br />X Comprehensive See Schedule for Deductible
<br />X Collision See Schedule for Deductible
<br />X Hired Auto with limit of $50,000
<br />Garage Keepers
<br />Liability Limit
<br />Liability Deductible
<br />Comprehensive Deductible
<br />Collision Deductible
<br />_........... - --.......... ..............._._.._.__........_.. _.............._....__.._.._.._ ......_.._._............ .
<br />.... .................. _._._........... _..... _— —.._._....._............ ............................._.
<br />NOTE:The most we will pay is further limited by the limitations set forth in Section 768.28(5), Florida Statutes (2010) or the equivalent limitations of successor law which
<br />are applicable at the time of the loss.
<br />Description of Operetonsl Locations/ Vehicles /Special items:
<br />Parcels 653 and 654 -State Road A1A and 856
<br />This sm on completed by member's agent, who bears complete responslbillly mld liabiUtyfor its acetvacy.
<br />This certiticale is issued as a matter ..._...- of - _. infonna..... ton only-and nd - confers no rights upon the cerHicate holder. This certificate does not amend, extend or alter We coverage
<br />afforded by the agreement above.
<br />Administrator
<br />Public Risk Underwriters@
<br />j SIIMXI)ANY ks
<br />1snnuLO.,MWr.R Gov "-4TM.WpinACTRUST IiLNIMAVO IMPOSE Till. rAVSW0TnATla
<br />tnr> alrer•, rvurtraahvoovaaNrsl +rnl.a�sunn+l�Tausr wiLUaran�avoarolNnn.eo oAVSU�emcN
<br />P.O. Box 958455
<br />'• NOTICIL OR IO DAYS WRITTEN NOTICE FOR PW- PAYMWOF PRRMRR.LTOTHE CEItT@TCATti nOLOR
<br />NAMED ABOVE, PUT rAILURETO MAIL SUCH NOTICE SUALL IMPOSE NOOIILIOATION OR LIAIIILITY OFANY
<br />Lake Mary, P! 32795 -8455
<br />KIM) tAIM THE PROGRAM. G'S AGENTS ORRIP401ENTATIVES
<br />Producer
<br />/�/�
<br />Brown & Brown, Inc.
<br />14900 NW 79th Court, Suite 200
<br />Miami Lakes, FL 33016
<br />AUMORt7_ED 91.31RESENTAT1W.
<br />_..__..._.._..._.._.............. . ... --- _.._ .......... ......
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<br />1 POIT.CCRT (11109) PR1AT FORA4
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<br />2/20/2012
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