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<br /> ACOROe CERTIFICATE OF LIABILITY INSURANCE DATEMOAV°"N""
<br /> 4:::■-• 12/11/2012
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br /> I 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 ADDRIONAL INSURED,the policyftes)must be endorsed. R 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 /> I certificate holder hT Gen of such endorsement(s).
<br /> ROmCER ry FACT Michele Motes
<br /> McDaniel-Whitley, Inc. TIN?,F,0.. (901)881-6964 IIF c p,.(901)e01-6467
<br /> P.O. Box 382007 pp'4 L .mmotes @ncdanielwhitley.com
<br /> I INSURERS)AFFORDING COVERAGE tales
<br /> Memphis TN 38183-2007 INBIHFRA Starr Surplus Lines Ins Co 13604
<br /> INSURED isulleTsTravelers Casualty 4 Surety 19038 -
<br /> Global Synthetics Environmental, LLC irmNERcflational Union Fire Ins Co of 19445
<br /> I
<br /> INSURER OMa XUs Ins 00111
<br /> 6326 Highland Road
<br /> INSURER E:
<br /> Baton Rouge LA 70808 INSURER F, I
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> I THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE US/tU BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATE). 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 SHOW MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> OMR Y' " POLICY EFT POLICY E '
<br /> LTR TYPE OF INSUIANCE INSA wen POLICY Nla ER IFa69D'YYWI lb{'DO'YWYI UNITS
<br /> GENERAL taauIY EACH OCCURRENCE 5
<br /> � „ 1,000,000
<br /> DAMAGE TO RENTED
<br /> E COMMERCIAL GENERAL UABAITY pgEA15E IEa P I S 50,000
<br /> A ICLAIMS-MADE e OCCUR SLPG(a,0o]s1 /15/2012 4/15/2013 gED p o p am penal, S 5,000
<br /> 8 I I.O.U. Coverage PERSONAL&AO✓INJURY S 1,000,000
<br /> I � GOBtALAGGAEGA E S 2,000,000
<br /> GEM.AGGREGATE LLWF APPLES PER: VROOICFS-COIAPOPAGG 5 2,000,000
<br /> nPOLICY X 1 1 n 10
<br /> AIROICOILEUABIITY SINGLE UMW
<br /> 11 L 1,000,000
<br /> 1 B I ANY AUTO
<br /> ALL ONNm _SCHEDI ILFO
<br /> AUTOS _AUTOS
<br /> I I NCN-01ANED
<br /> BRED AUTOS AUTOS B431962140
<br /> Hired Auto Physical Ole ROOMY INJURY(PCW ) S
<br /> /15/2012 4/15/2013 BODILY g a m y ova S
<br /> PROPERTY[MANGE
<br /> (Pa aamBn0
<br /> I mil MHO 3CV/5100/51,000 Dad Unravel metre=raec 5
<br /> D X 11I0311F11A DAB X OCLUq 113013101121®® 12/11/12 04/15/2013 EMIT OCOJRRENCE s 9,000,000
<br /> EXCESS UAB CIAMSIMOE AGGREGATE t 9,000,000
<br /> DEDI IRETBRgN1 S _
<br /> B
<br /> WORKERS COMPENSATION I YC STATI' I I MOTW
<br /> AND EMPLOYERS- BLI
<br /> UATY Y/N I TORY'NRS FR
<br /> AMY PROPRIETORIPARINERIEXECUTIVE I. N/A EL EACH ACCIDENT S 500,000
<br /> OFFCERNEIMER EXCLUDED'
<br /> (lYtlseayn NM) U882503646 4/15/2012 4/15/2013 ELDISFAO=-EAEAPLOYEF 5 500,000
<br /> tl Yleatv C6cEep,da'
<br /> DESLRPTO.OF OPEPATWNS 6elae El.DlSEASE-POLICY LIAR 5 500,000
<br /> B Contractors Equip. 56084943604 4/15/2012 4/15/2013 teasedlRe s on $50,000
<br /> I Special Form Ded ea. $5,000
<br /> OESCIPTMIN OF OPERATpNS/LOCATNNS/VEHICLES(Mach ACORD'Cl.Aannoml Rmra*S SON/Mo.if rave moon is,aprbad)
<br /> Project: 12-10-03
<br /> City of Sunny Isles Beach ai named as Additional Insured with respects to General Liability 4 Auto
<br /> 1 Liability in regards to projects under a written contract.
<br /> ICERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE E)(PIRASON DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Sunny Isles Beach
<br /> ACCORDANCE WITH THE POLICY PROVISIONS
<br /> I 18070 Collins Avenue
<br /> sunny Isles Beach, FL 33160 AUTHORED REPRESENTATIVE / r1
<br /> I 34 McDaniel/MOTES /K A�e I�e+�'--°
<br /> ACORD 25(2010i05) ®1988-2010 ACORD CORPORATION. All rights reserved.
<br /> WCmS,a vem m The A ,ffn name and ln,,.are en,.ielnan,l mar*c,'d brrInn
<br /> IGlobal S■ndletics Environmental.LLC • 6326 Highland Road • Baton Rouge.LA 70808 • 225.907.4763• YAVW.geOSUrfaceS.COP1 2
<br /> RFP#12-10-03
<br /> I
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