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FORMS + ATTACHMENTS© Professional Architecture Services for Government Center Lobby+Gateway Park I -,---'''''''''iSO18588 A D CERTIFICATE OF LIABILITY INSURANCE DATE(10117 Y) 2/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 policy(ies)must have ADDITIONAL INSURED provisions or 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 NAME Commercial Lines-(305)443-4886 PHONE 888-572-2412 I Fax 1ALCJJs,Ea9� Marc.Rn), Wells Fargo Insurance Services USA,Inc. E-oEss: @tdnet.com 2601 South Bayshore Drive,Suite 1600 INSURER(S)AFFORDING COVERAGE I NAIC a Coconut Grove.FL 33133 INSURER A: Indemnity Insurance Company of North America 43575 i • INSURED Strategic Outsourcing,Inc. INSURER B: PO Box 241148 INSURER C INSURER D: Charlotte,NC 28224 I INSURER E: RE: Song&Associates,Inc. INSURER F: COVERAGES CERTIFICATE NUMBER: 11430808 REVISION NUMBER:See below 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. TR( TYPE OF INSURANCE I"SDI WYD I POLICY NUMBER POLICY EFF POLICY EXP (MM/DO/YYYY) 1MM/DO/YYYY), LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S b J3AGE TO RENTED CLAIMS-MADE I OCCUR PREMISES(Ea occurrence) S _ MED EXP(Any one person) S PERSONAL&ADV INJURY S GENT AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S _l POLICY I ECT I LOC PRODUCTS-COMP/OP AGG S I OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 S (Ea accident/ ANY AUTO BOOILY INJURY(Per person) S II OWNED SCHEDULED AUTOS ONLY I AUTOS BODILY INJURY(Per accident) S NON.OWNEAUTOS ONLY _I AUTOS ONLYY PROPERTY DAMAGE S fPer PERT m) I I I I S i 1 UMBRELLA LIAR I I EACH OCCURRENCE S EXCESS UAB I (OCCUR CLAIMS-MAGE AGGREGATE S I I DED 1 1 RETENTIONS I S WORKERS COMPENSATION 'STATUTE AND EMPLOYERS'LIABRJTY YIN WLRC64309535 03/01/2017 03/01/2018 x I STATUTE I I ER .ANYPROPRIETOR/PARTNER/EXECUTNE OFFICERiMEEMBEREXCLUDED9 N!A E.L.EACH ACCIDENT S 1.000.000(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE!5 1.000,000H yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1-000.000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached it mon space K required) Workers'Compensation Insurance is limited to employees of Song&Associates,Inc.through a co-employment contract with Strategic Outsourcing,Inc. CERTIFICATE HOLDER CANCELLATION Song&Associates.Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1545 Centrepark Drive North ACCORDANCE WITH THE POLICY PROVISIONS. West Palm Beach,FL 33401 AUTHORIZED REPRESENTATIVE For proposal purposes 9,......4.,),_ I The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) 1111111111111111111111111111111111111IIll 11.111I1111111111HID 110I 1111 1111 I SONG +ASSOCIATES 78