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Proof of Insurance ® General Liability & Workman's Comp _ :.Z:5_ ACO CERTIFICATE OF LIABILITY INSURANCE °ArECVWOPn DYYY 01!1712015 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 INSURERIS), 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. It SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorSemenL A statement on this certificate does not confer rights to the Certificate holder in lieu of such endorsementls).• PRODUCER COr(TACT Leah-Acosta Commercial Lines-(305)443-4886 NAME: E PAS Ane Ne,E.g:3C1544342a6 tAIG.Nap Wells Fargo Insurance Services USA,Inc. JAA0. pooHcss- LeslieAcos1a@wellsfargo.com 2601 South Eayshore Drive.Suite 1800 IsaunERISI AFFOROING COVERAGE KW+ Coconut Grove.FL 33133 INSURER A, Old RepubEX Insurance Company 24147 INSURED INSURER B: SFM Services.Inc.(See Description of operations) INSURER C: 0700 NW 70 Avenue INSURER 0: INSURER!: _ Ffialeah Gardens.FL 33016 INSURER F: COVERAGES CERTIFICATE NUMBER: 12438344 REVISION NUMBER:See below THIS IS TO CERTIFY THAT THE POUCIES 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 RTTH 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,UMfTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. II TRI TYPE OF INSIFR/WCE 41'4= POUCY ATJMBERIMSOLICY Eli YTI IPOLICYESP YYYYI I LAMS , 1 COVAIERGIAL G.ENERALLIAPILJTY cACHC.CCLJRP.ENCI; S 1,�,E0T A L i X NPNZY3IY A0 0310111 i 03/01115 CSCE Tp HTEO I I CLAIMS-WIDE C._OU= PREL15ES1T:u:,.,,..rA vi_ 5 FACED WO EXP(Am ax Po'suo) S mem I_ Is[RsO,L,&Awis,Xf{1' I lrxctcm e 'CF.NI ACOREGATE I{1I1p51APPLIE5 PER GF FR,M,AG GATE S ;»�[� PCIIC'!I X I ACI III LOC I'RO'VA'TS-IS AUG S 2.0:DECO I DTHER I I1 � I AUTOMOBILE I man RY I(MAmEtII INbLE EMIT I S 1 1 ANY AU I O I ROAM INJURY IPu Ycrnn} 15 OANE7CICE1 ECFEDULED I:sODLY INJURY(Per=irk-311 I AUTOS LY AUTOS I Ur ) NCNrynnED PRC Et I DAMAGE I AUIOS ONLY' AUTOS ONLY 5:Per D:c0001I 1 5 (UMBRELLA LlAB Li Ccztp I EACH OCCURRENCE 15 1 I EXCESSUAB I I CLAUS-MACE AOGRFG.STE I S I I CEO I I PEIENT,ONS I I I S TrcPtxxxsA A EMPLOYER 5" �nY rrN N MWC30g7.S.D0 O.3Ji11/17 03101/IS XX I Mina I 1.asR 1 AHYP. RIETOR,PARTNERs%EOUTWE I i 1 s,1,.EACH ACC10ENT I S 1,500 orriaRAELIT5R E.YCLUDED? ` ! NIA ,Mandatory L.,UNI EL OIEEASE-EA EIROYETI 5 I EDUCE 1%75'Y"s UO OF IZOODCC RIPTIQNoForFRar'IQV$b..N E.L.Ot5EA5E.P 11CYLFAIT I5 OESCRIPTTOa OF OPERATIONS I LOCATIONS r VEHICLES(ACOSO 501,Additional Rea-Arts SoSedde,may b/atbdrd d rare spaces mauaetl) The Cera f tate Holder is listed as an adaitional insured in respect ID the General Liability policy when required on a when contract or agreement CERTIFICATE HOLDER CANCELLATION SAMPLE CERTIFICATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTNORIEO REPRESEYTATWS 9f I — The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) . _ -a SFM IIISC ES,OEC.