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• <br /> _ i. <br /> E <br /> A� (MMIDD/YYYY)) <br /> ® CERTIFICATE OF LIABILITY INSURANCE 5/5/2018 <br /> 5/2018 <br /> itTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY TIE POLICIES <br /> ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTIORIZED <br /> EPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. <br /> tf SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT Darius-Mcjimpson <br /> Teamworks Insurance Agency,LLC PHONE FAX <br /> 23371 Mulholland Dr.#306 rac.No.Ext1: (805)531-5060 (A/C,No): (805)531-5065 <br /> E-MAIL <br /> SS: certholder@teamworkinsurance.com <br /> Woodland Hills CA,91364 @ <br /> INSURER(S)AFFORDING COVERAGE NAC# <br /> INSURERA: Employers Preferred Insurance Company <br /> INSURED INSURER B: <br /> DP&O,Inc.Dba Triquetra Inc <br /> Robert Hirsch CPA CIO DPO INSURER C: <br /> 10033 Sawgrass Dr.W.Ste. 121 INSURER D: <br /> Ponte Vedra,FL 32082-2832 INSURER E: <br /> INSURERF: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR 11-IE 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 /> INSR TYPE OF INSURANCE ADDL SUBRI POLICY EFF I POLICY EXP <br /> LTR INSD WVD I POLICY NUMBER (MM/DD/YYYY)I(MMIDD/YYYY) UMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S <br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED <br /> PREMISES(Ea occurrence) $ <br /> MED EXP(Any one person) $ <br /> PERSONAL 8 ADV INJURY_ $ <br /> GEN`L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S <br /> POLICY PRO <br /> JECT LOC _ PRODUCTS-COMP/OP AGG $ <br /> OTHER: S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S <br /> (Ea accident) <br /> 0 ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURYPer accident $ <br /> AUTOS ONLY AUTOS INJURY(Per <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> ❑ AUTOS ONLY AUTOS ONLY (Per accident) <br /> $ <br /> UMBRELLA UAB OCCUR EACH OCCURRENCE _ S <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED I RETENTIONS $ <br /> WORKERS COMPENSATION PPEERRNTE U ERTH- <br /> AND EMPLOYERS'UABLITY Y/N EIG2539335-00 08/28/17 08/28/18 @ <br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ ,V1,000,000 <br /> OFFICER/MEMBER EXCLUDED? y N/A <br /> (Mandatory in NH) E.L DISEASE-EA EMPLOYEE S $1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ $1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Sunny Isles Beach SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Office of the City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 18070 Collins Avenue, ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Sunny Isles Beach, FL 33160 <br /> MBetanCUr@Slbfl.net A"T"g�IZED EPF: ITAT1rgE— <br /> x: (305) )792- 1563 !(/J �/�/(Ja�unioty <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br /> 1 <br />