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Last modified
4/25/2019 11:14:17 AM
Creation date
3/14/2019 12:20:28 PM
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40 • <br /> lir <br /> 4 CERTIFICATE OF LIABILITY INSURANCE DATE(YMIDDIYYYY) <br /> lir 03/12/2019 <br /> . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> lir 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 /> lir REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> 4110 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 /> certificate holder in lieu of such endorsement(s). <br /> CONTACT <br /> PRODUCER MARIA L.DIAZ <br /> -- <br /> Discovery Entr.Insurance Agency Na ExU (305)718-8919 (; Ni: (305)718-3584 <br /> 10733 N.W.58th Street •MAIL <br /> _A Dr7 REBS: marilu cc discodoraIIns.com <br /> 4IIIII, Miami,FL 33178 _ INSURERS)AFFORDING COVERAGE 1 NAIC C <br /> Phone (305)718-8919 Fax (305)718-3584 INSURER A: MT.HAWLEY INSURANCE COMPANY 37974 <br /> INSURED INSURERS. MERCURY IND.CO.OF AMERICA 012490 <br /> gir NUNEZ CONSTRUCTION, INC. INSURER C: MT.HAWLEY INSURANCE COMPANY 37974 <br /> 6400 S.W.62 AVENUE INSURER o: KINSALE INS COMPANY 38920 <br /> INSURER E: CNA 086301 <br /> SOUTH MIAMI FL 33143 — - <br /> INSURER F: STARSTONE NATIONAL 25496 <br /> Iiir 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 THE POLICY PERIOD 7 <br /> lir 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 /> 411, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ��/NSR I 'ADD U _ POLICY EFF POLICY EIDE <br /> 7R IT TYPE OF INSURANCE POLICY NUMBER �MWODIWYY) (IiMiDD/YYYYI LIMITS <br /> © COMMERCIAL GENERAL.LIABILITY i EACH OCCURRENCE $ 1,000,000.00 <br /> Illi I 1 CLAIMS-MADE k OCCUR DAMAGE TO RENTED 1 50,000.00 <br /> — $ <br /> � XCU NOT EXCLUDED _ <br /> MED EXP(Any onePREMISES(Ea nGeL s 5,000.00 <br /> iir _ I07/22/1019 person) <br /> [] CONTRACTUAL LIAR PERSONAL NI ADV INJURY $ 1,000,000.00 <br /> A Y Y MGL0186895 07222018 <br /> GEN L AGGREGATE LMIT APPLIES PER f GENERAL AGGREGATE $ 2,000,000.00 <br /> lirU POLICY C❑ JEL' LOC <br /> PRODUCTS-COMP/OP AGG $ 1,000,000.00 <br /> lir U OTHER — <br /> $ <br /> AUTOMOBILE LJABILITYC HIED SINGLE LIMB <br /> �._. $ 1,000,000.00 <br /> 411, i 1 ANY AUTOff, BODILY INJURY(Per penton) $ <br /> - <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> Billir U AUTOS AUTOS Y V BA090000012855 09/11/2018'09/11/2019 I <br /> NON-OWNED R <br /> PROPERTY pAMAGE $ <br /> �/ HIRED AUTOS '� AUTOS ;iPer ec�derltL I $ <br /> OP - <br /> _ f +- <br /> U UMBItELLALlAB v•I <br /> OCCUR EACH OCCURRENCE s 4,000,000.00 <br /> 111, C k EXCESS LIAR _ 1 CLAMS-MADE Y Y MXL0427284 07/22/2018 07/22/2019 AGGREGATE $ 4,000,000.00 <br /> lir J DED LJ RETENTIONS $ -- --- <br /> WORKERS COMPENSATIONt rI ,I PER <br /> AND EMPLOYERS'UABILJIY Y f N LI STATUTEEl ER <br /> _ <br /> imly <br /> ANY PROPRIETORJPARTNER/EXECUTIVj E.L.EACH ACCIDENT $ <br /> OFFICERIAIEMBER EXCLUDED? N!A i <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S <br /> ilir It yes.describe order I I E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS below t <br /> D 'EXCESS UMBRELLA Yj07128/201807/22/2019 <br /> EACH OCCURRENCE!AGG $5,000,000.00 <br /> Y <br /> Ir 1_ __ <br /> 0544 -1 i <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more apace Is required) <br /> (E) EXCESS UMBRELLA Y Y 6049830725 07/28/2018 0728/2019 $10,000,000.00 <br /> (F) EXCESS UMBRELLA Y Y 89994N172ALI 07/22/1018 07/22/2019 $10,000,000.00 <br /> lir <br /> 'i <br /> CERTIFICATE HOLDER CANCELLATIONIP <br /> AO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> CITY OF SUNNY ISLES BEACH THE EXPIRATION DATE THEREOF,NOTICE WILL BE DEUVERED IN <br /> 18070 COLLINS AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. <br /> lirSUNNY ISLES BEACHINV THORIZED REPRESENTATIVE <br /> FLORIDA,33160 , <br /> iiir __ p <br /> CITY OF SUNNY ISLES BEACH,AS ADDITIONAL INSURED - <br /> Or ACORD 252014/01 ©1988-2014 ACORD CO`•ORATION. Alt rights reserved. <br /> ( )QF The ACORD name and Io,• are registered marks of ACORD <br />
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