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Liability Insurance
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Last modified
11/2/2022 11:25:01 AM
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11/2/2022 11:24:51 AM
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CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDDIYYYY) <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO <br />11/1/2022 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />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 ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certMcate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />$itateFarm STATE FARM INSURANCE <br />• IMMA PIERRE, AGENT <br />• e♦t <br />NAMEA� IMM Pierre/ Latoya Brown <br />PHONE 954-251-4537 FAX No): 954-239-7488 <br />—EMAIL <br />Imma Imma Ierre.COm/ tato a Imma Iem3.00m <br />ADDRE @ P Y @ P <br />61QQ HOLLYWOOD BLVD SUITE 520 <br />INSURER(S) AFFORDING COVERAGE NAIC@ <br />NsuRfRA, State Farm Mutual Automobile Insurance Company 25178 <br />INSURED <br />VALROSE ENTERPRISES INC <br />4450 E 11TH AVE <br />HIALEAH, FL 33013-2535 <br />INSURER B: 0 <br />NsuRER C: <br />INSURER D. <br />INSURER E: <br />INSURER F: Ell <br />..c�wwn nvnnocrt: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR <br />THE 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 <br />ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR <br />TYPE OF INSURANCE <br />ADOL <br />SUER <br />POLICY NUMBER <br />POLICY EFF <br />POLICY t7CP <br />LMITS <br />COMMERCIAL GENERAL LIABRJTr <br />CLAIMS -MADE <br />EACH OCCURRENCE $ <br />PREMISES Ea occurrence $ <br />MED EXP (Arty me Person) $ <br />PERSONAL & ADV INJURY $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />❑ PRO-JECT <br />GENERAL AGGREGATE $ <br />PRODUCTS - COMPIOP AGG $ <br />POLICY LOC <br />OTHER: <br />$ <br />AUTOMOBILE <br />LIABILITYY <br />Y <br />G39 0791-E12-59 <br />05/12/2022 <br />11/12/2022 <br />COMBI1We'd) LE LIMIT $ 1,000,000 <br />X <br />NYAUTO <br />BODILY INJURY (Per pawn) $ <br />OWNED SCHEDULED <br />0390799 -E12 -59D <br />05/12(2022 <br />11(12/2022 <br />BODILYINJURY(Peraccident) $ <br />AUTOS —OAUTOS <br />HIRED ONLY NON -OWNED <br />039 0788-E12 59B <br />05/12/2022 <br />11 /12/2022 <br />PROPERTY DAMAGE <br />(Per accident $ <br />AUTOS ONLY AUTOS ONLY <br />S <br />UMBRELLA UAB <br />OCCUR <br />EACH OCCURRENCE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE $ <br />DED RETENTIONS <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY I, / N <br />STATUTE ER <br />E.L. EACH ACCIDENT $ <br />ANY PROPRIETORIPARTNERISMCUTIVE <br />OFFICERIMEMBEREXCLUDED? <br />NIA <br />(Mandatory in NIS <br />I= ( <br />ss.describe under <br />E.L. DISEASE - EA EMPLOYE $ <br />E.L. DISEASE - POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more sWce Is required) <br />08 FORD F450SD VIN: 1FDXF46R88ED99020 <br />13 FORD F250 VIN: 1 FT7X2AT1 DEA47206 <br />01 MITSUBISHI FE640T VIN: JW6BHF1SX1L000995 <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny Isles Beach, FL. 33160 <br />ACORD 25 (2016/03) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />94,91M-�� a <br />019138 2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />10014M 132849.13 04-22-2020 <br />
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