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I <br /> G. BAIISTA <br /> L &ASSOCIATES <br /> I <br /> I ACORD,. CERTIFICATE OF LIABILITY INSURANCE I PA'V27neo Z n) <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS 'F <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 tt <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. p <br /> I MPORTANT:If the certificate hol der is an ADDITIONAL INSURED.the poeg0esj must be endorsed.If SUBROGATION IS WANED.subject to +,g <br /> the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not corder rights to the i <br /> certificate holder in lieu of such itndorsem end sl. it <br /> PRODUCER LOI/ACI <br /> SAWS: <br /> !SU Surlcoast Inslrance Assoc PHONE 813 289-5200 1T AN 813 289-4581 <br /> I air- LAIC,IE.F -` <br /> P.O.Box 22888 <br /> ADDRESS: <br /> Tampa,FL 33622-2668 mSIOSER <br /> 813 289-5200 CUSTOMER o <br /> SOURER'S)AFFORDING COVERAGE IBMX A ![ <br /> SOURED Amos s:Travelers Casualty&Surety Co 131194 i` <br /> Wier Legg&Associates,Inc ,yr <br /> 5717 N.Andrews Way Gismos e:Hudson insurance Company 125051 <br /> FL Lauderdale,FL 33709-2766 SOARER C: <br /> INSURER D: ILZ <br /> SINIRERE: I h! <br /> 'MIRE R1: -.. III <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: Zr" <br /> :HIS IS TO CEPTIFY T.-EAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUPED NAMED ABOVE FOR THE POLICY PERIOD { <br /> INi9CA TED NOTWINSTANDING ANY PE CUIPEM EN T.TERM OP CONETION OFANY CCN WPACT OP OTHIEP DOCUMENT WITH.RESPECT TO`MHIGH THIS jt <br /> I CERTIFICATE MAY BE ISSUED OP MAY PERTAIN.THE INSURANCE AFFORDED SI THE POLICIES DESCRIBED PEPSIN IS SUBJECT TO ALL THE TERMS, <br /> SIOCCLUSIONS ANDCONOITIONS OF SUCH POLICIES.UNITS SHOWMAY HAVE BEEN REDUCED BY PAD CLAIMS. •, <br /> SN {,DOL bUBR pQ�il Fff POtiVE19 <br /> LIR TYPE OF INSURANCE <br /> IL MYD POIFCYNUMBFR IMM90JYYYYI IPOIODIYYYI]I LYns Fj <br /> I 4EMERAI LMDNn EACH OCCURRENCE { IRT <br /> --COII.EPGAL GENERAL LMBLiY AM.GE.0 <br /> PREMISE.0RENTED Al I{ j <br /> I CLANS':ADE 0 OCCUR I SEGOS UA Mn <br /> DuS <br /> e I! <br />' PERSONAL AGGREGATE <br /> I{ 4[ <br /> C•ENEFJLI! Ys <br /> OENt AGGPEOATE IND APPLIES ERA PRODUCTS-COIIPWP AGO Is <br /> 'lPOUCYn TO. Fl sac I{ 'G <br /> AUTON/OSA UABLIIY* COBB/MED SINGLE OMR I IT <br /> it Eazm <br /> Avp <br /> •m'AIIFO BODLV INAIFh'�n peFar! II Y. <br /> UTOS <br /> SCHEDULED•u OWF€O ASCHEDULED AUTOS <br /> BODILY MASH pre mason,I! <br /> — PROPERTYI?DDAAMAGE II 11p <br /> HARED AUTOS Rn...a."0 <br /> NONOwIEDAVT05 H 1 i{ `C <br /> I <br /> UMBRELLA LMB t� <br /> OCCUR EACH OCCURRENCE I{ F.. <br /> E KESS LLB I CLAIMS-BADEI AGGREGATE I! j <br /> — <br /> JEDIKTBLE I{ i <br /> I RERNnnN s Is /r <br /> A WORKERS cosENvloN UB5868Y29A 06/01/2011 05101/2012X ^`;''nt!J I°a"I iI <br /> AND EM0.P'ERT WBUn <br /> ANY PROPPETORPAR:NEPIEXECUnVEri YIM E EACH ACCIDENT I{1,DDO,000 <br /> OD saaAyEMBEP EXCLUDED) NA (t. <br /> dINMRen In NM E L DISEASE-EA EM PLOYEEI 11,000,000 <br />' eeAt Ott<ree J�F°'o'PE=.-.nNc,..�,�. 1E L wsEABE.POLICY UNET 1 11.000,000 I`1 <br /> B LiabWtyonal AEE7258601 1102J21/2012102.121f20111 156,000.000 arm!aggr. <br /> • <br /> DESCRIPTION a OPERATIONS/LOCATIONS/VEHICLES IA ACORD ut AeemA Rants Samna emay Rad n neunel <br /> Professional Liability coverage is wrtben on a claims-made and reported basis. <br /> CERTIFICATE HOLDER CANCELLATION <br />' For Proposal Purposes SHOULD ANY OF THE ABOVE DESCRIBED POLICES OE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF.NOTICE WILL BE DELIVERED DI <br /> ACCORDANCE WITH THE POLICY PROVISIONS. T I <br /> ,i <br /> AUINORME D REPRESENTATIVE <br /> CIS <br />' I OLA's nL 04SL-O[.FLS— ,;E <br /> 01988-2009 ACORD CORPORATION.All nights reserved. <br /> CITY OF SUNNY ISLES BEACH <br /> • RFQ NO. 12-04-02 <br />