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• <br /> • . <br /> • <br /> • <br /> • <br /> CERTIFICATE OF INSURANCE <br /> • SUCH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER WILL NOT BE CANCELED OR OTHERWISE <br /> TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT IN NO <br /> • <br /> EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DATE WRITTEN.THIS CERTIFICATE OF INSURANCE <br /> DOES NOT CHANGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW. <br /> • This certifies That: 0 STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington.Iuino6,or <br /> • in force O STATE FARM FIRE AND CASUALTY COMPANY of Bbansgton.Illinois <br /> has forcoverage the following Named Insured as shown below: <br /> • Named Insured COSTOYA, FRANCISCO JR 8 ALBA <br /> • Address of Named Insured 5230 S. UNIVERSITY DR STE 103 <br /> • DAVIE.FL 33328 <br /> • POLICY NUMBER 9110245013 59 <br /> • EFFECTIVE DATE OF 64113112.10.1112 I I <br /> POLICY <br /> ® DESCRIPTION OF 10 LAND ROVER LR4 SPORT <br /> SALAM2Dl3AA536527 <br /> V IlCLE <br /> • LIABILITY COVERAGE f OYES ONO ®YES ONO I ®YES ONO I EYES ONO <br /> LIMITS OF LIABILITY <br /> • I a.Bodily Injury <br /> Each Person <br /> • a.Bodey Injluy I ' <br /> Each Atcidera <br /> • D.Property DamageI <br /> c.Bodey Injury 8 <br /> Property Damage 61,000,000.00 <br /> • Single Lank Each <br /> Acrilent <br /> • PHYSICAL DAMAGE Duo OYES UNO OYES ❑NO I OYES ONO <br /> COVERAGES 550410Q DeductibleDeductible Deductible Deductible <br /> a.Comprehensive <br /> • BYES LJNO LYES Duo OYES ONO OYES LINO <br /> • 0.C ioA 5500.00 Deductible Deductible _ Deductible _ Deductible <br /> EMPLOYER'S <br /> • NON-OWNERSHIP <br /> COVERAGE DYES ONO OYES NO OYES ®NO EVES ONO <br /> • HIRED/ COVERAGE I OYES NO OYES ONO OYES NO OYES NO <br /> I <br /> • 1 [ .4 AGENT 2719 0424!2012 <br /> ® Signature of Authorized Repress n. e This Agent's Code Number Date <br /> Name and Address of Certificate Ho. er Name and Address of Agent <br /> • r- i <br /> JANET FERNANDEZ INS.AGENCY <br /> • I City of Sunny Isles Beach 10600 GRIFFIN RD STE 101 <br /> 18070 Collins Avenue COOPER CITY,FL 33328 <br /> • Sunny Isles Beach, FL 33160 <br /> ® <br /> H J J I <br /> • <br /> • <br /> Check rf a permanent Certificate of Insurance for fiat bty coverage is needed: p <br /> • Check if the Ceruflcate Holder should be added as an Additional Insured: O <br /> • Remarks: <br /> • <br /> • <br /> ® 15614302 Rt..9-94 Prelec n U S A <br /> • <br /> • <br /> • <br /> O 4 <br /> 0 <br />