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~ . ACORD_ CERTIFICATE OF LIABILITY INSURANCE CSR C8 I DATE (MM/DD1YYYY) BEISW-1 02/16/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A M~TTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BROWN & BROWN INC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 8000 GOVERNORS SQUARE BLVD 400 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. MIAMI LAKES FL 33016-1588 Phone: 305-364-7800 Fax: 305-822-5687 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. HARTFORD INS OF THE S. E . 38261 INSURER B: HARTFORD CASUALTY INS CO 09263 BEISWENGER HOCH & ASSOC. INC. INSURER C: TWIN CITY FIRE INS CO 29459 NORONA LTD PO BOX 1368 FL 33160 INSURER 0: NORTH MIAMI BEACH, INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR lNSR[ TYPE OF INSURANCE POLICY NUMBER DAjE iMM/DDlYY1 DA TE'IMMIDDIYYl' LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 - A X X COMMERCIAL GENERAL LIABILITY 21UUNUT9243 12/31/03 12/31/04 ~~I.>.I;., _..,~v $ 300,000 PREMISES (Ea occurence) l CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 10,000 - PERSONAL & ADV INJURY $ 1,000,000 - GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , 000 , 000 ~ nPRO- n POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $ 1,000,000 A .!.. ANY AUTO 21UENLJ4417 12/31/03 12/31/04 (Ea accident) ALL OWNED AUTOS BODILY INJURY - $ SCHEDULED AUTOS (Per person) - HIRED AUTOS BODILY INJURY '--- $ NON-OWNED AUTOS (Per accident) - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIOENT $ ~ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE $ 2,000,000 B !J OCCUR 0 CLAIMS MADE 21XHUUT7094 12/31/03 12/31/04 AGGREGATE $ 2,000,000 $ ~ DEDUCTIBLE $ X RETENTION $10000 $ WORKERS COMPENSATION AND X IT~Wv"~I~h~Js I lu~r ER C EMPLOYERS' LIABILITY 21WBGD0141 12/31/03 12/31/04 ANY PROPRIETOR/PARTNER/EXeCUTiVE E.L. EAGH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? E,L DISEASE - EA EMPLOYEE '$ 500,000 If ~es, describe under S ECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *10 Day Non-Payment Cancellation clause applies. Certificate Holder named as an Additional Insured for General Liability coverages with regard to project work being conducted in the City. CITY OF SUNNY ISLES BEACH 17070 COLLINS AVENUE, ST. #250 SUNNY ISLES BEACH FL 33160 CANCELLA TION CI T 316 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA TlOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL * 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIA OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATI E CERTIFICATE HOLDER ROBERT HOLLANDE @ ACORD CORPORATION 198; ACORD 25 (2001/08)