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Fax sent by STAB S��a iesuuecc N CERTIFICATE OF INSURANCE 05 -23 -11 09:10 Pg: 2/3 SUCH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER NAMED BELOW WILL NOT BE CANCELED OR OTHERWI$E TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER, BUT IN NO EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE DOES NOT CHANGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW. This certifies that: M STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois ❑ STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois ❑ STATE FARM COUNTY MUTUAL INSURANCE COMPANY OF TEXAS of Dallas, Texas ❑ STATE FARM INDEMNITY COMPANY of Bloomington, Illinois, or ❑ STATE FARM GUARANTY INSURANCE COMPANY of Bloomington, Illinois has coverage in force for the following Named Insured as shown below: G C C0NSTRUC'1'lUN AND CONSULTING SFRVTCF.$ LLC NAMED INSURED: ADDRESS OF NAMED POLICY NUMBER EFFECTIVE DATE OF POLICY DESCRIPTION OF VEHICLE (Including VIN) LIABILITY COVERAGE LIMITS OF LIABILITY a. Bodily Injury Each Person Each Accident b. Property Damage _ Each Accident c. Bodily Injury & Property Damage Single Limit PHYSICAL DAMAGE COVERAGES b. Collision EMPLOYERS NON -OWNED CAR LIABILITY COVERAGE HIRED CAR LIABILITY -- COVERAGE FLEET• COVERAGE FOR ALL OWNED AND LICENSED MOTOR VEHICLES k, AGENT l.hy! F606 05 /22/11 Signat e of Au ri d Representative Tithe Agent's Code Number Data Name and Address of Certificate HQlder Name and Address of A ent CITY OF SONNY 1;LES Bt;ACH KEITH BRADSHAW 10070 C:OLL7NIS AV&,, 12092 BISCAYNF RT.Vr3 -, SUNNY ISLES REACH, FL.33160 N. MIAMI, FL- 3:5181 INTERNAL STATE FARM USE ONLY: ❑ Request permanent Certificate of insurance for liability coverage - 122429.3 Rev. 07 -26 -2006 ❑ Request Certificate Holder to be added as an Additional Insured. 2221 N- E. 164' ST., 5TE 337, N. M1i1M1 BEACH, FL. 33160 6:37 5',88 D03 59C 011103/11- 10,x03/17 ENOL 0 YES ❑ NO ❑ YES ❑ NO I ❑ YES ❑ NO I ❑ YES ❑ NO ]000000 1000oa0 1000000 ❑ YES ® NO $ Deductible ❑ YES ❑ NO $ Deductible ❑ YES ❑ NO $ Deductible ❑ YES ❑ NO $ Deductible ❑ YES $ ® NO Deductible ❑ YES $ ❑ YES ❑ NO Deductibic ❑ NO ❑ YES ❑ NO $ Deductible ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES S n YES ❑ NO Deductible ❑ NO ® YES E] NO {g YES C1 NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES [] NO I ❑ YES ❑ NO I ❑ YES ❑ NO I ❑ YES ❑ NO