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<br />ACORD CERTIFICATE OF LIABILITY INSURANCE I DAU1IMI.I-!lDlVYYYl
<br /> '" 08/04/2011
<br />I'ROOUC~1l (305)822-7800 FAX 305-362-2443 THIS CERTIFICATE IS ISSUED AS A PMTTER OF INFORMATION
<br />Coll illSI~OI.th, Altar, Fowlar & Fr'cllch LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />ttOLDER. THIS CERTIFICATE DOES tlOT AMEND, EXTEND OR
<br />8000 Governors SqllarQ Blvd. I Suite 301 ALTER THE COVERAGE AFfORDED BY THE POLICIES BELOW.
<br />Miami Lokes, FL 33016
<br />lOI'aid" Gonzul ez Ext 159 zgonza1ez@caffllc.com INSURERS AFFORDING COVERAGE NAIC#
<br />ItI~UR(D SRS Engineering, Inc. ItlWRtR A: lIal'tford Casualty InsuranCQ Co A XV 29424
<br /> 5001 SW 74th Court 11I~)I>;ER6; Travel aI's Casual ty & Surety Co A XV 19033
<br /> Suite 201 ItISl.~ER c: RLI Insurance Co. A+ XI
<br /> Miami, FL 33155 11I"~flEA 0:
<br /> ItlS\,fiERF.:
<br />COVERAGES
<br />"THE POLICIES OF INSURl.NCli I..ISTI;Q IlEI.OW HAVE OF-EN ISSUED TO THE INSJ,.IAEDNAMED AllOVE FOR 1HE POLICY PERIOl) INDICATED. NOTVllTHSfANOI~(l
<br />III-N REQUIREMENT, 1ERM OR CONDmOU OF ANY CONTRACT OR OTHER DOCUMiiNT WITH RESPECT 10 WHICH THIS CElnFICATE MAY BE ISSUED OR
<br />,.,,,y PERT A1t4. TilE INSURANCE AFrORDED BY TIlE POLICIES OESCRIOED IIERE;N IS SUBJECT TO ALL TfjE TERMS, EXCLUSIONS NIO CONDITKlNS 01' SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS.
<br />Itl!lft DO' TYPE OF IJlgURmeE PllLlCY IIUII.UII rO~lo.Ur.~~~,1!:ve I PO~ICY n~lno\TI~II LIt.tJTa
<br /> ceNSRA.L LIADlutY 21SBAT04453 03/04/2011 03/04/2012 rACII OCCt.MCNCC $ l,OOO,OO~
<br /> ~ CC\W.IEI'l;)IAJ,. OEUEAAL 1I1<6~1lY O~-,.v,OE TO REN'TED $ lOO,OOC
<br /> ~b CLNMS IJo\Oo []J occun MEO CXP (o\m ono ",..on' $ lO,OO~
<br />^ ffnWIMl &J..OV IUJUfI( $ 1.000 ooe
<br /> - 2,OOO,00e
<br /> - OttlEP.Al AOOflWATE S
<br /> Otll1. AOORCOATC liMIT J.I'l'urs ren, mODUCTG . COMPiOP AGO $ 2.000 ooe
<br /> XlI'OLK;V n ~ n LOC
<br /> ~TO/.f09ILE LlADlI.lTY CO/AEI/lEO &'AGl F.. liMIT 5
<br /> NIYAl.JTO <F.HOOO~'r,J
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<br /> - All O'fI.'JW"'UTOS snDIl Y Ill).iF.Y
<br /> Cr., p_~~ $
<br /> ~CH(DUL[O AUTOS
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<br /> Ijl~.l:O AUIOS eoOlY Ilt\liH
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<br /> NONOWUEO I.UTOS (1'., ><<ld'"11
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<br /> R 1.lf( AUTO OTHER 111.\\/ E"'ACC $
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<br /> AUTO aUl V: AGO $
<br /> t:rSi> UAlnAELL,l, UA~ILlTY EACH OCCIJF AEr<<:e $
<br /> OCCUR 0 ClA1'J5 l'J,OE '.~ORIiOATE $
<br /> $
<br /> H DEDUDlIBLF. 5
<br /> RETENTIO!-I $ $
<br /> \'IOflKfRS CO\lPEIiS'" 11011 olliO UB3294TlO8 01l/21/l011 08/21/2012 XJ;WG:;'AfU~LJ~TH'
<br /> _ .JCflY,LII1JIS .en.
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<br /> O~f ~f\'MF.IlBF.R ElO:;lLtJED1 YES El. OSEA$f. €" wr1.OYt[ S 1 OOO,OO~
<br /> ~~~8I1~~~~~g tdllM' EU~SEASE.PlXICHt'JIT S 1,000,000
<br /> p~THrc . 1 L' b'l' ROPOOOH16 01/10/2011 01/10/2012 $1,>000,000 Each C1 aim
<br /> ro CSSlona ,n, lty
<br />C C1 aims-~i'~C Form $1,000,000 Annual ^"grcgatc
<br /> Ratro: 12 20/96 SZS.OOO Deductible
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<br />"SPECIMEN"
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<br />5}!OUlO "'IY Of 111 Ii AGO"" on.r;OIIlED I'OllC11!S Il" eMICoUED llEfO"e THe
<br />EXFfIlAnOIl PATE THEn;;Of. THE rSs~II(l"lSuIIER \'~Ll EltOf,l,VOA TO '.\All
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<br />PUT FAILURE TO "'All Buell II011<:E GJIAU WOlle lIO OBLlOo\JIOII on L1MlllITV
<br />OF AIIV ttrJD UPOlllHE ItISIIRER, ITa "OElITS 011 REfRESEtITATrit:s,
<br />AUTHORIZED REPRESEHTAlII'E.. <1~J2 ''-.1.-# A..-7 ~
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<br />ACORD 25 (2001l00}
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