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r(1 ' Proof of Insurance , to General Liability & Workman's Comp ACOR[7@AINOWYYYI CERTIFICATE OF LIABILITY INSURANCE DATE D01/17/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsemenL A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsementls). PRODUCER NCITEACT LesEe Acosta Commercial Lines-(305)443-4886 PHONE PAX 0.t,1212,10.3t?5443-228 IA/C,Nn): Wells Fargo Insurance Services USA.Inc_ laNE.0 u,ss: LesfieAcasta@wefsfargo.com 2801 South Bayshore Drive.Sute 1800 INSURER'S)AM FORDING COVERAGE I NAILa Coconut Grove,FL 33133INSURER A: Old Rept±&Insurance Company 24147 INSURED INSULTER 8: I SFM Services.Inc.(See Description of operations) INSURER C: J} 9700 NW 79 Avenue INSURER D: INSURER e.: Hialeah Gardens,FL 33018 INSURER F: COVERAGES CERTIFICATE NUMBER: 12438344 REVISION NUMBER:See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY ROU1REMENT,TERM OR CONDITION O=ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED CR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.UMITS SHOWN MAY HAVE BEEN RECIJCED BY PAID CLAIMS. TA3il i1411dG51RN POLICY EFF POLICY END LTR TYPED INSURANCE TINSDT n'n POLICY-NUMBER nVUP YYYYI IMSSVrJITYYYI I UNITS X COMMERCIAL GENERPLuaeILITY c EACH OCCURTZ;NCE S I,X ET A ■ MWZYI-D D0 03101117 03101/1 CLAIMSaLACE X OCCUR PREUE 5OR:Ru.. ■ 6 (Ea o,...-anal S `S�CLO WED EXP Qin,.ax pe"rrl} S 188120 PERSONAL aADVIH,ARY 5 1% 'CCC ® GENI.AGGRECATE LIMIT APFLIF..S PER CF LRAL ACCs CATS 5 30 E0[I PCEICY I X I Vi LOC PRCOIA'T5-GOrlPIOP ACfa s 2.=0,ECO OTHER. - S 110110BILE UAMUTY I VL',A7v:ET151Nalt UI I S F�acfA0T1 MI I ANY AUTO BADLY INJURY Wm ocr..on) IS CNThECI•iEDUL ED BOXY INJURY p—xi:Ricci I S CtS AUTCNLY 0.1T-05 _ NHED ICN-OSUSED =-rto=EHTYD.'M•.0 I S I AUTOS ONLY _AVYOSONLY IIRYa:CaaMl 1 S I I uMeRELLA Lisa I I OGCLR I I EACH OCCIARENGE I S I EXCEss LIAR I I CLAMS-MADE I ACCREOATE I S I I CEO I I RETENTIONS I I I s MOANERS COtPETtSAYgN o 03191/17 03/01/IS �I Si+tIutE I Lei" 1 A YIN M4VC30_72'rD0 1 41,m EMPLOYERS'LIABILITY ANYP.ROPRIETOR,PARTWERSIECLIWE I I NIA L EACH ACCIDENT S 1F�RZ . OFFICERAtMEIER EXCLUDED? ! IMlndatory in NM EL DIEEASE-EA EMPLOYEE]S iLWpS d�ee,.den:1k* DFSCOF OPERATIONS b•HH. E.L.DISEASE•POLICY LPATT I S 1L00 I DESCRIPTION OF OPERATIONS I LOCATIONS(V&OCLES IACORD 10T,additional Reworks ScMdTfk.miry be albrtrd d ware space es requited) The Certificate Holder is listed as an additionalinsured in respect to the General Liability policy when required on a writen contract or agreement. CERTIFICATE HOLDER CANCELLATION SAMPLE CERTIFICATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AuTNorazED REPRESEYTATNE 99 0 I - - The ACORD name and logo are registered marks of ACORD RI 1986-2915 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) • ES IHSFM SERVIC ,INE.