Certificate of Insurance
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"i ACORDj
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,PRODUCER" ,
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Aon Risk Services ,
201 Alh'V'lillra Circle, Suite 900-
(bral Gables, FL mt3.1
DATE(MMIDO/VY)
5/20/98
THIS.CERTIFICAl"E~.fS'1SSUED AS AMAtTEROF'INFORMATION\'
ONLY AND CONFERS-NO -RIGHTS UPON . THE CERTIFJCATE
HOLDER; . THIS''CERTIFICATE -nOES. 'NOT . AMEND, .EXTEND' OR
ALTER THE COVERAGE AFFORDED . BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
National Union Fire (Revised)
INSURED
COMPANY
A
I
. I-:_u
or
)
I COMPANY
1__ B
1, cm'cANY
COMPANY
D
THIS IS TO CERTIFY THATTHE POLICIES OF1NSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCYPERIOD
!NDICATED, NOTWITHS'rANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS
,'eERTlFICATEMAY'BE1SSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO-ALL THE TERMS,
.:',':E:XCLUSIONS ANDC()f~DITIO~ OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
;..,,; ..
(hn'l'll1nity.Asphalt Corp.
14005 NW 1:B6th Street
Hialeah, FJL 3ro18
Ins. Co. of the State of Penn.
co
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MNVDDrrY) DATE(MNVDD~
LIMITS
A
COMMERCIAL GENEFlAL LIABILITY
CLAIMS MADE i=xl OCCUR
OWNER'S & CONTRACTOR'S PROT
817 81 64 CJ7/01/97 CJ7/01/98
SIR: $25000 each occ
$10??oo aggregate
after v.bich $1??oo
SIR applies
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED EXP (Anyone person) $
I A 833 52 16 CJ7 /01/ 97 07/01/98 COMBINED SINGLE LIMIT $ 1, 000, 000
I COO:Ip.rehenst ve & I
I ALL OWNED AUTOS BODILY INJURY
$
/ SCHEDULED AUTOS Collision (Per person)
X HIRED AUTOS Deductible: $1,000 BODILY INJURY 1$
i.1 X NON-QWNED AUTOS APPR VED BY RISK MA ACrMENT (Per accident)
X Physical Damage PROPERTY DAMAGE $
<- BY
I
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OATE OTHER THAN AUTO ONLY:
WA!VER N/A EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY EACH OCCURRENCE 20.000.000.
A X UMBRELLA FORM BE3098846 7/1/97 7/1/98 AGGREGATE 20 000 000.
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION I'ND
EMPLOYERS' LIABILITY
B THE PROPRIETOR! INCL 817 91 88 07/01/97 CJ7/01/98 EL DISEASE - POLICY LIMIT
PARTNERSlEXECUTIVE
OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE
OTHER
DESCRIPTION Of OPERATlONSIlOCATIONSlVEHICLESlSPECIA1.ITEtlS ~t:SS
Re: Cudjoe Keys Roads III - Roadway l.mproveffien
CACII3763
Certificate..ho.lder is additional insured as respects to the above policies with the
,
or;
f.
OR. REPRESENTATIVES.