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Certificate of Insurance
^ l SYZYG -2 OP ID: SG DATE (MM/DD /YYYY) A CERTIFICATE OF LIABILITY INSURANCE �� 08/05/2015 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: Sh aron Gardner Insurance Services Group, Inc. PHONE (ac No): 410 - 296 -7490 309 International Cir, Ste 100 (a/C, No, Ext): E Iusa.c0m s ardner s Hunt Valley, MD 21030 ADDRESS: 9 9 Sharon Gardner INSURER(S) AFFORDING COVERAGE Nom# INSURER A : USLI INSURED SYZYGY CONSULTING INC. INSURER B: Dr. Thomas James INSURERC: 1400 NE 103rd Street INSURER D: Miami Shores, FL 33138 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THS IS TO ND CATED. CERTIFY NOTWITHSTANDING POLICIES REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT POLICY O PERIOD 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR -- 'ADDLISUBR. POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD' WVD POLICY NUMBER (MM /DDIYYYY) (MM /DD /YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PPP1551238 05/15/2015 05/15/2016 DAMAGE TO RENTED 300,000 CLAIMS -MADE I X I OCCUR PREM ISES ( occurrence) $ MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1 ,000,000 GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: 2,000,000 PRODUCTS - COMP /OP AGG $ PRO- LOC $ POLICY JECT OTHER: COMBINED SINGLE LIMIT $ AUTOMp81LE LIABILITY COMBINED accident) BODILY INJURY (Per person) $ ANY AUTO ALL OWNED — SCHEDULED BODILY INJURY (Per accident) $ AUTOS _ AUTOS NON -OWNED PROPERTY DAMAGE $ _ HIRED AUTOS AUTOS (Per accident) $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS -MADE AGGREGATE $ DED RETENTION$ $ PER OTH- WORKERS COMPENSATION STATUTE ER AND EMPLOYERS' LIABILITY Y I N E.L. EACH ACCIDENT $ ANY PROPRIETOR /PARTNER/EXECUTIVE N / A OFFICER /MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) , If yes, describe under E.L. DISEASE - POLICY LIMIT $ 'DESCRIPTION OF OPERATIONS below I ! I DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is named as additional insured with regard to General Liability coverage for work performed by the Named Insured 7:1 .a ril Ilh► 311i;NOil CERTIFICATE HOLDER dA del / SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I OR NOTICE WILL BE DELIVERED IN T §jn E POLICY PROVISIONS. Amy Heavlin, Clerk of the Court & Comptroller ki el U 41 `(3q TIATA/ E Monroe County bn G� �ttT� ' anon r r 1 500 Whitehead Street - - - ,Key West, FL 33040 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD