Certificate of InsuranceClient#: 31137
BERMEAJA
ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
F
11 /30/2010
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).
PRODUCER
CONTACT
NAME:
USI Insurance Services, LLC-CL
PHONE FAX
A/c No Ext : 954 607-4000 A/C, No):
200 West Cypress Creek Rd #600
E-MAIL
Fort Lauderdale, FL 33309
ADDRESS:
954 607-4000
CUSTOMER ID #:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURED
A: Hartford Casualty Insurance Com
29424
BerINSURER
l
Bay 8r Partners, Inc.
INSURER B : Hartford Fire Insurance Company
19682
2601 S u h
South Bayshore Drive
INSURER C : Continental Casualty Company
20443
Suit
Suite 1000
Miami, FL 33133
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: RFVISInN NIIMRFR-
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 REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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.
TYPE OF INSURANCE
POLICY NUMBER
MMIDD CY EFF
XP
MM/DD OLICY E/YYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE Fx] OCCUR
21UUNKK3709
11/11/2010
11/11/2011
EACH OCCURRENCE
$1,000,000
PREMISES Ea occurrence
s300,000
MED EXP (Any one person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
17 POLICY PRO- LOC
PRODUCTS - COMP/OP AGG
$2,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
21UUNKK3709
� r �
11/11/2010
11/11/2011
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
X
$
$
A
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
21XHUKK3260
11/11/2010
11/11/2011
EACH OCCURRENCE
$5,000,000
AGGREGATE
$5,000 000
DEDUCTIBLE
RETENTION 10000
$
X
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY
OFFICER/MEMBER EXCLUDED? ECUTIVEF7N
(Mandatory in NH)
yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
21WBZS6321
11/11/2010
11/11/2011
x WCSTATU- OTH-
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
E.L. DISEASE - POLICY LIMIT
$1,000,000
C I
Errors & Omi
AEH288262231
11/11/2010
11/11/2011
$1,000,000 Each Claim
$1,000,000 Aggregate
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
RE: Contract for Bernstein Park Project
Monroe County Board of County Commissioners are named as additional
(See Attached Descriptions)
Monroe County Board of County
Commissioners Attn: Michelle
Lee
1100 Simonton Street
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
&4_107P
ACORD 25 (2009/09) 1 of 2
#S5051769/M5050564
m 1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
P21 JA