HomeMy WebLinkAboutexhibit 5- certificate of insACORD CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
Oswald Trappe & Co. Ft. Myers
P. 0. Box 60139
Ft. Myers FL 33906-6139
Phone:239-433-4535 Fax:239-433-4148
OP ID DATE (MM1DCVYYYYI
DAVI-il 09/02/03
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURED
David Plummer & Associates
1750 Ponce Deleon Blvd
Coral Gables FL 33134-4417
INSURER A: The Hartford Insurance Co. 22357
INSURER B:
INSURER C:
INSURER D:
INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSK
LTR
AULM
INSRC
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMIDDIYY}
POLICY EXPIRATION
DATE IMMIDDIYYI
LIMITS
A
X
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
21SBALD5168
08/11/03
08/11/04
EACH OCCURRENCE
$ 1 r 0 00 , 00 0
X
UAMAtit I U HtN I hi)
PREMISES (Ea occurence)
$ 300,000
CLAIMS MADE X OCCUR
MED EXP (Any one person)
$ 10 , 0 0.0
X
Contractual Liab.
PERSONAL&ADVINJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2, 0 0 0, 0 0 0
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
JECT LOC
POLICY - PROpi
A
AUTOMOBILE
LIABILITY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
21UECVP9351
07/23/03
07/23/04
COMBINED SINGLE LIMIT
(Ea accident)
$ 1, 0 0 0 , 0 0 0
X
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE
LIABILITY
I ANY AUTO
AUTO ONLY- EA ACCIDENT
$
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
A
EXCESS/UMBRELLA LIABILITY
21SBALD5168
08/11/03
08/11/04
EACH OCCURRENCE
$ 2, 0 0 0, 0 0 0
X
OCCUR CLAIMS MADE
AGGREGATE
$ 2, 000, 000
DEDUCTIBLE
RETENTION $
$
$
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
MIf yyeS, deSCnbe under
IIAZ PROVISIONS below
OR STATY LIMITSS ER O
TOR
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
$
E I. DISEASE - POLICY LIMIT
5
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
Re: Dupont Plaza Project
Certificate holder is named as additional insured with interest in insured's
operations with respect to General Liability only.
CERTIFICATE HOLDER
CANCELLATION
City of Miami
Planning & Zoning
Attn: Lilia Medina
444 SW 2th Ave 3rd Floor
Miami FL 33130
4
CITY444
SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIC
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORPRESENTATIV
m ACORD CORPORATION 19t
ACORD 25 (2001108)