HomeMy WebLinkAboutexhibit article1.5c_ _RD. CERTIFICATE OF LIABILITY INSURANCE
3ER
on,Washburn & Forster Ins..
1: inf oLswwf ins . com
1 So. Dixie Hwy. Ste. 300
!crest FL 33156-3151 -
le:305-666-6636 Fax:305-662-7778
:D
Belafosste-Tacolcy Center
MiaTL NWFL9th 331Ave7
INSURER A:
INSURER B:
.INSURER C:
INSURER
INSURER E:
CSR IG
BELAF-1
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
Royal Indemnity Compass
:RAGES
G
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 0TO WHICH THIS CERTIFICATE MAY BE ISSUED OR DIN
REQUIREMENT,
PERtA1CN�� THE
LIMITS TS AFFORDED
BEEN REDUCED BY PAID CLAIMS. SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
iCIES
POLICY NUMBER
SRC
TYPE OF INSURANCE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
GEM. AGGREGATE LIMIT APPLIES PER:
POLICY dE ■ LOC
AUTOMOBILE UABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED ALTOS
NON -OWNED AUTOS
x
x
x
GARAGE LIABILITY
ANY AUTO
EXCESS/UMBRELLA LIABILITY
OCCUR Ei CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
AON IPROPRIETOR/PARTNER/EXECUTIVE.
RW RIETOR/PAEEMBER TNER/EXECU
CLUDED?
If yes, dsw1bs under
SPECIAL PROVISIONS below
OTHER
Professional R2ST341394
,RIPTiON OF OPERATIONS 1 LOCATIONS !VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT ! SPECIAL PROVISIONS
LIabilit,
:y of Miami as additional insured as respects to agreement for General
ability only-
R2SP243992
R2ST341395
•
DATE MMIDOIYY
02/22/04
02/22/04
DATE MMI00
02/22/05
02/22/0.5
EACH OCCURRENCE
PREMISES
•
•
LIMITS
Ea accurense
MED EXP (Any one person)
PERSONALS AOV INJURY
GENERAL AGGREGATE
PRODUCTS • COMP/OP AGG
COMBINED SINGLE LIMIT
(Ea sceiden1)
BODILY INJURY
(Per person)
(POeraccieINJURY
PROPERTY DAMAGE
(Per awdIM)
AUTO ONLY - EA ACCIDENT
EA ACC
AGO
OTHER THAN
AUTO ONLY:
EACH OCCURRENCE
AGGREGATE
LTIFICATE HOLDER
City. of Miami Department
of Parks & Recreation
Attn: Ed Blanco
444 SW 2 Avenue
d.auni FL 33128
02/22/04
02/22/05
TORY LIMITS ■
E.L. EACH ACCIDENT
E.L DISEASE - EA EMPLOYE
NAIC #
31,000,000.
s 100,0 ' O.
s 5,000
51,000,000.
s 3, 00C, 000.
33,000,000.
E
E.L. DISEASE • POLICY LIMIT
Par claim
A-Qre ate
DATE (MMIDOIYYYY/
03/03/04
s 1,000,000•
5
S
S
$
$
$
$
s
$
$
5
$
5
1, 000, 000 •
2, 000, 000 •
CANCELLATION EXPIRATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXP
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WFUTTENL
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 90
SHAL
IMPOSE NO OSLIGATION•OR LIABILITY OF ANY FUND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Thomas E. Washburn CPC'CT
ACORD CORPORATION 198E
)R❑ 25 (2001/08)