HomeMy WebLinkAboutExhibit 16Attachment I:
The City's Insurance Requirements for
Provider with
Provider's
Insurance Certificates
rjj:Docurnent PSA1
ACORD., CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
MORTON D. WEINER/AMPAC
CORAL GABLES
362 MINORCA AVENUE
CORAL GABLES is 33134
Phone:305-444-2324 Fax:305-444-4990
4NSUREO
Museum of Science. Inc.
3280South31iami Avenue
Miami
csR GP
MUSEU-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.
VNSURERS AFFORDING COVERAGE
IN$LR.ER A: Traveler, P rop.rty o Co malty
INSURERe' AXA Art Insurance Company
INSLNERC: Zenith Insurance Company
INSURER D' Rational union fin :neurone,
COVERAGES
A POLICIES E T, TERM
OR CONDITION
ION OF 101Y CONTRACT BEEN ORO TH THE INSURED
ISW T IRESPECT TO pL O W ERh1 IS CEW$FICAOD p �� Y EIS UEOOF `i H
OR
MIYRERTAIIi. HEITSRMORCAFF DEOFMT!OLICEOOTHERDOEREINI
WITH RESPECT TO WHICH THIS CERTIFICATE ATE NOTWITHSTANDING ISSUED
MAY POLICIES
PERTAIN. THE INSURANCE ITS AFFORDED BY THE POLICIESCE DESCRIBED H •r
FlJLICIESArGREGATELfMIT55HOVJNMAY HAVEBEEN REDUCE05YPAID CLAIMS. DATE{MMIDDNY)
.rwt>Fa1�!1
TYPE OF INSURANCE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE u OCCUR
GENT_ AGGREGATE LIMIT APPLIES PER.
. III LOC
PULICI' JECT JECT
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
N[,N•OWNE0 AUTOS
GARAGE LIABILITY
ANY AUTO
EXCESSIUMERELLA LIABILITY
OCCUR E CLAIMS MADE.
DEDUCTIBLE
■ R£TENT4ON $ 10 , 000
WORKERS COMPENSATION AND
EMPLOYERS` LIABILITY
ANY OFFICECR/MEMBE EXCLUDED?E'UT1VE
If yes, deecribo tIf 4+
SPECIAL PR.GVIS10N5below
729X7069
BA0454C76405SEL
BL5194046
Z836497206
03/21/05
09/01/05
03/21/05
01/01/06
03/21/05
03/21/06
PERSONAL d ADS! INJURY
GENERAL AGGREGATE
PRODUCTS • COMP/OP AGO
09/01/06
03/21/06
01/01/07
COMBINED SINGLE LIMIT
(Ea sodden')
IBODlILYperIN.) RY
BODILY INJURY
IP.I occident}
03/21/06
OTHER
Inland Marine
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
CERTIFICATE HOLOER
CFA204399
City of Miami
Department of Risk
Management
444 SW 2nd Ave 9th Floor
Miami FL 33130
ACORD 25 (200if09)
CITYOTM
AUTO ONLY • EA ACCIDENT
E.L. EACH ACCIDENT
$1,000,000
$ 100,000
$1,000,000
$2,000,000
$2,000,000
1,000,000
$1,000,000
E L. DISEASE - EA EMPLOYEE
E L. DISEASE • POLICY LIMIT
$10,000,000
$10 000 000
$500,000
1E00,000
7,000,000
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE SXPIRA I N
ON
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES,
O ACO RD CORPORATION i9Be
IMPORTANT
it the certificate holder is an ADDITIONAL INSURED,
the
holder (ies) lieu must
ot be endorsed.ee Anstatement
on this certificate does not confer rights to the c certain policies may
s and conditions of the
If qufB an endorsement.
IS Wnt. sEDement ono the this certificate does not confer rightslto the certificate
require an endorsement. A
holder in lieu of such endorsernent(s).
DISCLAIMER
onstitute a
ct
The Certificate of insurance on the reversee oarthis form p producer, and theoes not ccertificate holderanorbdoeseit
the issuing insurer(s), authorized representative afforded by the policies listed thereon.
affirmatively or negatively amend, extend or alter the coverage
ACORD 25 (20011OS1