HomeMy WebLinkAboutCertificate of Liability Insurance 3A CERTIFICATE, OF LIABILI'
IOOUCER
DCG & Associate, Inc.
536 Biltmore Way
Coral Gables, F1. 33134
305 447 9577
EIUFIED
De Hostos Senior Center, Inc.
2902 NW 2nd Avenue
Miami, FL 33127
1305 573 6220
________ OATE(MMlDD1YYYY)
INSURANCE e/16/2005
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#
IN&URERA: Scottsdale Insurance CO.
,r__
INSURER B: Florida Retail. Federation
1NsuPt:Rc: Hartford Fire Ins. ancg CO.
INSURER D:
INSURER E:
OVERAGES
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.. c7I4LI� J�A��p
SR �e POLICY NUMBER P ATEY MIDE[YYVE PDATE(MMIDD/YY1 N
fR NIRO 1N
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
1 CLAIMSMADE TO OCCUR
GE IL AGGREGATE LIMIT APPLIES PER.
POLICY JECT LOC
AIJTOMDBILE1_IABILITY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON•OWNEDAUTOS
GARAGE LIABILITY
HANY AUTO
EXCESS/UMBRELLA LABILITY
—1 OCCUR CLAIMBMAOC
DEDUCTIBLE
RETENTION _ 5
WORKER3COMPENSATIONAND
EMPLOYERS LIA8ILIiY
ANY RROPRIETGAIPARYNERtexacuTIVk
OFFICERrMEUBER EXCLUDED?
If yet; 'macaw under
SPECIAL PROVISIONS below
CLS1094071 12/04/04
12/04/05
�IMI
EACH OCCURRENCE
SASKGETONEN!EU
PREMJSF$ (Ea otavonoe)
MED EXP (Any one person)
PERSONAL& AOV INJURY
: 1, 000' 000
100,000
$ 5,000
$ 1, 0045,000
GENERAL AGGREGATE S 1, 0 0 O r 0 0 0
PRODUCTS-COMPIOPAGG T 1, 000,000
COMBINED SINGLE LIMIT
(Ea accident}
BODILY 3NJU RY
(Par perm))
PVOILYINJURY
(Per aceidEnt)
PROPERTY DAMAGE
(Per ;CCldent)
b
AUTO ONLY • EAACCIDENT
6
OTHER THAN
AUTO ONLY' AGG
EA ACC
FRFSTF052030553 04/07/05
OTHER
C FIDELITY BOND 21BDDCC0009 01/05/05
_ 27/19 05
DESCRIPTION OF OPERATIONS /LOCATI0NS1VEHICLE6) EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
04/07/06
01/05/06
7/19/06
EACH OCCURRENCE
AGGREGATE
b
a
X 3�o vtin1T- I lO�R• ��
E.L. EACH ACCIDENT $ 00, 000
DISEASE - to EMPLOYEE $ 100,000
E.L DISEASE • POUCY LIMIT b 500,000
$20,000 Emp- Dishonesty
$20,900 rOrgery & Alteration
Add $7,0,000 Emp AiH/F . A
N-L.
City Of Miami is listed as Loss payee with respect to the Fidelity Bond issued
by The Hartford. City of Miami is also listed as additional insured with
respect to commeroial general liability
FIDELITY FOND RAS SEEN EDEDORBEP ADDTONO $20,000 IN EMPLOYEE DIBH0t7ESTY, FOROERR & ALTERATIONS 7/19/05
+wr.
CERTIFICATE HOLDER
City Of Miami
Department Of Community Development
444 SW 2nd Avenue
Second Floor
Miami, Fl. 33130
ACORc25(2004s0B)
CA CELLATIQN
SHOU0 ANY OF THE ABOVE DESCRIBED POLICIE& RECANCELLED BEFORE THE ExP1RAT10
7R TO MAIL,,,,_ DAYS WRITTEN
DATE THEREOF, THE ISSUING INSURER VALL EN)) DEA
NOTICE TO THE CERTIFICATE HOLDER�AI�IE TOiT LEFT, BUT FAILURE •(0 00 50 SHALL
IMPOSE NO 05L4GAFION DR LIABILIe01?�I� XI ''LIP THE INSURER, ITS AGENTS 0R
REPRE65NTATLVES. IIIIII //
AUTHORIZED REPRESENTATIVE
ORPORATION HISS
IP/TO 3E d
93IVIDOSSV ? 99O
8L96L171790E SS:TO 9022/91/89