HomeMy WebLinkAboutCertificate of Liability Insurance 4Ni5K M(aM[ SUP PAGE 02/04
J ACORD CERTIFICATE OF LIABILITY INSURANCE
PRODUCER -
JLM Risk Management Group
260 Peachtree St., Suite) 501
Atlanta, Cdl 30303
Phone:404 874--2929 Fax:404 874-2923
INSURED
Zanies E. Scott Community Assoc
23BD N.W. 54th Street
Miami FL 33142
COVERAQE8
OP ID MO DATE (MMrpp/YyyY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAT}ON3 / 0 5
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 NAIL #
INSUriER.A• MI lAG.lohLA Infur,cnoo cmmC .ny
INSURER B; IlyLfoi. National Iniurnnc, Co
INSURER C; Commerce and Iladuatry
/NSURER D:
INSURER E.
THE POLICIES Of INSURANCE L{$TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE I:DR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CCNDITIaN OF ANY CONTRACT CR OTHER DOCUMENT WITH RESPECT TO whim -I TWS CERTfFICATE MAY BE rssuED oR
MAY PERTAIN. THE fNSURANCE AFFORDED EY THE POLICIES DESCRIBED HEREIN IS SLJaJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED OY PAID CLAIMS.
Nal•5 ilU'I.
LTR WIC
TYPE OF INSURANCE
GENERAL LIABILITY
X
COMER GAL OENERAL LIABILITY
CLAIMS MADE I OCCUR
GENL AGGREGATE LIM
IT APPLIES PEFI.
X POLICY 7 JEpT LOC
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED AUTOS
SCHSOUI,ED AUTOS
HIRED AUTOS
NON•DWNED AUTO
GARAGE LIABILITY
ANY AUTO
t7SCESSIUMBRELLA LJABILITY
POLICY NUMBER
PHPX111618 6
PHPF1116185
app
POLICY EFFECTIVE; jPOLICY-EV/NA I ION
BATE'(MI.VbDKY) DATE iMm/DE/YYl
04/10/05
04/10/05
04/10/06
LIMITS
EACH OCCURRENCE
uAMAL+t-TCrRENrt❑
PREMISES (Ea occurenea)
MED EXP (Any ono person)
PERSONAL & ADV INJURY
21,000,000
$100, 000
$ 5, 000
21,000,000
GENERALAGGIiEGATE $ 3, 000, 000
PRODUCTS - COMF/OPAGO $ 3, 000, 000
04/10/06
COMBINED $INQLE MOT
{En acoldoni)
BODILY INJURY
1Per person)
$1,000,000
ODDLY INJURY
(Par aocldwnl)
X OCCUR El CLAIMS MADE
DEDUCTIBLE
X RETENTION S 10, 000
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/pARTNF,R/EXECUTIVE
OyFF!CEWMEMBER cXCLIJPE1)?
SPECIAL PAOviSIONS below
OTHER
FM1130437E7
MC9683335
S D&0 Liability 4905009
04/10/05
10/0&/05
04/10/05
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSION& ADDED BY ENDORSEMENT / SPECIAL O I ISIONS
The City of Miami ill nod as additional immured with respect, to general
liability and auto liability arising out of the operations of the namedinsured.
04/10/06
10/08/06
04/10/06
CERTIFICATE HOLDER
City of Miami.
aohn Lyons (305-400-5224)
444 SW 2nd Avenue, 24d Floor
Miatd. FL 33131
ACORD 25 (2001/08)
OPERTY DAMAOE
(Per sctlden»
$
AUTO ONLY - EA ACCIDENT $
OTHER THAN
AUTO ONLY:
EA ACC $
AGO F
EACH OCCURRENCE $1,000,000
AGGREGATE
$1,000,000
S
x
W U BTATU.
TORY LIMITS
$
E,LL EACH ACCIDENT
ER
$100,000
EL DISEASE -.EA EMPLOYEE
E,L DISEASE • POLICY LIMIT
$ 100, 000
$ 500, 000
Aggregate 1,000,000
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCE;LLFA BEFORE THE EXPIRATION
DATE THEREOF, THE f$SUING INSURER WrLL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE To DO SO SHALL
IMPOSE NO OBLIWATICIN OR LABILITY OF ANY KrND UPON THE ENSURER, ITS AGENTS OR
REPREEENTAT1VES,
AUTHORIZED REPRESENTATIVE
Miranda Greene
C9 ACORD CORPQRATION 19&8
V..f ;,..�f LC%4JJ L J. 1 J
N rJ clo r {
JLM RISK MGMT
ADORD 25 {2001/0aj
IMPORTANT
PAGE r73/94
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s),
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate &es not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the Issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon,