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HomeMy WebLinkAboutCertificate of Liability InsuranceACORD. CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE IS ISSUED AS A MATTER Avante Insurance Agency, Inc. 7490 West Flagler Street mann.' C 1a a.ii s Phone:305-648-7070 Fax:305-648-7090 INSURED Action Community Center Inc. Miami FL 33172 OP1D .TOM DATE {MM(DDf( YY) ACTIO-2 07/11/05 THIS 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 INSURER A: INSURER B: INSURER C: Associated Industries Ins. Co. Soottada Le Irvui apes Co.pony Progressive Companies INSURER D: rrr Nartf ore' Insurance company INSURER E: NAJC COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREIYIENf. TERM OR CONDITION Of ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E 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. TNSR'TItJU L LTR NSRO A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE j X 1 OCCUR GEM. AGGREGATE LIMIT APPLIES PER: POLICY n JEC n LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS jC SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO EXXCEssIUMBRELLA LIABILITY —1 OCCUR I I CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe uncles SPECIAL PROVISIONS below OTHER B Personal Property Business Income cPS0693503 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 5% Wind dr Hail Deductible/ Location: 970 SW 1st St. #304 Miami, Fl 33172 D.BOND 21BDDAH7B07 7/02/05-7/02/06 $50,000 $500 DED City of Miami is listed as Additional Insured POLICY NUMBER CP50693503 04597898-4 2004327964 DATE�MID NYIk ATEMacy (MNI DYYIION 12/31/04 12/31/05 01/07/05 01/07/06 Qi LIMES EACH OCCURRENCE: ,._,._.. $ 500 , 000 UAMRL'C I u RKrI I to PREMISES (Es occurence) $100 ,000 MED EXP (Any one Person) $ 1. , 0 0 0 PERSONAL & ADV INJURY $Excluded GENERAL AGGREGATE $ 1, O 0 0, 0 0 0 PRODUCTS. COMP1OP AGG $ Excluded COMBINED SINGLE LIMIT (Ea accident $300,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per necklet -A) AJJTO ONLY - EA ACCIDENT • OTHER THAN AUTO ONLY: EA ACC AGG imiH OCCURRENCE XI LTORY LIMITS X I ER 11/20/04 11/20/05 E.L. EACH ACCIDENT $ 500 , 000 EL DISEASE. EA EMPLOYEE s500,000 E.L. DISEASE - POLICY LIMIT $ 500000 CPS0693503 12/31/04 12/31/05 12/31/04 12/31/05 1000 Ded . $20,000 1000 Ded $30,000 CERTIFICATE HOLDER City of Miami community Development Dept. 444 SW 2nd Ave., 2nd Floor Miami FL 33130 CITYOF1 CANCELLATION SHOULD AM' OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 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 SHALL IMPOSE NO OBLIGATION OR LLABILITY Of ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ,UTAi�RI?�, $!7R _y1 �:,�,,";'.;19.rti�,�',k;.,uW ©ACORD CORPORATION19B8 ACORD 25 {2001108) CSR GD Accum CERTIFICATE OF LIABILITY INSURANCE ACTIO-2 DATE (MM/DDIYYYY) 11/04/05 PRODUCER Avante Insurance Agency, Inc. 7490 West Flagler Street Miami FL 33144 Phone:305-648-7070 Fax:305-648-7090 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 Action Community Center Inc. 970 SW 1 Street #304 Miami FL 33172 INSURER A: Associated Industries Ins. Co. INSURER B: scettadete Insurance Company INSURERC: Progressive Companies INSURER D: rrr Hartford Insurance Company INSURER E: THE POLICIES OF INSURANCE LISTED BELOW I-AVE 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, -POLICY Iris LTR -ADO.POLICY NERD TYPE OF INSURANCE NUMBER POLICY Erhal.IIVI DATE (MM/DDtYY) EXPIRATION DATE (MMIDD!YYI LIMITS 5 X GENERAL X LIABILITY COMMERCIAL GENERA.LLIABILITY CPS0693503 12/31/05 12/31/06 EACH OCCURRENCE $ 500 , 000 PREMISES $ 100,000 CLAIMS MADE X OCCUR MED EHP (My ere person) $ 1 , 0 00 PERSONAL & ADV INJURY $ Excluded GENERAL AGGREGATE $ 1, 0 0 0, 0 0 0 GEM. AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ Excluded 7 POLICY n JET n LOC C X AUTOMOBILE LIABILITY ANY AUTO • ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 04597898-4 01/07/05 01/07/06 COMBINED SINGLE LIMIT (Ea accident) $30q,aoa X BODILY INJURY (Perpereon) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORlPARTNERlEXECUTIVE OFFICERIMEMBER EXCLUDED? yes,IIEunder SE.L. SPECIALALPROVISIONS below_ 2005327964 11/20/05 11/20/06 X TRY LIMITS X }OER EL. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 DISEASE- POLICY LIMIT $ 500000 B OTHER Personal Property Business Income CP50693503 CPS0693503 12/31/04 12/31/04 .12/31/0S 12/31/05 1000 Ded $20,000 1000 Ded $30,000 DESCRIPTION OF OPERATIONS / LOCATIONS l VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ' 5% Wind & Hail Deductible/ Location: 970 SW 1st St. #304 Miami, Fl 33172 D.BOND 21BDDAH7807 7/02/05-7/02/06 $100,000 $1000 BED Including as additional insured City of Miami and Loss Payee. CERTIFICATE HOLDER CANCELLATION CITYM33 City of Miami Department of CIP and Transp. Office of City Manager 444 SW 2nd Ave #10th Floor Miami P'L 33130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 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 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ACORD 25 12001/08) @ACORD CORPORATION 1988