HomeMy WebLinkAboutCertificate of Liability InsurancePRODUCER
ANDERSON & JACOBY INSURANCE CO
7855 SW 104TH STREET
:TIC #100
MrAMr _Fr, 3,3_15Fr
INSURED
MIAMI RIVER COMMISSION
UM ROSENSTILE SCHOOL
4600 RICXSNEACKER CSWY SG207
MIAMI, FL
.ACORD,M CERTIFICATE OF LIABILITY INSURANCE n,/12/2004
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.
1
MT wen 9
INSURERS AFFORDING COVERAGE
DATE IMM4DDIVYYYI
NAIC #
INSURER A: L$.gni? iTrR C 0. Oi AMBRSCA
INSURER B:
INSURER C:
INSURER D:
INSURER E:
COVERAGES
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 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE
NSA ADD'L POLICY NUMBER OATEIMMIDDIVY!
LTA INSRD TYPE OFINSUjSANCE
A
A
GENERAL LIABILITY
x COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
7 POLICY PRO-
7 LOC
AUTOMOBILE LABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
g HIRED AUTOS
X NON•OWNED AUTOS
GARAGE UABILITY
ANY AUTO
EXCESSNMBRELLA LIABIUTY
OCCUR I CLAIMS MADE
DEDUCTIBLE
RETENTION 5
BND-MIAM09-000000002835
END-MIAMO9-000000002835
01/22/2004
01/12/2004
OTS
POLICY EXPIRATION
DATE IMMlDDL Y!
01/22/2005
01/12/2005
‘4Vy
t:1
LIMITS
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES IEe oecurenCal
MED EXP (Any one person)
PERSONAL & ACV INJURY
GENERAL AGGREGATE
PRODUCTS • COMP/OP AGG
COMBINED SINGLE LIMIT
IEa accident)
BODILY INJURY
IPer person'
1,000,000
$ 1, d 01111.0
5 70,000
er
1,000,000
$ 2,000,000
2,000,O40
I,000,00D
BODILY INJURY
(Par accident)
PROPERTY DAMAGE
(Per accident)
AUTO ONLY • EA ACCIDENT
OTHER THAN
AUTO ONLY:
EACH OCCURRENCE
EA ACC
AGG
AGGREGATE
s
WORKERS COMPENSATION AND
EMPLOYERS' LIABIUTY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS !VEHICLES ! EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CITY OF MIAMI IS NAMED AS ADDITIONAL INSURED.
WC STATU-
TORY LIMITS
E.L. EACH ACCIDENT
OTH•
ER
E.L. DISEASE - EA EMPLOYEE
5
E.L. DISEASE • POLICY LIMIT
5
CERTIFICATE HOLDER
CITY OF MIAMI, ISA0A
444 SW 2ND .AVENUE
2ND FLOOR
MIAMI, FL 33130
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN
NOTICE TD THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTOO D REPREE 1ATIVE
.717
ACORD 25 (2001108)
ACORD CORPORATION 1988