HomeMy WebLinkAboutExhibit10DEPARTMENT OF RISK MANAGEMENT
INSURANCE/SAFETY APPROVAL FORM
Name
Ramona Fiumara
Department
Risk
Review
Status
General Liability:
Zurich American Insurance Company
Automobile
Workers Comp:
Transportation Casualty Insurance Co.
Liquor Liability:
Builder Risk:
Professional Liability:
T:xington insurance Company
Garage Keepers Liability:
Description
Paragon Dental Services
Project # Date:
12/2/2004
Financial
Ratings Strength REQUIREMENTS:
A
XV
B+
A++
XV
Excess Liability:
Crime
Fidelity & Deposit
Pollution:
APPROVAL STATUS
APPROVED
AppRO
Frank Gomez
Insurance Coordinator
Patrice Noval
Safety/ADA Coordinator
A
XV
xx
Insurance NOT Required
City of Miami is Named Additional Insured
The City is providing insurance
City of Miami is Loss Payee
Bayfront Park Named Additional Insured
Not Approved
Coverage is insufficient
Not A Rated Company
A Type of Coverage is Missing
Other
The City NOT Named Additional Insured
Insurance/Safety Comments:
Risk 001 12/2/2004 2:35 PM