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PM CERTIFICATE OF LIABILITY INSURANCE 08/13/2007 PRODUCER (305)822 -7800 FAX (305)827 -0585 Collinsworth, Alter, Fowler, Dowling & French Group Inc. P. 0. Box 9315 Miami Lakes, FL 33014 -9315 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 Post, Buckley, Schuh, & Jernigan, Inc. d /b /a PBS &J 2001 NW 107 Avenue Miami, FL 33172 -2507 INSURERA: Lloyds of London A XV POLICY EFFECTIVE IDDIYY INSURER B: LIMITS EACH OCCURRENCE INSURER C: INSURER GENERAL LIABILITY INSURER E: COVFRAGFS 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. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE IDDIYY POLICY EXPIRATION LIMITS EACH OCCURRENCE $ Meade Collinsworth /ANNA` ` GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE ❑OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY PRO LOC JECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESS /UMBRELLA LIABILITY - EACH OCCURRENCE $ OCCUR FI CLAIMS MADE AGGREGATE $ $ s� $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR /PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ OFFICER /MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - POLICY LIMIT 1 $ SPECIAL PROVISIONS below OTH rolessional/ LDUSA0600811 09/30/2006 09/30/2007 $1,000,000 Limits A ollution Liability Ea Claim and Annual Aggregate 99 ate 9 CLAIMS -MADE FORM 11/11/1961 Retrodate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS E: Project No.: 07 -2503; Combined Project Study Report /Project Report (PSR /PR), nvironmental Document, (ED), and PS &E preparation for the SR -55 /MacArthur Blvd. Interchange Ramp Widen roject Issuing company will provide 30 days written notice of cancellation; 10 days for non - payment. CERTIFICATE Hinl nFR I-AkIt M I ATInKI ACORD 25 (2001/08) © ACORD CO'RO.RA*TION 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Santa Ana, City of EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Public Works Agency M -36 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 20 Civic Center Plaza BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LI 4th Floor OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIV Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE Meade Collinsworth /ANNA` ` ACORD 25 (2001/08) © ACORD CO'RO.RA*TION 1988