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2 ,112 2 , � OPN� Coastal Tel: hnrporatlon id : . 0 � � 3 F , 3 <br /> Cllent#: 2198 COASTEC3 <br /> ACORDw CERTIFICATE OF LIABILITY INSURANCE p04110r2012 <br /> y) <br /> THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIB CERTIFICATE OF INSURANOL23 DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHGRIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> I PO TA T: r the certificate holder is an ADDITIONAL , the po cy as muss be en arse , au ec <br /> Lo <br /> the terms and condlllons of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to <br />the <br /> certificate holder in lieu of such pndorssmani(s). <br /> MODUCER AMTACT <br /> Mi <br /> ISU Suncoast Insurance Assoc O 32E9 5200 ,Uc NA ; 813289AStii <br /> P.O. Box 22888 WONAILTampa, FL 33622-2655 )f <br /> 1113 289.5200 INSUP&R(S) AFFCIROINO COVERAGE NAIL 9 <br /> INSURED 1NsuRsaA : XL Specialty Insurance Company 37895 <br /> Coastal Teohnology Corporation <br /> 3625 20th Street INSURER B : _ <br /> INSURl74 C <br /> Vero Beach, FL 32960 r-- <br /> IlxsuREu�INSURER O^_ <br /> IN9URHt e <br /> INSURFA F <br /> COVERAGES CERTIFICATE NUMBER REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELCW HAVE BEEN ISSUED TO THE Mt'iURED NAMED ABOVE POR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERT IFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOF=D BY THE POLICIES DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERMS, <br /> GX.CLUSION5 AND CONDITIONS OF SUCH PMICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS , <br /> [max TYPE OF INSURANCE L a PCIJCYNUMIILk ►MIOD E M�MUP9M�TY UMITs <br /> GENERAL LIARILITY EACH OCCURRENCE I <br /> COMNENT IA) <br /> "OIAL OEN15W LIABILITY �ocrurrenc 3 — <br /> CLAIAtS•MADG F71 OCCJR I MED EXP (My one Perw) $ _ <br /> PE:R3000L d ADV INJURY S <br /> GENERALAGGREGATE i <br /> GENT AGGREGATELD&TAPPLIES PER: PRODUCTS - COMPIOFAGG _ <br /> POLICY 7 <br /> P LOC <br /> AUTOMOBILE LIABILITY COMOINED SINGLE WAIT i — <br /> (Ee aocWenti <br /> ANY AUTO BODILY INJURY (Per "mw) S <br /> ALL OWNED AL1T03 <br /> BODILY INJUt3Y (Peraooltllrk) E <br /> 30HEDULED AUTOS 11101 LIAMAQE <br /> HIRED AUT05 (Par eceiUenQ i <br /> NUN-OWNED AUTOS <br /> UYRRCLLAUAi Oa;,JR EAC:.eiOCCURRENCE i <br /> EXCESS LIAR r,LAIMS-MADE AGGREGATE E <br /> DEDJCTIALE $ <br /> RETENTION 3 $ <br /> WORKERS COMPENSATIONWC S. ATUIUIT OTH- <br /> AND EMPLOYIM98 LIAMIL1TY YiN <br /> ANY PROMETORIPARYNEW24GOUTIV91 I E.L . KACHACCIDENT i <br /> OFF"PAiEMAGREXCLUCE02 INIA1 <br /> (Mandatory In NH) E.L. OISEAIiE - EA EMPLOYEE _ _ _. <br /> if yyas, dascrba under <br /> DGSCRPTION OF OPERATIONS Intlow E.L. DISEASE - POLICY LIMIT Is <br /> A Professional DPR8701338 4/11012012104/111012013 $1 , 000,000 per claim <br /> Lrabii $2,000,000 anni pggr. _ <br /> DESCRIPTION of OC MAYICNS I LDGA`rK)KS I VEN)CLEe (Much ACORD 101 , Additional Remarks 36lxdule, K more *01ca to r0QUIrad) <br /> Professional Liability coverage is written on a elalms-made and reported baste. <br /> C RTIPICAYI= HOLDER CANCELLATION <br /> For proposal purposes sHOULD ANY or THE ABOVE DESCRIDED POLICIES SE CANCELLED BEFORE <br /> THE EXPIRATION DATE THERL•OF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTNOR12ED REPRESENTATIVE <br /> 01989 .2009 ACORD CORPORATION . All rights reserved. <br /> ACORD 25 (2009109) 1 of 1 The ACORD name and logo are reglslered marks of ACORD <br /> #9378180IM378165 MRL <br />