Certificates of Insurance
ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYY)
11/02/2006 -,
,.
PRODUCER Serial # 109659 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
A&A UNDERW~iITERS, INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PABLO M CONllE A052667 ALTER THE COVERAGE AFFORDED BY THE POLICiES BELOW.
8796 SW 8 ST I -..
_"0'"- ..-
MIAMI, FL 33174 INSURERS AFFORDING COVERAGE NAIC#
INSURED 1 4 I ' SURER A: NORTH POINTE CASUALTY INSURANCE
PAVERS & STONE, INC. NOV _~ .J I SURER
KRAIG SHOOI<
50 DOGWOOD RIDGE 1 SURER
L. . .~-->_..__._--'-
,T AQUEFT A, FL 33469 ~:,:',-!~}~i (~i f! \~~'~r;'~~';T INSURER
INSURER
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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INi~ I~~ TYPE OF INSUFtANCE POLICY NUMBFR Pgk!fJ,~f.flli.%J}~E P~k~CI"Y, ~~b~~N LIMITS
!:.:NERAL LIABILITY EACH OCCURRENCE . 1,000,000
A X COMMERCIAL GENERAL LIABILITY 3290000029 02/19/2006 02/19/2007 D~~~~~~q~~ENTE~n'_' . 100,000
I CLAIMS MADE 00 OCCUR MED EXP IAnv one nArson\ . 5,000
PERSONAL & ADV INJURY . 1,000,000
X BROAD FORM GENERAL AGGREGATE . 2,000,000
GEN'L AGGREr5[i lIMrr APri ~ER: PRODUCTS. COMPfOP AGG . 2,000,000
I POLICY X ~&W~ LOC
~TDMOBILE LIABILITY COMBINED SINGLE LIMIT .
ANY AUTO (Eaaccident)
-
X All OWNED AUTOS BOOIL Y INJURY
(Per person} .
.:..:.. SCHEDULED AUTOS
4 HIRED AUTOS BODILY INJURY
.
~ NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE .
(Per accident)
~RAGE UABIUTY AUTO ONLY. EA ACCIDENT .
ANY AUTO OTHER THAN EA ACC .
AUTO ONLY: AGG .
::EJ~SSIUMBRELLA LIABILITY 2290001433 02/19/2006 02/19/2007 EACH OCCURRENCE . 2,000.000
A X OCCUR 01 CLAIMS MADE AGGREGATE . 2,000.000
.
=i ~EDUCTIBLE .
RETENTION . .' . - .
WORKc",'S COMi'cNSATl01'4 AND nk'fI ,..U ~ I T~~-tI;}.lN~ I tol~-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE I ~lte-u ~ El EACH ACCIDENT .
OFFICERfMEMBER EXCLUDED? EL DISEASE. EA EMPLOYEE .
~~E~I~tS~R~~tS~ONS below f EL DISEASE - POLICY LIMIT .
OTHER
DESCRIPTION OF OPERATIONsn..OC.~T10NSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECtAL PROVISIONS
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS IS LISTED AS ADDITIONAL INSURED.
PROJECT: FREEMAN JUSTICE CENTER IN KEY WEST
Qc...:
p 1'\ Q..1'l (..e... I
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
MONROE COUNTY BOARD OF DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL~DAYS WRITTEN
COUNTY COMMISSIONERS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT FAilURE TO DO SO SHALL
1100 SIMONTON ST IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
KEY WEST, FL 33040 REPRESENTATIVES.
AUTHORlZE~7-;!fVE AU UNDERWRITERS, INC "OF"
I . ;;t-( .
ACORD 25 (2001/08)
C:\FMPROICERTPROS.FP5
@ACORDCORPORATION1988
ACORDm CERTIFICATE OF LIABILITY INSURANCE T DATE (MMIOOIYYYV)
11/02/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
InsuranceNoodle I Inc. ~~~ Y AND CONFERS NO RIGHTS UPON THE CERTIACATE
222 s. Riverside Plaza l7t ER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
RECEIVED ALT R THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Chicago, IL 60606 M?nrOe '~C!'Jnty
-~-_. ... --!1NSUR RS AFFORDING COVERAtwi:::c. ')o.-".pme /lAIC'
INSURED " Commerce & Industry
~NSURE
PAVERS AND STONE me NOV 29 r,i;f.! '-)": {Gun
79 Uno Lago Drive NSURER ,.....,-J
Juno Beach, FL 33408 JNSURER i
NSURER n~r ....,.- .._-"-'-..1_
Mr1i'Rni" rnlINTY'--' i INSURER REeD";:.!.:' ,:'~ .v'.._
COVERAGES RISK MANI,GfMENT
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 INSLJRANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDlTIONS OF SUCH
POLICIES. AGGREGATE :..IMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~~: ~~9.~~ T..., i POLICY NUMBER ! PRH~~ EFFECTIVE I POLICY EXPIRATION \ LIMITS
~E!NERAL L1ABIUT'( I EACH OCCURRENCE $
;_ 3MMERCIAL GENERAL LIABILITY PREMI ES Eaoccurence' $
~ CLAIMS MADE D OCCUR MED EXP (Arw one person) $
: PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
,
, ~'~AGG~~~: LIMIT APnSPER: , PRODUCTS.COM~OPAGG $
POLICY ~~R.,: LOC
i , AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
R ANY AUTO , (Eaaccident)
ALL OWNED AUTOS BODilY INJURY
t: 'SCHEDULED AUTOS {Per person) $
- HIRED AUTOS <~. BODILY INJURY
(Peraccidenl) $
NON-OWNED AUTOS yy
~ ! ~q .
f-- " ..,. ~ PROPERTY DAMAGE i$
, (Per accident)
, RAGE LIABILITY ll-'-~'l)Jo AUTO ONLY - EA ACCIDENT $
;
I ANY AUTO OTHER THAN EAACC $
! 'I: ! AUTO ONLY: AGG $
I t=J~5SlUMBRELLA LIABILITY , .. -r
EACH OCCURRENCE $
OCCUR :=J CLAIMS MADE I AGGREGATE $
I H DEDUCTIBLE $
! I- 1$
! 1$ ------
! RETENTION $
WORKERS COMPENSATION AND .; I T"Xt,3T~T,~~ I ,OJb'-
EMPLOYERS' LIABILITY 500,000
ANY PROPRIETOR/PARTI\IERfEXECUTlVE 13551749 08/08/2006 ! 08/08/2007 E.L. EACH ACCIDENT $
A OFFICER/MEM8ER EXCLUDED? 500,000
E.L. DISEASE. EA EMPLOYEE $
~t~~e:t~~6~rs1~NS billow E.L. DISEASE - POLICY LIMIT $ 500,000
OTHER i
I I I
,
I
DESCRIPTION OF OPER.6.T10NS I LOCATIONS /VEHIClES/ EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDEIl
CANCELLATION
MONROE COUNTY
1100 SIMONTON
KEY WEST FL
BOARD OF
STREET
33040
COUNTY COMMISSIONERS
SHOULD.6.NY 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.
AUTHO REPRESENT
ACORD 25 (2001/08)
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c.~ ~i. C~,
@ACO
ACORD," CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YY)
02/26/2007
P~ODuCER Senal # 110712 THIS CERTIFICATE IS ISSuED AS A MATTER OF INFORMATION
A&A UNDERWRITERS, INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PABLO M CONDE: A052667 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
8796 SW 8 ST
MIAMI, FL. 33174 INSURERS AFFORDING COVERAGE NAIC#
INSURED :.ii.' INSURE~ A NORTH POIWE CASUALtt INStlR'!\NQli
PAVERS & STONE, INC. INSUR[R B PROGRESSIVE EXPRESS INS CO -,. ..,~
KRAIG SHOOK II\lSURER c C 1"iQ IJi) t'~
.
50 DOGWOOD RIDGE , ~ .
INSURER 0
I TAQUEFTA, FL 33469 . . .. " ----. _...IN.S.URER E All,
COVERAGES "(l.._
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD tN-DICATE{)NO~STAND!NG
ANY REQUIREMENT, TERM OFt CONDITION OF ANY CONTRACT OR OTHER. DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJFCT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOW'" MAY HAVE BEEN REDUCED BY PAID CLAIMS
IIIISR ~~L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY Ell,PIRA TION LIMITS
T" DATE MM/DD/YY DA TE MM/DDIYY
~NERAL LIABILITY "'ACH OCCuRRENCE . 1 ,000,000
A X COMMERCIAL GENERAL LIABILITY 3290000029 02/19/2007 02/19/2008 5~~~~~~u ~t ~T~~~~nce' . 100,000
I CLAIMS MADE ::zJ occu~ MED "'XP (Anv one person) $ 5,000
~ BROAD FORM PERSO"lAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE . 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COM PlOP AGG . 2,000,000
n POLICY -00 ~~PT n lOC
~TOMOBILE LIABILITY 0564772-0 02/16/2007 02/16/2008 COMBINED SI"lGlE LIMIT . 1 ,000,000
B (EaaCCldentl
f- ANY AUTO
'x ALL OWNED AUTOS BODilY INJURY
.
SCHEDULED AUTOS - IPerperson'
"-'-
4 HIRED AUTOS BODll Y INJURY
.
L NON-OWNED AUTOS IPer aCCident)
- PROPERTy DAMAGE .
I,Per aCCldent,1
~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
, - . ,...... A'JTO ONLY AGG .
5,:SSIUMBRELLA LIABILITY l Y\,~~r. "'- EACH OCCU~RENCE .
OCCUR D CLAIMS MADE -OJ AGGREGATE .
--- ,~ .
~ ~EDUCTIBLE .
RETE"lTIO"l . .
WORKER'S COMPENSATION AND I T'8~y" ~t~I'fS I IU~R
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERtEXEOCUTIVE EL EACH ACCIDENT .
OFFICER/MEMBER EXCLUDED? EL DISEASE. EA EMPLOYEE .
It yes, descnbeunder
SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT .
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHtCLES/EXCLUSIONS ADDEO BY ENDORSEMENTISPECIAL PROVISIONS ,
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS IS LISTED AS ADDITIONAL INSURED. -'
~ ek
PROJECT: FREEMAN JUSTICE CENTER IN KEY WEST .~~ .._:.J [!~ }~tJ~
I~
. , _U -
'-'
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOve: DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF THE ISSUING 'NSURER Will ENDEAVOR TO MAIL ~DAYS WRITTEN
MONROE COUNTY BOARD OF NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
COUNTY COMMISSIONERS
1100 SIMONTON ST 'r-./lPOSE NO OBLIGATION OR LIABILITy OF ANY KIND UPON THE INSURER, ITS AGENTS OR
KEY WEST, FL 33040 REPRESEI\JTATIVES
AUTHORIZED REPRESENTATIVr/ UNDERWRITERS, INe "OF"
I 7~
1 ../ ,
ACORD 25 (200 108)
C:\FMPRO\CERTP~S.F~5
c.c.";.~'...i....
@ACORD CORPORATION 1988
with respect to General Liability and Automobile for operations performed
by the named insured cmly.
AMS 25.3 (2001/08)
3 of3
#S569711M56492