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Certificates of Insurance-ACORD CERTIFICATE OF LIABILITY INSURANCkD NF DATE(MM/DD/YY) RNW 1 03/12/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 INSURERS AFFORDING COVERAGE Phone:305-294-6677 Fax:305-292-4641 INSURED INSURERA: Capacity Insurance Co INSURER B: AmComp William P Horn Architect PA, I INSURERC: Bill Horn 915 Eaton St INSURER D: Key West FL 33040 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DDIYY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY X�I COMMERCIAL GENERAL LIABILITY CLAIMS MADE X1 OCCUR CLP007208 09/21/01 09/21/02 EACH OCCURRENCE $ 1000000 FIRE DAMAGE (Any one fire) $ 100000 MED EXP (Any one person) $ 5 0 O 0 PERSONAL & ADV INJURY $ 1000000 i -I GENERAL AGGREGATE $ 1000000 F_GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS -COMP/OP AGG $ O POLICY JECT PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ — ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS AP BY DATE ANAGEMEN BODILY INJURY (Per accident) $ �NAI\ cq NIA YES PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: AGG $ ANY AUTO ANY - $ EXCESS LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND TORY LIMITS'I ER E.L. EACH ACCIDENT $ 100000 B EMPLOYERS'LIABILITY WCV7029381 01/01/02 01/01/03 E.L. DISEASE - EA EMPLOYEE $ 10 0 0 0 0 E.L.DISEASE-POLICY LIMIT 1 $ 500000 OTHER I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER Y I ADDITIONAL INSURED; INSURER LETTER: A GANIaLLA I IUN MONBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 5100 College Road Key West FL 33040 REPRESENTATIVES. Norman Fuller ACORD 25-S (7/97) ©ACORD CORPORATION 1988 ACO D CERTIFICATE OF LIABILITY INSURANC ID NF [:fE(MM/DD/YY)RNWI1 3/12/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phone:305-294-6677 Fax:305-292-4641 INSURERS AFFORDING COVERAGE INSURED William P Horn Alma Horn 151 Key Haven Rd Key West FL 33040- COVERAGES INSURER A: Progressive Express INSURER B: INSURER C: INSURER D: INSURER E: 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMlDD/YY POLICY EXPIRATION AT DE MMlDD/YY LIMITS GENERAL - LIABILITY COMMERCIAL GENERAL LIABILITY J CLAIMS MADE OCCUR EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- 1 LOC JECT PRODUCTS - COMP/OP AGG $ A AUTOMOBILE -I X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 35352550-4 AP D 04/06/02 (" GEM 10/06/02 NT OMBINED SINGLE LIMIT [(E.accident) $ BODILY INJURY (Per person) $ 100000 4 BODILY INJURY (Per accident) $ 300000 PROPERTY DAMAGE (Per accident) $ 5 0 0 0 0 GARAGE LIABILITY ANY AUTO iii DATE' AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY l � 1 _I OCCUR El CLAIMS MADE r � DEDUCTIBLE RETENTION $ 1 EACH OCCURRENCE $ AGGREGATE $ $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 1999 CHEVR C1500 SI 2GCEC19T4X1215430 CFRTIFIRATF 14AI n=o ., I_ --- Monroe County BOCC Risk Management 5100 College Road Key West FL 33040 •` A vPu QL-LMI IVIY MONBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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. A /11 11 Norman Fuller ACORD 25-S (7/97) ©ACORD CORPORATION 1988 ACORD,E TIF LATE � tN URAI PRODUCER Suncoast Insurance Associates P.O. Box 22668 Tampa, FL 3 3 6 2 2 - 2 6 6 8 HORNWIL3 CE DATE(MM/DD/YY) 0 7 / 12 / 01 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. COMPANIES AFFORDING COVERAGE COMPANY INSURED AAgricultural Excess & Surplus Lines William P. Horn, Architect, p•A 915 Eaton Street COMPANY B COMPANY C Key West, FL 33040 COMPANY D COVERAGES THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR OWNER'S & CONTRACTOR'S PROT GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ PERSONAL & ADV INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ TO AUMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS uY e?� - -- - A'""� i (/�) _ �j COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY IN JURY $ PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ 1-1 AGGREGATE EACH OCCURRENCE $ EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM $ AGGREGATE $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY LIMITS EACH ACCIDENT $ A THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL °TREK Professional iability EDN3208475 08/20/01 08/20/02 DISEASE -POLICY LIMIT $ DISEASE - EACH EMPLOYEE $ $500,000 ea claim $500,000 ann agg DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Professional Liability is written on a claims made basis. CERTIFICATE HOLDER :CANCELLATION County of Monroe Attn: Risk Management 510 0 -College Rd. Key West, FL 33040 . ACfJRD 25 $ (3198),] o€ 7 5 50 83 f} M5 629 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL -4 n DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTH RIZED REPRESENTATIVE C] W? ®AC(]RD CORPORATION IS93 *** THIS DECLARATION DOES NOT SUPERSEDE ANY CANCEL NOTICES *** *** THIS DECLARATION REPLACES DECLARATION EFFECTIVE 12/02/01 *** PROGREMME° PROGRESSIVE EXPRESS INSURANCE COMPANY P.O. BOX 31260 (sehabla espanol) 24 Hour Policy Service 1-800-888-7764 TAMPA, FL 33631-3260 Automated Billing Inquiry 1-800-999-8781 305-294-6877 24 Hour Claims Service 1-800-274-4499 PERSONAL AUTO POLICY DECLARATIONS PAGE FOR NAMED INSURED: 00000 I�rlirr�llrllrrr�l��lll�r��ir�lr�llr��lll�l��llrr�ll��r�rllrl MONROE COUNTY BOCC 5100 COLLEGE RD KEY WEST FL 33040 REASON FOR ISSUANCE: POLICY CHANGE WILLIAM P HORN 151 KEY HAVEN RD KEY WEST FL 33040 POLICY NUMBER: 35352550-3 POLICY PERIOD: 10/06/01 TO 04/06/02 This policy incepts the later of: 1. the time the application for insurance is executed on the first day of the policy period; or 2. 12:01 a.m. on the first day of the policy period. This policy shall expire at 12:01 a.m. on the last day of the policy period. The following coverages and limits apply to each described vehicle as shown below. Coverages are defined in the policy and are subject to the terms and conditions contained in the policy, including amendments and endorsements. No changes will be effective prior to the time changes are requested. PROGRESSIVE EXPRESS INSURANCE COMPANY THE FOLLOWING CHANGES WERE REQUESTED BY POST OFFICE ON 12/26/01 AND EFFECTIVE ON 12/26/01: CHANGED INFO - VEH 1,1997 BMW ; ADDITIONAL INTEREST CHANGED . VEH# YR MAKE - MODEL SERIAL NUMBER STATED AMT DRV# LISTED DRIVERS EXCLUDEDSR22 CASE # 1 1997 BMW 328I AUTOMA41) WBACD432XVAU45270 1 WILLIAM P HORN NO 2 1974 TRIUM TR6 CF21249U 2 ALMA HORN NO 3 2001 PORSC BOXSTER S CV WPOCS298SIU664020 3 4 1999 CHEVR C1500 SILVE3C 2GCEC19T4X1215430 4 5 COVERAGES - LIMITS OF LIABILITY PREMIUMS THE COVERAGE IS APPLICABLE ONLY IF A PREMIUM IS INDICATED. VEH #1 VEH #2 VEH #3 VEH #4 TOTAL BODILY INJURY & PROPERTY DAMAGE LIABILITY BI $100,000 EACH PERSON - $300,000 EACH ACCIDENT $104 $102 $134 $125 $465 PROPERTY DAMAGE LIABILITY - $50,000 EACH ACCIDENT $58 $58 $74 $69 $259 BASIC PERSONAL INJURY PROTECTION $50 $51 $63 $41 $205 $10,000 LIMIT NO DEDUCTIBLE NAMED INSURED ONLY UNINSURED/UNDERINSURED MOTORIST NON-STACKABLE $50 $44 $62 $39 $195 $25,000 EACH PERSON - $50,000 EACH ACCIDENT COMPREHENSIVE ACV LESS $250 DEDUCTIBLE $38 $105 $38 $181 COLLISION OR UPSET ACV LESS $250 DEDUCTIBLE $221 $444 $131 $796 ADDITIONAL COVERAGES: TOWING & LABOR $50 PER DISABLEMENT $300 MAX $5 $5 A � A �®BEMENi BY � —0)3' aa- DATE WAIVER N/A YES SEE REVERSE PREMIUM BY VEHICLE $526 $255 $882 $443 %TTACHMENTS IDENTIFIED BY FORM NO. TOTAL POLICY PREMIUM $2. 106 COUNTERSIGN: Ms._ Form No. 1113 (05/01) ADDITIONAL INTEREST COPY PMFL0926011205L1113 ANY LOSS UNDER PART IV IS PAYABLE TO NAMED INSURED AND LIENHOLDER: LIENHOLDER VEH #1 VEH #2 BMW FINANCIAL SERVIC PO BOX 390902 MINNEAPOLIS MN 55439 VEH #3 VEH #4 PORSCHE FIN SVCS VT INC TRUSTEE WOLT EXECUTIVE PLAZA #4 PO BOX 5787 HUNT VALLEY MD 21031 CINCINNATI OH 45201 ADDITIONAL INTEREST INSURED BMW FINANCIAL SERVIC MONROE COUNTY BOCC PO BOX 390902 5100 COLLEGE RD MINNEAPOLIS MN 55439 KEY WEST FL 33040 FOR COMPANY USE ONLY VT iNC AS TSTEE WO LT P.O. BOX 5787 CINCINNATI, OH 45201 PT GARAGE SYMBOL VEH CL ZIP LIAB COMP COLL COMPANY 41 1 00 33040 05 22 25 MARKET UL 2 00 33040 69 LEVEL A 3 00 33040 06 29 29 PAY PLAN 60 4 00 33040 07 21 07 R/R 0106 FACTOR % 0.555 AGENT CODE PF 56862 PREV POL # 35352550-2 DRIVER DRIVER # AGE SEX M/S 1 41 M M PRORATER 2 40 F M FORM 9607 ED. 0798 3 FR Al 4 UW B1 FC G3 113547 FKA 02006 100 *** THIS DECLARATION DOES NOT SUPERSEDE ANY CANCEL NOTICES *** *** THIS DECLARATION REPLACES DECLARATION EFFECTIVE 10/06/01 *** PROGREll/YE° PROGRESSIVE EXPRESS D.A. Ram 31296 TAMPA, FL 33631-3260 305-294-6677 00000 INSURANCE COMPANY Irrllrr�llrllr�r�lrrlllrrrrl�rlr�ll��lll�l��ll��ll��rr�llrl MONROE COUNTY BOCC 5100 COLLEGE RD KEY WEST FL 33040 (se habla espanol) 24 Hour Policy Service 1-800-888-7764 Automated Billing Inquiry 1-800-999-8781 24 Hour Claims Service 1-800-274-4499 PERSONAL AUTO POLICY DECLARATIONS PAGE FOR NAMED INSURED: WILLIAM P HORN 151 KEY HAVEN RD KEY WEST FL 33040 POLICY NUMBER: 35352550-3 POLICY PERIOD: 10/06/01 TO 04/06/02 This policy incepts the later of: 1. the time the application for insurance is executed on the first day of the policy period; or 2. 12:01 a.m. on the first day of the policy period. This policy shall expire at 12:01 a.m. on the last day of the policy period. The following coverages and limits apply to each described vehicle as shown below. Coverages are defined in the policy and are subject to the terms and conditions contained in the policy, including amendments and endorsements. No changes will be effective prior to the time changes are requested. REASON FOR ISSUANCE: POLICY CHANGE, PREMIUM INCREASE $304 PROGRESSIVE EXPRESS INSURANCE COMPANY THE FOLLOWING CHANGES WERE REQUESTED BY NORMAN FULLER OF FULLERS INS AGCY ON 11/23/01 EFFECTIVE ON 12/02/01: ADDED VEH 4,1999 CHEVR ; ADDITIONAL INTEREST CHANGED . VEH# YR MAKE - MODEL SERIAL NUMBER STATED AMT DRV# LISTED DRIVERS EXCLUDEDSR22 CASE # 1 1997 BMW 328I AUTOMA413 WBACD432XVAU45270 1 WILLIAM P HORN NO 2 1974 TRIUM TR6 CF21249U 2 ALMA HORN NO 3 2001 PORSC BUSTER S CV WPOCS29861USS4020 3 4 1999 CHEVR C1500 SILVE3C 2GCEC19T4X1215430 4 c COVERAGES - LIMITS OF LIABILITY PREMIUMS THE COVERAGE IS APPLICABLE ONLY IF A PREMIUM IS INDICATED. VEH #1 VEH #2 VEH #3 VEH #4 TOTAL BODILY INJURY & PROPERTY DAMAGE LIABILITY BI $100,000 EACH PERSON - $300,000 EACH ACCIDENT $104 $102 $134 $125 $465 PROPERTY DAMAGE LIABILITY - $50,000 EACH ACCIDENT $58 $58 $74 $69 $259 BASIC PERSONAL INJURY PROTECTION $50 $51 $63 $41 $205 $10,000 LIMIT NO DEDUCTIBLE NAMED INSURED ONLY UNINSURED/UNDERINSURED MOTORIST NON-STACKABLE $50 $44 $62 $39 $195 $25,000 EACH PERSON - $50,000 EACH ACCIDENT COMPREHENSIVE ACV LESS $250 DEDUCTIBLE $38 $105 $38 $181 COLLISION OR UPSET ACV LESS $250 DEDUCTIBLE $221 $444 $131 $796 ADDITIONAL COVERAGES: TOWING & LABOR $50 PER DISABLEMENT $300 MAX $5 $5 AP B S GEME BY DATE YES WAIVER N/A SEE REVERSE PREMIUM BY VEHICLE $526 $255 $882 $443 ATTACHMENTS IDENTIFIED BY FORM NO. 4809FL(0499) TOTAL POLICY PREMIUM $2, 106 COUNTERSIGN: " Form No. 1113 (05/01) ADDITIONAL INTEREST COPY PMFL0926011205L1113 ANY LOSS UNDER PART IV IS PAYABLE TO NAMED INSURED AND LIENHOLDER LIENHOLDER VEH #1 VEH #2 BMW FINANCIAL SERVIC PO BOX 16075 READING PA 19612 VEH #3 VEH #4 PORSCHE FIN SVCS VT INC TRUSTEE WOLT EXECUTIVE PLAZA #4 PO BOX 5787 HUNT VALLEY MD 21031 CINCINNATI OH 45201 ADDITIONAL INTEREST INSURED BMW FINANCIAL SERVIC MONROE COUNTY BOCC VT INC AS TSTEE WO LT PO BOX 16075 5100 COLLEGE RD P.O. BOX 5787 READING PA 18612 KEY WEST FL 33040 CINCINNATI, OH 45201 FOR COMPANY USE ONLY DISCOUNTS: VEH 1 VEH 2 VEH 3 VEH 4 MULTI -CAR DISCOUNT X X X X HOMEOWNER DISCOUNT X X X X ANTI-LOCKOU T X X FART15AN USE SURCHARGE x PT GARAGE SYMBOL VEH CL ZIP LIAB COMP COLL COMPANY 41 1 00 33040 05 22 25 MARKET UL 2 00 33040 69 LEVEL A 3 00 33040 06 29 29 PAY PLAN 60 4 00 33040 07 21 07 R/R 0106 FACTOR % 0.687 AGENT CODE PF 56862 PREV POL # 35352550-2 DRIVER DRIVER # AGE SEX M/S 1 41 M M PRORATER 2 40 F M FORM 9607 ED. 0798 3 FR Al 4 UW Bl FC G3 131906 RKI 01347 100 COVERAGES rnnTucTeniniur THE ANY MAY POLICIES. ILTR POLICIES OF INSURANCE LISTED BELOW REQUIREMENT, TERM OR CONDITION OF PERTAIN, THE INSURANCE AFFORDED BY AGGREGATE LIMITS SHOWN MAY TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR HAVE BEEN ISSUED TO THE INSURED NAMED ANY CONTRACT OR OTHER DOCUMENT WITH THE POLICIES DESCRIBED HEREIN IS SUBJECT HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER CLP006361 AttUVE run i HE FGLn. RESPECT TO WHICH TO ALL THE TERMS, POLICY EFFECTIVE DATE MM/DD 09/21/00 r FEn,w� ,,. THIS CERTIFICATE MAY EXCLUSIONS AND CONDITIONS POLICY EXPIRATION DATE MM/DD 09/21/01 . •• • ••• • • •— • • ••-- -- BE ISSUED OR OF SUCH LIMITS RENCE $ 1,000,000 A (Any one fire) $100,000 one person) MPERSONAL $ 5,000 ADV IN $ 1, 0 0 0. 0 0 0 GENERAL AGGREGATE $ 1 r 0 0 0 r 0 0 0. PRODUCTS - COMP/OP AGG $ 0 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT AUTOMOBILE LIABILITY C' m Ben. COMBINED SINGLE LIMIT (Ea accident) 0 $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ NON -OWNED AUTOSNON I PROPERTY DAMAGE (Per accident) $ AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY ANY AUTO _ _-- 5 l ^ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ TAIU B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC 1905739-00 01/01/01 01/01/02 X TORY LIMITS ER E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEE $ 10 0 0 0 0 E.L. DISEASE - POLICY LIMIT $ 5 0 0 0 0 0 OTHER ,,/�pp�� / Il'M\RK MP 1 1 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS FEB 0 2001 am RUS M CERTIFICATE HOLDER Y ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION MONBOC,C SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 5100 College Road REPRESENTATIVES. Key West FL 33040 Fu 25-S (7197) N 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-S 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMlDD POLICY EXPIRATION DATE MMlDD LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CA04270021-1 12/02/00 12/02/01 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000, 000 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTOEA AUTO ONLY - EA ACCIDENT $ OTHER THAN ACC AUTO ONLY: AGG $ $ $ EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ R;. V ' • e ER: j;, ; .� vCr `--- EACH OCCURRENCE AGGREGATE $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS TOR Y LIMITSI ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ ,ijR6y� MAN��ry� _—"—"`w�� wvf�lcmG1�1 FEB 0 2001 �___ I CERTIFICATE HOLDER y ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION ,mIFEILM CM vv MONBOC.+C+ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management 5100 College Road IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West FL 33040 REPRESENTATIVES. 11 ACORD 25-S (7/97) c CO DR CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD- CERTIFICATE OF PRODUCER Suncoast Insurance Associates P.O. BOX 22668 Tampa, FL 3 3 6 2 2 - 2 6 6 8 INSURED HORNWIL3 INS. RANCE DATE(MM/DD/YY) 01 / 3 1 / 01 RT THIS CEIFICATE 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. COMPANIES AFFORDING COVERAGE COMPANY ARA&MCO William P. Horn, Architect, P.A. COMPANY 915 Eaton Street B Key West, FL 33040 COMPANY C COMPANY D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY INDICATED, NOTWITHSTANDING PERIOD 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. T TYPE OF INSURANCE LTR POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ CLAIMS MADE [_] OCCUR PRODUCTS-COMP/OP AGG $ OWNER'S & CONTRACTOR'S PROT PERSONAL & ADV INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ AUTOMOBILE LIABILITY MED EXP (Any one person) $ ANY AUTO ��, Rat .. .,_ . COMBINED SINGLE LIMIT $ �1: t ALL OWNED AUTOS SCHEDULED AUTOS { LL� / f ( j BODILY INJURY $ V HIRED AUTOS -- 0 1 (Per person) t l �-� BODILY INJURY NON -OWNED AUTOS P yTF t✓ — (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY AGGREGATE $ UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY LIMITS THE PROPRIETOR/ INCL EACH ACCIDENT $ PARTNERS/EXECUTIVE OFFICERS ARE: EXCL DISEASE -POLICY LIMIT $ A OTHER EDN3208475 DISEASE - EACH EMPLOYEE $ 08/20/00 08/20/01 $500,00 Ea Claim Professional Liability $500,000 Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Professional Liability is claims made and reported. CERTIFICATE HOLDER CANCELLATION County of Monroe SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Attn: Risk Management EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 3_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 510 0 -College Rd. Key West, FL 33040 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE �. JVbt�C a, ACCIRD 25-S (ZIM Of 1 ', S 4 4 7 5 7 M3 9i14 7 \ii .U�4/ TKC ©ACORD CORPORATION:1s931 AoRa� CERTIFICATE OF LIABILITY INSURANCkID NF DATE(MM/DD/YY) RNWI1 12/16/00 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3600 Roosevelt Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phone:305-294-6677 Fax:305-292-4641 INSURERS AFFORDING COVERAGE INSURED INSURERA: Progressive Commercial Div William P Horn INSURER B: Alma Horn INSURER C: 151 Key Haven Rd q INSURER D: Key West FL 33040- h✓ INSURER E: CAVFRAr:FR 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD POLICY EXPIRATION DATE MM/DD LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE F—I OCCUR EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICYF_j PRO- JECT LOC PRODUCTS - COMP/OP AGG $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CA04270021-1 12/02/00 12/02/01 r COMBINED SINGLE LIMIT (Ea accident) $ 1, 000, 000 BODILY INJURY (Per (Per person) X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ HVluGARAGE LIABILITY ANY AUTO ! ' _ - —' AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR El CLAIMS MADE DEDUCTIBLE RETENTION $ / CS /�' V/ EACH OCCURRENCE $ AGGREGATE $ $ $$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER _ ` TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 1999 Chevy C1500 PU 2GCEC19T4X1215430 CERTIFICATE HAI nFR I v I Aft—^....... MONROE2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management 5100 College Rd. IMPOSE NO OBLIGATION OR LIABILITYOFANY KIND UPON THE INSURER, ITS AGENTS OR Key West FL 33040 REPRESENTATIVES. /i % f� ACORD 25-S (7197) v CACORD CORPORATION 1 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 25-S AcoRo. CERTIFICATE OF LIABILITY INSURANC�ID RNW2JF F7ATE(MM/DD/YY) 1 07/21/00 PR5�; CEF THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3600 Roosevelt Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phone:305-294-6677 Fax:305-292-4641 INSURERS AFFORDING COVERAGE INSURED INSURER A: Progressive Commercial Div William P Horn INSURER B: Alma Horn INSURER C: 151 Key Haven Rd INSURER D: Key West FL 33040- INSURER E: k.. V v r_rwU cQ 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. ILTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD POLICY EXPIRATION DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR FIRE DAMAGE (Any one fire) $ 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 A ANY AUTO CA04270021-0 12/02/99 12/02/00 COMBINED SINGLE LIMIT (Ea accident) $ 1000000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PPROPERTY DAMAGE (Per accident) $ - r GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO H'� _��►J'J , r , OTHER THAN EA $ $ AUTO AUTO ONLY: AGG EXCESS LIABILITY OCCUR CLAIMS MADE -- -- EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE i '$ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ATU TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ _F OTHER MONROE COUNTY DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 1999 Chevy C1500 PU 2GCEC19T4X1215430 IL �s K1 U L 2 5 2000 TIMEnl2i RECEIVED BY: MONROEC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN MonrNOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 5100 10 0 C Countyollege Rd. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR C Key West FL 33040 REPRESENTATIVES. Full 25-S (7/97) ©ACORD CORPORATION 19RR IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 25S (71971 A CORD PRODUCER The Fullers Inc 3600 N Roosevelt Blvd Key West, FL 33040 INSURED William Horn Architects PA, Inc 915 Eaton Street Key West, FL 33040 :. :;,v: : -•; :: vim:.. ;: TE Y 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. COMPANIES AFFORDING COVERAGE _ COMPANY — A Clarendmn National Insurance Co COMPANY Capacity Insurance Co B COMPANY ---- — C COMPANY D THIS IS TO CERTIFY THAT 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 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE DOCUMENT WITH RESPECT TO WHICH THIS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, WN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE j POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION -- DATE (MM/DD/YY) DATE EXPIRATION LIMITS GENERAL LIABILITY GENERAL AGGREGATE is B X COMMERCIAL GENERAL LIABILITY I PRODUCTS - COMP/OP AGG $ CLAIMS MADE 'X OCCUR ;CLPoo6361 09-21-99 09-21-2000 PERSONAL &ADV INJURY $ 1, 000,00( OWNER'S & CONTRACTOR'S PROT j EACH OCCURRENCE �$ 1 , OOo , 00( FIRE DAMAGE (Any one fire) l $ l 00,00 O,OO MED EXP (Any one person) $ 5, OOC AUTOMOBILE LIABILITY ANY AUTO -•K •__ern yy; . F��> ,COMBINED SINGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS vY -- BODILY INJURY (Per person) $ HIRED AUTOS BODILY INJURY (Per accident) i $ NON -OWNED AUTOS —�� I'�f l PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO AUTO ONLY • EA ACCIDENT $ OTHER THAN AUTO ONLY. EACH ACCIDENT I $ AGGREGATE I$ EXCESS LIABILITY' EACH OCCURRENCE $ UMBRELLA FORM � AGGREGATE $ OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND Ol-01-2000 TORY LIMITS ER EMPLOYERS' LIABILITY A - 04wCFL9207037 THE PROPRIETOR/ PARTNERS/EXECUTIVE _ INCL — OFFICERS ARE: X EXCL 09-01-99 EL EACH ACCIDENT ______— _, 7 $ v, VVV _—_ _-- EL DISEASE • POLICY LIMIT ! $ 5O0 , OOO �L DISEASE • EA EMPLOYEE $ 100 , 000 OTHER MONROE COUNTY CONISTRUGTION Psi .^,GEMENT JUN 0 9 00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS T ^E: ,�•,, Additional Insured on General Liability Policy Monroe County Board of County ommissioners 5100 Jr College Rd Key West, FL 33o4o 1 BATE I Attn: Risk Management fNMAL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON T E COMPANY, ITS GENTS ��REPRESENTATIVES "SMWWREl�ESENTATIVE �� I// CERTIFICATE OF INSURANCE PRODUCER; Mr THE FULLERS INC 3600 ROOSEVELT''BLVD KEY WEST FL 33040 (305)294-6677 INSURED This certificate is issued as a matter of inform- ation only and confers no rights upon the certi- ficate holder. This certificate does not amend; extend or alter the coverage afford below. COMPANIES AFFORDING COVERAGE COMPANY A COMPANY B PROGRESSIVE EXPRESS William P. Horn COMPANY C 915 Eaton St. Key West, F1. 33040 _ COMPANY D COVERAGES: This is to certify that policies of insurance listed below have been issued to the named insured for the policy period indicated; not withstanding any requirement; term or condition of any contact 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. Limits shown may have been reduced by paid claims. CL TYPE OF INSURANCE POLICY NUMBER EFF DATE EXP DATE LIMITS GENERAL LIABILITY GEN'L AGG 0 [ ]Commercial GL / / / / PD-CMP/OP AG 0 [ ] Claim [ ]occur PR & ADV INJ 0 [ ]Owners/Cntr Prot EACH OCC. 0 [ ] FIRE DAMAGE 0 [ ] MED EXPENSES 0 AUTOMOBILE LIABILITY 3535255-0 04/06/99 04/04/00 COM. SIN. LT 0 B [ ]Any Auto [ ]All Owned Autos BOD INJ/PPER 100,000 [X]Scheduled Autos [ ] Hired Autos C;�--*0VFD P iv "I f, A4�: •r G4, BOD INJ/PACC 300,000 [ ]Non -Owned Autos [ ] Iy u DATE �' . a .Q/- PROP DAMAGE 50,000 EXCESS LIABILITY WAIVER: YFS EACH OCCURR . 0 [ ] Umbre l l a Form [ ]Other than Umb AGGREGATE 0 WORKERS' COMPENSATION / / / / EACH ACCID. 0 AND EMPLOYERS' LIABILITY DISEASE LIMT 0 DISEASE EMPL 0 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS certificate holder is additional insured CERTIFICATE HOLDER CANCELLATION: Should any of the above described MONROE COUNTY BOCC policies be cancelled before the expiration date 5100 COLLEGE RD thereof; the issuing company will endeaver to KEY WEST FL 33040 mail 10days Teitten notice to the certificate holder named to the left, but failure to mail such notice shall impose no obligation or liab- ility upon the company, its agents or reps. Authorized Representative AOBQTM CERTIFICATE OF LIABILITY INSURANCE 08120/02°""' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 22668 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa, FL 33622-2668 INSURERS AFFORDING COVERAGE 813 289-5200 INSURED INSURERg American Assurance Co. William P. Horn, Architect, P.A. INSURER 915 Eaton Street INSURERKey West, FL 33040 INSURER INSURER E: COVERAGES .—nnTuerenlnwr: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO IHt INZjUKtU rvnmmu hovv� „ -• DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICIES. POLICY EFFECTIVE POLICY EXPIRATION LIMITS NSR TYPE OF INSURANCE POLICY NUMBER T M EACH OCCURRENCE $ GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS -COMP/OP AGG $ GEN'L AGGREGATE LIM ITAPPLIES PER: POLICY PROEll LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS NT BODILY INJURY (Per accident) $ NON -OWNED AUTOS AP P 0 MAN PROPERTY DAMAGE $ - (Per accident) AUTO ONLY - EA ACCIDENT $ . GARAGE LIABILITY DATE EA ACC $ ANY AUTO N' WAIVEBEACH _YES OTHER THAN AUTO ONLY: AGG $ OCCURRENCE $ EXCESS LIABILITY OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE a $ RETENTION $ , WC STATU- OTH- WORKERS COMPENSATION AND EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT 1 $ A OTHER EDN320847501 08/20/02 08/20/03 $1,000,000 Each Claim $1,000,000 Ann Aggr Professional Liability DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Professional Liability is written on a claims made basis. County of Monroe Attn: Risk Management 1100 Simonton Street Key West, FL 33040 ACORD 25-S (7/97)1 of 2 #S64704/M64702 SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30DAYSWRI7TEN NOTICETOTHE CERTIFICATE HOLDER NAMED TOTH E LEFT, BUTFAILURE TODOSOSHALL IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURERJTS AGENTS OR REPRESENTATIVE I 4 4L- s/+ LMH © ACORD CORPORATION 1988 ACORE)_ CERTIFIGA` PRODUCER I'ne ruilers inc 3600 i'� Roosevelt H.ivd Key, West, F'L 33G44., INSURED v yG� 4lilLV11 l\RV1 V11Q1 _L110 VV Williaml:Horn architects PA, Inc 91 S La t on St COMPANY Key West, FL 33040 c COMPANY p COVERAGES T`+!S IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEFIOC INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH T14IS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE 'ERNS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION I LTR—_---.___ _—,I. LIMITS _ DATE (MM/DONY) DATE (MM/DDNY) GENERAL LIABILITY I A X. COMMERCIAL GENERAL LIABILITY CLAIMS MADE A, OCCUR CLIL006361 OWNER'S & CONTRACTOR'S PROT I I AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS j NON -OWNED AUTOS � rf)• �Ya a . GARAGE LIABILITY ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 05WCFL920703,7 -HE PROPRIETOR/ INCL PARTNERS.'EXECUTIVE OFFICERS ARE EXCL ----- --OTHER -- i DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS I Architect CERTIFICATE HOLDER' Additional Insur Monroe County Hoard of County Commissioners 5100 Jr College Rd Key W.e str,, FL 33040 A tn: $isk Management ACORD 25-S (195) GENERAL AGGREGATE - b 1 000 , 000 PRODUCTS COMP/OP AGG $ 09-21-99 0y-21-00iPERSONAL &ADVINJURY $ 1 ,000, 000 EACH OCCURRENCE S 1, 0 0 0, 000 FIRE DAMAGE (Any one lire) - . $ _ 100 000 t MED EXP (Any one person) S S 0 0 0 COMBINED SINGLE LIMIT $ J BODILY INJURY (Pe(person) BODILY INJURY j _ (Per accident PROPERTY DAMAGE AUTO ONLY - EA ACCIDENT S $ —. OTHER THAN AUTO ONLY EACH ACCIDENT $ AGGREGATE S EACH OCCURRENCE g AGGREGATE $ - $ _ I TORY LIMITS . __ vER 01-01-001 01-01-01FELEACH ACCIDENT $ 1C0,000 EL DISEASE • POLICY LIMIT $ 50 0 , 0 0 0 EL DISEASE EA EMPLOYEE $ 1 0 0 , 0 0 0 II, MONROE COUNTY CONSTPIICTION MANAGEMENT TIME: BY: *** THIS DECLARATION DOES NOT SUPERSEDE ANY CANCEL NOTICES *** *** THIS DECLARATION REPLACES DECLARATION EF' -TIVE 04/06/02 *** PROGREWYER PROGRESSIVE EXPRESS INSURANCE COMPANY P.O. BOX 31260 (se habla espanol) 24 Hour Policy Service 1-800-888-7764 TAMPA, FL 33631-3260 Automated Billing Inquiry 1-800-999-8781 305-294-6677 24 Hour Claims Service 1-800-776-4737 PERSONAL AUTO POLICY DECLARATIONS PAGE FOR NAMED INSURED: WILLIAM P HORN 151 KEY HAVEN RD KEY WEST FL 33040 POLICY NUMBER: 35352550-4 POLICY PERIOD: 04/06/02 TO 10/06/02 M O N R O E COUNTY B O C C This policy incepts the later of: 5100 COLLEGE R D 1. the time the application for insurance is executed on the first K E Y WEST F L 33040 day of the policy period; or 2. 12:01 a.m. on the first day of the policy period. This policy shall expire at 12:01 a.m. on the last day of the policy period. The following coverages and limits apply to each described vehicle as shown below. Coverages are defined in the policy and are subject to the terms and conditions contained in the policy, including amendments and endorsements. No changes will be effective prior to the time changes are requested. REASON FOR ISSUANCE: POLICY CHANGE, PREMIUM DECREASE -$65 PROGRESSIVE EXPRESS INSURANCE COMPANY CHANGES WERE REQUESTED BY NORMAN OF FULLERS INS AGCY ON 08/21/02 AT 10:23 AM EST EFFECTIVE ON 08/21/02: DELETED VEH ,1974 TRIUM . VEH# YR MAKE - MODEL SERIAL NUMBER STATED AMT DRV# LISTED DRIVERS EXCLUDEDSR22 CASE # 1 1997 BMW 328I AUTOMA413 WBACD432XVAU45270 1 WILLIAM P HORN NO 2 2001 PORSC BOXSTER S CV WPOCS298SIUSS4020 2 ALMA HORN NO 3 1999 CHEVR C1500 SILVE3C 2GCEC19T4X1215430 3 4 4 5 COVERAGES - LIMITS OF LIABILITY PREMIUMS THE COVERAGE IS APPLICABLE ONLY IF A PREMIUM IS INDICATED. VEH #1 VEH #2 VEH #3 VEH #4 TOTAL BODILY INJURY & PROPERTY DAMAGE LIABILITY BI $100,000 EACH PERSON - $300,000 EACH ACCIDENT $104 $128 $125 $357 PROPERTY DAMAGE LIABILITY - $50,000 EACH ACCIDENT $58 $71 $69 $198 BASIC PERSONAL INJURY PROTECTION $50 $60 $41 $151 $10,000 LIMIT NO DEDUCTIBLE NAMED INSURED ONLY UNINSURED/UNDERINSURED MOTORIST NON-STACKABLE $50 $82 $39 $151 $25,000 EACH PERSON - $50,000 EACH ACCIDENT COMPREHENSIVE ACV LESS $250 DEDUCTIBLE $38 $105 $38 $181 COLLISION OR UPSET ACV LESS $250 DEDUCTIBLE $221 $422 $131 $774 ADDITIONAL COVERAGES: TOWING & LABOR $50 PER DISABLEMENT $300 MAX $5 $5 AP P EtI K A A EME T BY DATE C 11 qJ WAIVER N/A YES ' • • SEE REVERSE PREMIUM BY VEHICLE $526 $848 $443 H I I AUMMCN 10 IUCN 111-ICU CT r'UHM NU. f TOTAL POLICY PREMIUM $1 , 817 COUNTERSIGN:' - Form No. 1113 (05/01) ADDITIONAL INTEREST COPY PMFL0926011205L1113 ANY LOSS UNDER PART IV IS PAYABLE TO NAMED INSURED AND LIENHOLDER: LIENHOLDER VEH #1 VEH #2 BMW FINANCIAL SERVIC PORSCHE FIN SVCS PO BOX 390902 EXECUTIVE PLAZA #4 MINNEAPOLIS MN 55439 HUNT VALLEY MD 21031 VEH #3 VEH #4 VT INC TRUSTEE WOLT PO BOX 5787 CINCINNATI OH 45201 ADDITIONAL INTEREST INSURED BMW FINANCIAL SERVIC MONROE COUNTY SOCC PO BOX 390902 5100 COLLEGE RD MINNEAPOLIS MN 55439 KEY WEST FL 33040 FOR COMPANY USE ONLY DISCOUNTS: VEH 1 VEH 2 VEH 3 VEH 4 -RUCIT-CAR DI COUN HOMEOWNER DISCOUNT X X ANTI -LOCK S DISCOUNT X PT GARAGE SYMBOL VEH CL ZIP LIAB COMP COLL 1 00 33040 05 22 25 2 00 33040 06 29 29 3 00 33040 07 21 07 4 DRIVER DRIVER # AGE SEX M/S 1 41 M M 2 41 F M 3 4 COMPANY 41 MARKET UL LEVEL A PAY PLAN 60 R/R 0106 FACTOR % 0.251 AGENT CODE PF 56862 PREV POL # 35352550-3 PRORATER FORM 9608 ED. 0701 FR Al UW 81 FC G3 102453 BUS 02233 100 *** THIS DECLARATION DOES NOT SUPERSEDE ANY CANCEL NOTICES *** *** THIS DECLARATION REPLACES DECLARATION EFFECTIVE 10/06/02 *** PROGREWITO PROGRESSIVE EXPRESS INSURANCE COMPANY P.O. BOX 31260 (se habla espanol) 24 Hour Policy Service 1-800-888-7764 TAMPA, FL 33631-3260 Automated Billing Inquiry 1-800-999-8781 305-294-6677 24 Hour Claims Service 1-800-776-4737 PERSONAL AUTO POLICY DECLARATIONS PAGE FOR NAMED INSURED: WILLIAM P HORN 151 KEY HAVEN RD KEY WEST FL 33040 POLICY NUMBER: 35352550-5 POLICY PERIOD: 10/06/02 TO 04/06/03 M O N R O E COUNTY B O C C This policy incepts the later of: 5100 COLLEGE R D 1. the time the application for insurance is executed on the first day of the policy period; or KEY WEST FL 33040 2. 12:01 a.m. on the first day of the policy period. This policy shall expire at 12:01 a.m. on the last day of the policy period. The following coverages and limits apply to each described vehicle as shown below. Coverages are defined in the policy and are subject to the terms and conditions contained in the policy, including amendments and endorsements. No changes will be effective prior to the time changes are requested. REASON FOR ISSUANCE: POLICY CHANGE, PREMIUM DECREASE -$7 PROGRESSIVE EXPRESS INSURANCE COMPANY CHANGES WERE REQUESTED BY LAMY OF FULLERS INS AGCY ON 11/20/02 AT 02:09 PM EST EFFECTIVE ON 11/20/02: READ THIS PAGE FOR POLICY CHANGES. VEH# YR MAKE - MODEL SERIAL NUMBER STATED AMT DRV# LISTED DRIVERS EXCLUDEDSR22 CASE # 1 1997 BMW 328I AUTONA40 WBACD432XVAU45270 1 WILLIAM P HORN NO 2 2001 PORSC BOXSTER S CV WPOCB29861US64020 2 ALMA HORN NO 3 1999 CHEVR C1500 SILVE3C 2GCEC19T4X1215430 3 4 4 5 COVERAGES - LIMITS OF LIABILITY PREMIUMS THE COVERAGE IS APPLICABLE ONLY IF A PREMIUM IS INDICATED. VEH #1 VEH #2 VEH #3 VEH #4 TOTAL BODILY INJURY & PROPERTY DAMAGE LIABILITY BI $100,000 EACH PERSON - $300,000 EACH ACCIDENT $104 $128 $125 $357 PROPERTY DAMAGE LIABILITY - $50,000 EACH ACCIDENT $58 $71 $69 $198 BASIC PERSONAL INJURY PROTECTION $50 $60 $41 $151 $10,000 LIMIT NO DEDUCTIBLE NAMED INSURED ONLY UNINSURED/UNDERINSURED MOTORIST NON-STACKABLE $50 $62 $39 $151 $25,000 EACH PERSON - $50,000 EACH ACCIDENT COMPREHENSIVE ACV LESS $250 DEDUCTIBLE $38 $95 $38 $171 COLLISION OR UPSET ACV LESS $250 DEDUCTIBLE $221 $422 $131 $774 ADDITIONAL COVERAGES: TOWING & LABOR $50 PER DISABLEMENT $300 MAX $5 1 $5 I MA AQ ENT AP DV BY ' C DATE ---- WAIVER NIA —"--' ES SEE REVERSE PREMIUM BY VEHICLE $526 $838 $443 A l l AL;HMtN I S IUtN I IFItU UY FOHM NU. 7915() ITOTAL POLICY PREMIUM $1 , 807 Form No. 1113 (05/01) COUNTERSIGN: ADDITIONAL INTEREST COPY PMFL08260212051-1113 ANY LOSS UNDER PART IV IS PAYABLE TO NAMED INSURED AND LIENHOLDER: LIENHOLDER VEH #1 VEH #2 BMW BANK OF NA PORSCHE FIN SVCS PO BOX 390902 EXECUTIVE PLAZA #4 MINNEAPOLIS MN 55439 HUNT VALLEY MD 21031 VEH #3 VEH #4 VT INC TRUSTEE WOLT PO BOX 5787 CINCINNATI OH 45201 ADDITIONAL INTEREST INSURED BMW BANK OF NA MONROE COUNTY BOCC PO BOX 390902 5100 COLLEGE RD MINNEAPOLIS MN 55439 KEY WEST FL 33040 FOR COMPANY USE ONLY DISCOUNTS: VEH 1 VEH 2 VEH 3 VEH 4 MULTI -CAR DISCOUNT X HOMEOWNE-R-015-COUNT PT GARAGE SYMBOL VEH CL ZIP LIAB COMP COLL 1 00 33040 05 22 25 2 00 33040 06 29 29 3 00 33040 07 21 07 4 DRIVER DRIVER # AGE SEX M/S 1 42 M M 2 41 F M 3 4 COMPANY 41 MARKET UL LEVEL A PAY PLAN 60 R/R 0106 FACTOR % 0.753 AGENT CODE PF 56862 PREV POL # 35352550-4 PRORATER FORM 9608 ED. 0701 FR Al UW 131 FC G3 141057 090 02324 100 0 M W N O O O O N cm 0 0 O -- O 0 O O O O O O O x 0 O O O a N N n O O 0 0 y _ CL x - OP ID N DATE (MM/DD/YYYY) _ACORD CERTIFICATE OF LIABILITY INSURANCE HORNW-1 02 06 03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phone: 305-294-6677 Fax: 305-292-4641 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Alea North America Ins. Co. INSURER B: William P Horn Architect PA, I INSURERC: Bill Horn 915 Eaton St INSURERD: ]ILA Key West FL 33040 INSURER E: i+nvoowr_ec 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. INUK LTR rUU SR TYPE OF INSURANCE POLICY NUMBER POLIY FEC DATE MM/DD POLICY EXPIRATION DATE MMIDD LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR EACH OCCURRENCE $ PREMISES (Ea occurence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GE N'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS APR"[ ISK M GEMENT COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ ri GARAGE LIABILITY ANY AUTO DATE-0 / YES AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ // V 64 co$ am' � ai La EACH OCCURRENCE $ AGGREGATE $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yyes, describe under SPECIALPROVISIONS below WC1010315 U 01/01/03 01/01/04 X TORY LIMITS ER E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEE $ 100000 E.L. DISEASE -POLICY LIMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS rF:PTIFIrATF 41n1 nFR CANCELLATION MONBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management 1100 Simonton St. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND PON THE INSURER, ITS AGENTS OR Key West FL 33040 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Norman Fuller ACORD 25 (20W A8) • V AGUKU GUKI•UKAI IUN IUt;tf CG� ' 3 � "7 PROORfll/W PROGRESSIVE EXPRESS INSURANCE COMPANY P.O. BOX 31260 TAMPA, FL 33631-3260 305-294-6677 MONROE COUNTY BOCC 5100 COLLEGE RD KEY WEST FL 33040 REASON FOR ISSUANCE: RENEWAL (se habla espahol) 24 Hour Policy Service 1-800-888-7764 Automated Billing Inquiry 1-800-999-8781 24 Hour Claims Service 1-800-776-4737 PERSONAL AUTO POLICY DECLARATIONS PAGE FOR NAMED INSURED: WILLIAM P HORN 151 KEY HAVEN RD KEY WEST FL 33040 POLICY NUMBER: 35352550-6 POLICY PERIOD: 04/06/03 TO 10/06/03 This policy incepts the later of: 1. the time the application for insurance is executed on the first day of the policy period; or 2. 12:01 a.m. on the first day of the policy period. This policy shall expire at 12:01 a.m. on the last day of the policy period. The following coverages and limits apply to each described vehicle as shown below. Coverages are defined in the policy and are subject to the terms and conditions contained in the policy, including amendments and endorsements. No changes will be effective prior to the time changes are requested. PROGRESSIVE EXPRESS INSURANCE COMPANY VEH# YR MAKE - MODEL SERIAL NUMBER STATED AMT DRV# LISTED DRIVERS EXCLUDEDSR22 CASE # 1 1997 BMW 328I AUTOMA40 WEACD432XVAU45270 1 WILLIAM P HORN NO 2 2001 PORSC BOXSTER S CV WPOCS29861U664020 2 ALMA HORN NO 3 1999 CHEVR C1500 SILVE3C 2GCEC19T4X1215430 3 4 4 5 COVERAGES - LIMITS OF LIABILITY PREMIUMS THE COVERAGE IS APPLICABLE ONLY IF A PREMIUM IS INDICATED. VEH #1 VEH #2 VEH #3 VEH #4 TOTAL BODILY INJURY & PROPERTY DAMAGE LIABILITY BI $100,000 EACH PERSON - $300,000 EACH ACCIDENT $102 $125 $122 $349 PROPERTY DAMAGE LIABILITY - $50,000 EACH ACCIDENT $52 $63 $62 $177 BASIC PERSONAL INJURY PROTECTION $47 $56 $39 $142 $10,000 LIMIT NO DEDUCTIBLE NAMED INSURED ONLY UNINSURED/UNDERINSURED MOTORIST NON-STACKABLE $64 $80 $50 $194 $25,000 EACH PERSON - $50,000 EACH ACCIDENT COMPREHENSIVE ACV LESS $250 DEDUCTIBLE $40 $97 $40 $177 COLLISION OR UPSET ACV LESS $250 DEDUCTIBLE $204 $388 $122 $714 ADDITIONAL COVERAGES: TOWING & LABOR $50 PER DISABLEMENT $300 MAX $5 $5 N� B Y YMANA APP BY D ATEWAIVER G o � � , YE8.- NSA r\ C. �. C C: SEE REVERSE PREMIUM BY VEHICLE $514 $809 $435 ATTACHMENTS IDENTIFIED BY FORM NO. TOTAL POLICY PREMIUM $1 , 758 COUNTERSIGN: _ Form No. 1113 (05/01) ADDITIONAL INTEREST COPY PMFL0826021205L1113 ANY LOSS UNDER PART IV IS PAYABLE TO NAMED INSURED AND LIENHOLDER: LIENHOLDER VEH #1 VEH #2 BMW BANK OF NA PORSCHE FIN SVCS PO BOX 390902 EXECUTIVE PLAZA #4 MINNEAPOLIS MN 55439 HUNT VALLEY MD 21031 VEH #3 VEH #4 VT INC TRUSTEE WOLT PO BOX 5787 CINCINNATI OH 45201 ADDITIONAL INTEREST INSURED BMW BANK OF NA MONROE COUNTY BOCC PO BOX 390902 5100 COLLEGE RD MINNEAPOLIS MN 55439 KEY WEST FL 33040 FOR COMPANY USE ONLY DISCOUNTS: ---CAR VEH 1 VEH 2 VEH 3 VEH 4 MULTI DISCOUNT X X X PAID IN FULL DISCOUNT X X HOMEOWNER DISCOUNT X X X ANTI-THEFT-2 DISCOUNT X X PT GARAGE SYMBOL VEH CL ZIP LIAB COMP COLL 1 00 33040 05 22 25 2 00 33040 06 29 29 3 00 33040 07 21 07 4 DRIVER DRIVER # AGE SEX M/S 1 42 M M 2 42 F M 3 4 COMPANY 41 MARKET UL LEVEL A PAY PLAN 21 R/R 0210 FACTOR % 1.000 AGENT CODE PF 56882 PREV POL # 35352550-5 PRORATER FORM 9608 ED. 0701 FR Al UW 131 FC G3 045503 S70 03061 100 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID N DATE(MM/DD/YYYY) HORNWII 05 15 03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phone:305-294-6677 Fax:305-292-4641 INSURED MG 08001 William P Horn 151 Key Haven Rd MAY Key West FL 33040- 11r%V9:0Af:9:C x ki / INSURERS AFFORDING COVERAGE INSURER A: Progressive INSURER 8: INSURER C: INSURER D: INSURER E: NAIC # THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INS 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY)DATE MM/DD EXPIRATION LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE F—IOCCUR EACH OCCURRENCE $ PREMISES (Ea occurence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEWL AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ A X AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 35352550-6 04/06/03 10/06/03 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 100000 BODILY INJURY (Per accident) $ 300000 PROPERTY DAMAGE (Per accident) $ SOOOO GARAGE LIABILITY ANY AUTO fAAN 'A .--YES ME AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG EACH OCCURRENCE $ $ $ EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ BY ,. DATE WAIVER AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Des, describe under SPECIAL PROVISIONS below TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS certificate holder is additional insured I.AIVI:tLLAI IVN MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County Board of County NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Commissioners 1100 Simonton Street Rm 268 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West 33040 REPRESENTATIVES. a ' Norman Fuller V / L/ ACORD 25 (2001/08) © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. Client#• 5675 Iun01JWIT z ACORDn CERTIFICATE OF LIABILITY INSURANCE M/DD/YY) 05/08/03 5/081 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 22668 Tampa, FL 33622-2668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 813 289-5200 INSURERS AFFORDING COVERAGE INSURED William P. Horn, Architect, P.A. 915 Eaton Street INSURERA: Great American Assurance Co. INSURER B:INSURER C: Key West, FL 33040 - --- 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR LTR I TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M DD POLICY EXPIRATION DATE (MM/DDMO LIMITS GENERAL LIABILITY EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MERCIALGENERALLIABILITY CLAIMS MADE OCCUR t MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIM ITAPPLIES PER: POLICY PRO LOC PRODUCTS -COMP/OPAGG $ AUTOMOBILE LIABILITY ANY AUTO (Ea accident, INGLE LIMIT $ I ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ _ BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS APP B i I M NA E T BY PROPERTY DAMAGE _ — - (Per accident) $ GARAGE LIABILITY �..»..,..._�...._.a"-- AUTO ONLY - EA ACCIDENT $ ANY AUTO WAIVER "I IA _,,,,. ES OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESS LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE • RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- IIQRY EMPLOYERS' LIABILITY LIMITS E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ A OTHER Architects rofessional iabili EDN320847501 08/20/02 08/20/03 $1,000,000 each claim $2,000,000 annual agg. DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Professional Liability is written on a claims -made basis. Project: Conch Key & North Key Largo Fire Stations Monroe County Board of County Commissioners Attn: Risk Management 1100 Simonton Key West, FL 33040 SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES B E CANCELLED B EFORE TH E EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_DAYSWRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL IMPOSE NO OBLIGATION OR LIABILITYOF ANY KIND UPON TH E INSURERJTS AGENTS OR REPRESENTATIVE OCnRn 9R_S twaT1w ... Irate/avwrini0avl BJH 0 ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACADII .3c_a /7/n• I _ t • - ic. vi c. tt,7/J060/Ln/-5.3 U.L ACORI�TM CERTIFICATE OF LIABILITY INSURANCE 0DATE (MMID 8/22/03D/YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 22668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa, FL 33622-2668 813 289-5200 INSURERS AFFORDING COVERAGE INSURED INSURER A: Great American Assurance Co William P. Horn, Architect, P.A. INSURER B: 915 Eaton Street INSURER C: Key West, FL 33040 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICYEXPIRATIONLIMITS LTR DATE MM/DDIYY DATE MM/DD GENERAL LIABILITY EACH OCCURRENCE $ r FIRE DAMAGE (Any one fire) $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE 17OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIM ITAPPLIES PER: PRODUCTS -COMP/OP AGG $ POLICY PEA - LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) $ $ HIRED AUTOS ^�E�� NON -OWNED AUTOS V A�tV1 n AG 1p�v (Per accidenILY t) ""®Y PROPERTY DAMAGE $ U 7 (Per accident) GARAGE LIABILITY DATE - AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC ' $ ANY AUTO N YES .� WAIVERNIA +-air^• AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE -.�•,�, AGGREGATE $ $ $ DEDUCTIBLE d RETENTION $ WORKEkS COMPENSATION AND WC STATU- OTH- TOIRY LIMITS ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE. $ E.L. DISEASE - POLICY LIMIT ! $ A OTHER Architects EDN320847502 08/20/03 08/20/04 $1,000,000 each claim Professional $2,000,000 annual aggr Liability DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Professional Liability is written on a claims made basis li M I Iril m 1 C County of Monroe Attn: Risk Management 1100 Simonton Street Key West, FL 33040 UANI:CLLA I IUN SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL30 DAYSWRITTEN NOTICE TO THE CERTIFICATE HOLD ER NAM ED TO TH E LEFT, BUT FAILURE TO DO SOSHALL IMPOSE NO OBLIGATION OR LIAB ILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE %7 AGURD Z5-5 (7/97)1 of 2 #S78094/M78091 GG LAF © ACORD CORPORATION 1988 ACORD,M CERTIFICATE OF LIABILITY INSURANCE 0DATE (M8/22/8122/M/D°/YY) 03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 22668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Tampa, FL 33622-2668 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 813 289-5200 INSURERS AFFORDING COVERAGE INSURED William P. Horn, Architect, P.A. INSURER A: Great American Assurance Co 915 Eaton Street INSURER B: Key West, FL 33040 INSURER c: INSURER D: INSURER E:. nrwrn . r. r-n 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 I POLICY EFFECTIVE - POLICY EXPIRATION - - ---- LTR TYPE Of INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE '$ GENT AGGREGATE LIM IT APPLIES PER: - j PRODUCTS -COMP/OP AGG $ PRO - POLICY CT LOC _ --- - -- ,. AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS '. SCHEDULED AUTOS BODILY INJURYI, $ (Per person) _ HIRED AUTOS `5 IR0 R AN E -- NON -OWNED AUTOS .APP ! BODILY INJURY $ (Per accident) Y - PROPERTY DAMAGE $ DATE (Per accident) GARAGE LIABILITY WAIVER NIA - AUTO ONLY - EA ACCIDENT $ EA ACC ANY AUTO �ES OTHER THAN $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE * AGGREGATE $ r .$ DEDUCTIBLE W/I, RETENTION $ $ WORKERS COMPENSATION AND I WC STATU�pYH- EMPLOYERS' LIABILITY TORY LIMIT$_ ! ER E.L. E.L. EACH ACCIDENT $ E.L. DISEASE • EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A OTHER Architects EDN320847502 08/20/03 08/20/04 $1,000,000 each claim rofessional $2,000,000 annual aggr iability DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Professional Liability is written on a claims made basis Project: Conch Key & North Key Largo Fire Stations Monroe County Board of County Commissioners Attn: Risk Management 1100 Simonton Key West, FL 33040 SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30_DAYSWRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTH E LEFT, BUT FAILURE TO DO SO SHALL IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURER,ITS AGENTS OR REPRESENTATIVE Arnon �. Q r an � ffQ10Uvumi0U21_l LAF 0 ACORD CORPORATION 1988 PROGRESSIVE EXPRESS INSURANCE COMPANY P.O. BOX 31260 TAMPA, FL 33631-3260 305-294-6677 MONROE COUNTY BOCC 5100 COLLEGE RD KEY WEST FL 33040 REASON FOR ISSUANCE: RENEWAL PROGRIMNE® (se habla espan0l) 24 Hour Policy Service 1-800-888-7764 Automated Billing Inquiry 1-800-999-8781 24 Hour Claims Service 1-800-776-4737 PERSONAL AUTO POLICY DECLARATIONS PAGE FOR NAMED INSURED: WILLIAM P HORN 151 KEY HAVEN RD KEY WEST FL 33040 POLICY NUMBER: 35352550-7 POLICY PERIOD: 10/06/03 TO 04/06/04 This policy incepts the later of: 1. the time the application for insurance is executed on the first day of the policy period; or 2. 12:01 a.m. on the first day of the policy period. This policy shall expire at 12:01 a.m. on the last day of the policy period. The following coverages and limits apply to each described vehicle as shown below. Coverages are defined in the policy and are subject to the terms and conditions contained in the policy, including amendments and endorsements. No changes will be effective prior to the time changes are requested. PROGRESSIVE EXPRESS INSURANCE COMPANY VEH# YR MAKE - MODEL SERIAL NUMBER STATED AMT DRV# LISTED DRIVERS EXCLUDEDSR22 CASE 1 2001 PORSC BOXSTER S CV WPOCB298SIUSS4020 1 WILLIAM P HORN NO 3 2 ALMA HORN NO 4 3 4 5 COVERAGES - LIMITS OF LIABILITY THE COVERAGE IS APPLICABLE ONLY IF A PREMIUM IS INDICATED. PREMIUMS VEH #1 VEH #2 BODILY INJURY & PROPERTY DAMAGE LIABILITY VEH #3 VEH #4 TOTAL BI $100,000 EACH PERSON - $300,000 EACH ACCIDENT $160 PROPERTY DAMAGE LIABILITY - $50,000 EACH ACCIDENT $79 $160 BASIC PERSONAL INJURY PROTECTION $79 $10,000 LIMIT NO DEDUCTIBLE $70 $70 NAMED INSURED ONLY UNINSURED/UNDERINSURED MOTORIST NON-STACKABLE $25,000 EACH PERSON - $50,000 EACH ACCIDENT $82 $82 COMPREHENSIVE ACV LESS $250 DEDUCTIBLE COLLISION OR UPSET ACV LESS $250 DEDUCTIBLE $106 $489 $106 $489 AF'P Y :aK M N SEMENT BY — DATE � _. WAIVER, N/A_T� C C� 1 ,�'j f ✓1 Q V-1 C. e1 SEE REVERSE PREMIUM BY VEHICLE I $986 ATTACHMENTS IDENTIFIED BY FORM NO. 4870FL(0603) 7951FL(0902) TOTAL POLICY PREMIUM $990.85 INCLUDES $4.85 FOR FIGA ASSESSMENT. COUNTERSIGN: Form No. 1113 (05/01) ADDITIONAL INTEREST COPY PMFLIE0529031205L1113 ANY LOSS UNDER PART IV IS PAYABLE TO NAMED INSURED AND LIENHOLDER: LIENHOLDER VEH #1 VEH #2 PORSCHE FIN SVCS EXECUTIVE PLAZA #4 HUNT VALLEY MO 21031 VEH #3 VEH #4 ADDITIONAL INTEREST INSURED BMW BANK OF NA MONROE COUNTY BOCC PO BOX 390902 5100 COLLEGE RD MINNEAPOLIS MN 55439 KEY WEST FL 33040 PT GARAGE VEH CL ZIP 1 00 33040 2 3 4 SYMBOL LIAB COMP COLL 06 29 29 FOR COMPANY USE ONLY COMPANY 41 MARKET UL LEVEL A PAY PLAN 21 R/R 0305 FACTOR % 1.000 AGENT CODE PF 56862 PREV POL # 35352550-6 DRIVER DRIVER # AGE SEX M/S PRORATER 1 43 M M 2 FORM 9608 ED. 0701 3 FR Al 4 UW 61 FC G3 064537 03283 100 AMR-D. CERTIFICATE OF LIABILITY INSURANCE OP ID N DATE(MM/DD/YYYY) PRODUCER HORNW-1 02 14 04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fullers, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phone:305-294-6677 Fax:305-292-4641 INSURED William P. Horn Architect, P.A., Inc. 915 Eaton St Key West FL 33040 COVERAGES INSURERS AFFORDING COVERAGE I NAIC # INSURER A: Ca acit Insurance Co LINSURER Alea North America Ina. co. 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE E FE T DATE MMID 10 LIMITS GENERAL LIABILITY A X X COMMERCIAL GENERAL LIABILITY CLP008496 09/21/03 09/2]./.04 EACH OCCURRENCE DAMAG70-REPREMISES $1,000,000 CLAIMS MADE a OCCUR (Ea ccurence) $100,000 MED EXP one An ( y person) $5,000 PERSONAL & ADV INJURY $ 1 , 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 11000,000 X POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ incl 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) $ l A4 K M U PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ DATE OTHER THAN EA ACC $ EXCESS/UMBRELLA LIABILITY WAIVt AUTO ONLY: qGG $ OCCUR M CLAIMS MADE EACH OCCURRENCE $ a AGGREGATE $ DEDUCTIBLE $ RETENTION $ �G . $ WORKERS COMPENSATION AND $ B EMPLOYERS' LIABILITY X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE WC1010315 OFFICER/MEMBER EXCLUDED? 01/01/04 01/01/05 E.L. EACH ACCIDENT $ 100000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYEE $ 100000 OTHER L.DISEASE- POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / ExCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Architectural Services. Monroe County B.O.C.C. is additional.insured on the general liability CERTIFICATE HOLDER CANCELLATION MONBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Monroe County BOCC DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Risk Management NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1100 Simonton S t . IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West FL 33040 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/Q8) el 0 ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE OPID N DATE(MM/DD/YYYY) HORNWII 05 22 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1432 Kennedy Drive Key West FL 33040 Phone:305-294-6677 Fax:305-292-4641 William P Horn Alma Horn 151 Key Haven Rd Key West FL 33040 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Progressive Commercial Div INSURER B: INSURER C: INSURER D: INSURER E: t'vvcrv+urw 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. INK LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD DATE MM/DD LIMBS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE E OCCUR EACH OCCURRENCE $ PREMISES (Ea occurence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PROJECT LOG POLICY M PRODUCTS - COMP/OP AGG $ A X AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 021583161 05/29/04 05/29/05 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 100000 X BODILY INJURY (Per accident) $ 300000 PROPERTY DAMAGE (Per accident) $ 50000 GARANY AUTO AGE LIABILITY HBY ApZ D M f�N M ENT AUTO ONLY - EA ACCIDENT $ EA ACC OTHER THAN AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ DATE WAIVER °�i. A __� YES EACH OCCURRENCE $ AGGREGATE $ $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below t bA IJ TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ .L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 2001 Jeep 1J4GX48S61C676602, Certificate holder is additional insured CERTIFICATE HOLDER I:AIVI:tI_LAI IVn MONBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 Simonton St. Key West FL 33040 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE i ACORD 25 (2001/09) © ACORD CORPORATION 1988 DATE AcogTM CERTIFICATE OF LIABILITY INSURANCE 08/19/040m) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 22668 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa, FL 33622-2668 813 289-5200 INSURERS AFFORDING COVERAGE INSURED INSURER A: Great American Assurance William P. Horn, Architect, P.A. INSURER B: 915 Eaton Street INSURER C: _ KeyWest, FL 33040 INSURER D: I INSURER E: L1VYCRANr-Q 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. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ CLAIMS MADE D OCCUR PERSONAL & ADV INJURY $ i GENERAL AGGREGATE '$ GENT AGGREGATE LIM ITAPPLIES PER: PRODUCTS-COMPlOPAGG $ POLICY PROT- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ - - ANY AUTO BODILY INJURY $ (Per person) ALL OWNED AUTOS SCHEDULED AUTOS — BODILY INJURY$ (Per accident) + HIRED AUTOS NON -OWNED AUTOS - t" �� ! ,. `d"f-1 . ` '• ,1 ��-��J� __-- n t,! PROPERTY AMAGE $ (Per accident) - -- - GARAGE LIABILITY ,.I_ ,_ ..... _ ,.. --' AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO f Irl M l^'. !'n _--�---`�" $ EXCESSLIABILITY� - OCCUR _ CLAIMS MADE n ` a t EACH OCCURRENCE $ $ AGGREGATE --— -- -- ..J CC $ $ DEDUCTIBLE • $.- -- RETENTION $ WORKERS COMPENSATION AND WC STATIU OTH- LIMIT ER I _ _ E.L. EACH ACCIDENT EMPLOYERS' LIABILITY $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A OTHER Architects EDN320847503 08/20/04 08/20/05 $1,000,000 each claim rofessional $2,000,000 aggregate lability DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Professional Liability is written on a claims made basis. County of Monroe Attn: Risk Management 1100 Simonton Street Key West, FL 33040 SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL30 DAYSWRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR AUTHORIZE"V16REPRESENTATIVE ACORD 25-S (7/97))/ of 2 #S92400/M92396 BJH © ACORD CORPORATION 1958 OP ID N DATE (MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE HORNw_1 os 27 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1432 Kennedy Drive Key West FL 33040 Phone:305-294-6677 INSURED Fax:305-292-4641 William P Horn ARchitect PA, Inc 915 Eaton St Key West FL 33040 INSURERS AFFORDING COVERAGE I NAIC # INSURER A: Alea North America Ina. Co. INSURER B: Bankers Security Insurance Co. 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POCK EFF CT P LIC EXP RAT O LIMITS LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MMIDD EACH OCCURRENCE GENERAL LIABILITY B X X COMMERCIAL GENERAL LIABILITY BINDER #041652 09/21/04 09/21/05 PREMISES (Ea occurence) CLAIMS MADE � OCCUR MED EXP (Any one person) PERSONAL BADV INJURY $ 1000000 $ 50000 $ 5000 $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 0 JECT LOC X POLICY PROFI AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS AP I ` ��)A BODILY INJURY (Per accident) $ NON -OWNED AUTOS ,f-jY . CAT is �___ _ _ _. _ --- PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO WAIVER N/A__ .. YES ' li��AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY • EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE DEDUCTIBLE / $ RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? WC1010315 01/01/04 01/01/05 X TORY LIMITS ER E.L. EACH ACCIDENT $ 100000 E.L. DISEASE- EA EMPLOYEE $ lOOOOO E.L. DISEASE - POLICY LIMIT $ 500000 If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS architect CERTIFICATE HOLDER MomocC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management IMPOSE NO OBLIGATION OR LIABILITY 01 ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 Simonton St. REPRESENTATIVES. Key West FL 33040 AUTHORIZED REPRESENTAT . I Norman Fuller ACORD 25 (20011 )) © ACORD CORPORATION 1988 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POL C EFF TN P IC EXPIRA ION LIMITS POLICY NUMBER DATE MM/DD/YY DATE MMIDD LTR NSR TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE El OCCUR EACH OCCURRENCE $ NTE PREMISES Ea occurence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ ---- PRODUCTS - COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PE0 LOC AUTOMOBILE LIABILITY ANY AUTO APPPi D K MAN MENT COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS BY BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS DATE �( BODILY INJURY (Per accident) $ NON -OWNED AUTOS WAIVER /A. 1` i�F` -'—'-i'� r PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO C i `' AUTO ONLY - EA ACCIDENT $ EA ACC OTHER THAN AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITYH OCCUR CLAIMS MADE /1 I A OCCURRENCE $U3ILITY AGGREGATE $ $ DEDUCTIBLE RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below TWC3064752 01/01/05 01/01/06 X I TORY LIMITS ER E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEE $ 100000 E.L. DISEASE - POLICY LIMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS / LOCAT/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ,IONS G o j t C. A TI^\I CERTIFICATE HOLDER MONBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management IMPOSE NO OBLIGATION OR LIABI ITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 Simonton St. REPRESENTATIVES. Key West FL 33040 AUTHORIZED REPRESENTATuller N rl ------ Norman F ACORD 25 (2001/08) © ACORD CORPORATION 1988 4CORD,� CERTIFICATE OF LIABILITY INSURANCE 08/22/ 5°""' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 22668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa, FL 33622-2668 813 289-5200 INSURERS AFFORDING COVERAGE I INSURED William P. Horn, Architect, P.A. 915 Eaton Street Key West, FL 33040 CAVFQAn=Q INSURERA: U.S. Specialty Insurance INSURER B: INSURER C: INSURER D: INSURER E: 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. NSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M D POLICY EXPIRATION DATE MWDD LIMITS GENERAL LIABILITY COMM ERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) _ $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIM ITAPPLIES PER: POLICY PR4 LOC CT PRODUCTS-COMPIOPAGG $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) § BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO- --"" ' , ,,,._.. __.- AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ `- J ; ,_... EACH OCCURRENCE $ AGGREGATE $ $ $ § WORKERS COMPENSATION AND EMPLOYERS' LIABILITY r WC STATU- OTH- I E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ A OTHER Architects rofessional labilltv US051141101 08/20/05 08/20/06 $1,000,000. Each Claim $2,000,000. Ann. Aggreg DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Professional Liability is written on a claims -made basis. LiL-lRU3k1 County of Monroe Attn: Risk Management 11?0 Simonton Street Key W—st, FL 33040 SHOULD ANYOF TH E AB OVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30DAYS WRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL IM POSE NO OBLIGATION OR LIAB ILITY OF ANY KIND UPON TH E INSURERJTS AGENTS OR ED REPRESENTATIVE A,.- D(Qtpe. AO, AGUKU ZO-5 (1197)1 of 2 #8109850/M109848 LMS © ACORD CORPORATION 1988 ACgRD CERTIFICATE OF LIABILITY INSURANCE OP ID N d DATE (MMIDD/YYYY) HORNw-1 01 26 06 PRODL 'ER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phone:305-294-6677 Fax:305-292-4641 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Bankers Security Insurance Co. INSURER B: Technology Insurance Company William P Horn Architect PA, Inc 915 Eaton St Key West FL 33040 INSURERC: 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY DATE MM/DD LIMITS A X GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE [ X] OCCUR X Business Owners 090004962995801 09/21/05 09/21/06 EACH OCCURRENCE $ 1000000 PREMISES(Ea occurence) $ 50000 MED EXP (Any one person) $ 5000 PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ CSL 1000000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS APP i� t� �.-;✓..-__.._. XMA(,a{; NNE �s = .. COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ _._ GARAGE LIABILITY ANY AUTO I "" _2 - INAIVER '9/A._- \7(/,— .-1,:.,_.yI' S,, _„�__ .y AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ ` Y r r14J26 GC EACH OCCURRENCE $ AGGREGATE $ $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Ii yes, describe under SPECIAL PROVISIONS below TWC3064752 01/01/06 01/01/07 X TORY LIMITS ER E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEE $ 100000 E.L. DISEASE- POLICY LIMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS architect. Certificate holder is an additional insured for liability. CERTIFICATE HOLDER CANCELLATION MONBOCC.+ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 Simonton St. Key West FL 33040 REPRESENTATIVES. Norman Fuller ACORD 25 (2001/08) G� ; © ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID N DATE (MWDDNYYY) PRODUCER HORNWII 02 07 06 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fullers, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phone: 305-294-6677 Fax:305-292-4641 INSURED INSURERS AFFORDING COVERAGE NAIC # INSURER A: Progressive Commercial Div INSURER B: William P Horn 151 Key Haven Rd Key West FL 33040 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER D L CYMMF T LI DATE MM/1 10 LIMITS LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ PREMISES (Ea occurence) $ CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO - JECT 7 LOC PRODUCTS -COMP/OP AGG $ AUTOMOBILE LIABILITY $ A X ANY AUTO 2158316-2 05/29/05 05/29/06 COMBINED SINGLE LIMIT (Ea accident) ALL OWNED AUTOS X BODILY INJURY (Per person) $ 100000 SCHEDULED AUTOS X HIRED AUTOS X BODILY INJURY (Per accident) $ 300000 NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ 50000 GARAGE LIABILITY $ ANY AUTO AUTO ONLY - EA ACCIDENT b%LR THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITYEACH OCCUR CLAIMS MADE DEDUCTIBLE OCCURRENCE $ -AGGREGATE $ $ RETENTION $ f $ WORKERS COMPENSATION AND v EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? / ) _ TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS certificate holder is an additional insured CERTIFICATE HOLDER CANCELLATION MONSOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Monroe County BOCC Risk Management 1100 Simonton St. Key West FL 33040 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF NY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATN�/ ACORD 25 (2001/08) GG Norman Fuller © ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID H DATE/12 YYYY) HORNWII 06 12 06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 ___. ..._._- Phone:305-294-6677 Fax:305-2 2-4641 f'I NSURERSAFFORDING COVERAGE NAIC# INSURED RA: 'Pro ressive Commercial Div ._ INSUR R8: William Horn j JUN 1 SURERG 1• K Key Haven Rd L NsuR$FR D: Key West FL 33040 INSUR R E: YVYCMV�.a THEPOLICIESOF INSURANCE LISTEDBELOW HAVE BEEN bSUED TO THEPERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONT OCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE 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. _ POLICY NUMBER DATE MMIDD'rFEC DATE MMIDD LIMITS BILITY OCCUR 7OCCUR 7GEN.L EACH OCCURRENCE $ GE TO PREMISES (Ea occurence) $ MED EXP (Any one person) $ _ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ IES PER: POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ A X AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS 2158316-3 -' .. 05/29/06 �, 05/29/07 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $100000 X X BODILY INJURY (Per accident) $ 300000 X PROPERTY DAMAGE (Per accident) $ 50000 t GARAGE LIABILITY ANY AUTO :� ..r,. ";' AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ /I l EACH OCCURRENCE $ AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? It yes, describe under SPECIAL PROVISIONS below I TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEEI $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS certificate holder is additional insured CERTIFICATE HOLDER moNBocc SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR 1100 Simonton St. Key West FL 33040 REPRESENTATIVES. EPRSENTTIVES. uT.Ta,c ACORD 25 L� Client#: 5675 HORNWIL3 ACORDTa INSURANCE CERTIFICATE OF LIABILITY o8';8, 6°"""' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates P.O. Box 22668 tt Tampa, FL 33622-2668 813 289-5200 €r____—_----INSURERS%FFORIiING ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR RAGE AFFORDED BY THE POLICIES BELOW. COVERAGE NAIC # INSURED William P. Horn, Architect, P.A. 915 Eaton Street Key West, FL 33040 f AUG 2 xr,nrj��_ INSURER A: U. . Specialty Insurance Company 29599 NSUW INSURER Q COVERAGES I --- 21 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE( MAID I PDATEI MMINYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES IF, cur,nU_ $ CLAIMS MADE O OCCUR MED EXP (Any one person) $ PERSONAL SADV INJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO LOC JETAUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea aWdent) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILYINJURY$ (Per eccitlent) HIREDAUTOS NON -OWNED AUTOS �/�� PROPERTY DAMAGE (Per smd.rt) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC $ ANYAUTO $ . _._. AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE ��/. AGGREGATE $ g DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND CSTATLL OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/ R/E%ECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE _ $ OFFICEILMEMBER EXCLUDED? If yes, tlPantler E.L. DISEASE -POLICY LIMIT $ SPECIAL PROVISIONS belay A OTHER Professional US061141102 08120/06 08/20/07 $1,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Professional Liability Is written on a claims -made basis. County of Monroe Attn: Risk Management 1100 Simonton Street Key West, FL 33040 LO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL '40_ DAYS WRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL HE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTNORIZED)It 0EN—W 0(�� 'L VA{Ai1��r $ Or 2 rFS129004/M729002 C_ LMS 0 ACORD CORPORATION 1988 r acoRU CERTIFICATE OF LIABILITY INSURANCE OP ID N HORNW-1 DATE (MMIDDM YY) 09 25 06 PRODUCER The Fullers, Inc 1432 Kennedy Drive Key West FL 33040 RECEIV Phone:305-294-6671' Fax:305-292 4641 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. URERS AFFORDING COVERAGE NAIC# INSURED William P Horn Architect, PA 915 Eaton St Key West FL 33040 SEP2 5 Fi et community Insurance co. 13990 : Technology Insurance Cw any EINSURER -- COVERAGES VKV AAAMnrruruf THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IN Y 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. LTRINSRO TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE (MI N LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 PREMISES (Ea occurence) $50000 X COMMERCIAL GENERAL LIABILITY 090004962995802 MED EXP(Any one person) $ 5000 CLAIMS MADE [X] OCCUR PERSONAL B ADV INJURY $ 1000000 A X Business Owners 09/21/06 09/21/07 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1000000 X POLICY PRO- 71 LOC ECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ - --- - GARAGE LIABILITY „_. _... .-... AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC S ANY AUTO- 1� $ - _ AUTO ONLY: AGO EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE /9 ` / I EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE / I $ RETENTION $ WORKERS COMPENSATION AND X TORV LIMITS ER B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE TWC3089569 01/01/06 01/01/07 E.L. EACH ACCIDENT _ $100000 E.L. DISEASE - EA EMPLOYEE $ 100000 OFFICER/MEMBER EXCLUDED? U yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $SGOG00 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS certificate holder is an additioanl insured for liability c GC; `' 06r%eI ' CERTIFICATE HOLDER momocc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHA11. Risk Management IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 Simonton St. Key West FL 33040 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE , ACORD 25 (2001/08) 1 /- Iq —6ACORD CORPORATION 1988 CERTIFICATE OF LIABILITY INSURANCE OP ID N DATE(MM/DD/YYYY) HORNW-1 01 03 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phone:305-294-6677 Fax:305-292-46 1 NO COVERAGE NAIL# INSURED , ,ff INSURER B' William P Horn Architect P N SU 915 Eaton St n S Key West :FL 33040 INSURER E: CnVFRAnFS THE POLICY P IOD INDICATED. NOTWITHSTANDING THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED THE INSURED�� iR ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR O RTIFICATE 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. ri DLr- LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE MWDD DATE MWDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADIE OCCUR PREMISES (Ea occurence) S MED EXP (Any one person) $ PERSONAL $ ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO JECT LOC AUTOMOBILE LABILIT'y ANY AUTO (ECOMa accident) ANGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ _ . I F F, t 1� PROPERTY DAMAGE (Per accident) $ _. GARAGE LIABILITY ANY AUTO - --"- .. �.+�/ 1 <-0— �-.—__ � ....__--- AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY"''" OCCUR El CLAIMS MADE .,FF EACH OCCURRENCE 1 $ AGGREGATE $ $ 1, DEDUCTIBLE RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE TWC3121812 01 /01/07 01/01/08 X TORY LIMITS ER E.L.EACHACCIDENT $100000 OFFICER✓MEMSER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1000Q0 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $SQ0606 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Monroe County BOCC Risk Management 1100 Simonton St. Key West FL 33040 MONBOCC I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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. A / ACORD 25 U 1988 �- A -A RD_ CERTIFICATE OF LIABILITY INsuReNr_G AV In DATE POUDWYYM PROWLER The Fullers , Inc 1432 Kennedy Drive FOY West FL 33040 HOAW- �Y Ol 03 07 THIS CERTFICATE IS ISSUED AS A MATTER OF INFORNATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.�COVERAGE �ORDETB THEEN�E ES BELOW Phone:305-294-6677 Fax:305-292-46 1 INSURED COVERAGE Monroec;+Iln NAIC III INSURER & — William P Horn Architect P O C: Rey WestnFLt33040 0 INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED THE INSURED THE POLICY . �•� , .,,~��._�._..__..__ ANY REQUIREMENT, TEAM OR CONDITION OF ANY CONTRACT OR O INDICATED. NOTWITHSTANDING MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES IY ICATE MAY LE ISSUED OR POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAYS. HEREIN IS SUBJECT TO ALL THE TFANS, EAyUBpNSANDCONOMONSOFSUCH LTR B TYPE OF INSURANCE POUCYNUfAM GENERAL LIABILITY LIMITS i COMMERCIAL GENERAL LIABILITYEACHOCCUFSwCE PRELBeFx °�N"p) s CLAIMS MADE ❑ OCCUR NED EXP WW one INROR) S PERSONAL S ADV INAARY s GENERAL AGGREGATE S GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMRbPAGG $ POLICY M LOC AUTOMOBILE LIABILITY a ANY AUTO C IWM SNOW LIMIT N mcddant) ALL OWNED AUTOS BODILYINJURYS SCHEDULED AUTOS HIRED AUTOS BODILY S NON-OWNEDAUTOS PROPERTY DAMAGE GARAGE LIABILITY _.. AUTO DI AUTO Y-EAACCOE SANY TWIN C $OTHER _... - ._.._ .. EXCESSAaNRELLA LIABILITY; •-. •.. .... '. ,__. AUTO ONLY: AGG D OCCUR CLAM MADE p/ Ilk- `/C 7 EACH OCCURRENCE s AGGREGATE s S DEDUCTIBLE RETENTION $ n ` S $ WORKERS COMPENSATION AND A EMPLOYERSLLABRT•Y - TK3121812 D1�0I�07 01�01OFFICERIMEE�ARE08 R TORY UNITS ER FL. EACH ACCIDENT $10G0D0 yas SPECIALP SCIONSba1bW �-01BFr�'EA $100000 FL DISEASE -POLICY LIMIT s500000 OTHER DESCRPMN OF OPERATgNS / LOCATIONS I VEHICLES I EXCLUSNNN ADDED BY lIIDORSEIm1TT I SPECIAL PROVMIOYt Monroe County SO= Risk Management 1100 Simonton St. Rey West FL 33040 NCIRSOCIC 1 SHOULD ANYOF THEAISM DeRmaga POl1Cp SE GANGBJ•MBQpIK Tii@lXPSLILTID DATETI161M T"B"Is 1"S BNLMMWLL BErAVORTO MAIL 10 DAYS WROTNN NOTICE TO T11! CERTS'iC1LTE WILDER MANID TO THE LET, BUT FAILURE TO DO SO SHALL YSN70E MOONLJOALTEMORLPSSnYOPANYIMMLN TINSglANikNSADWMOR cc acoRv CERTIFICATE OF LIABILITY INSURANCE OP ID N DATE(MM/DDNYYY) HORNWIl 08 17 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE _ The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phone:305-294-6677 Fax:305-292-4641 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Progressive _ William P. Horn Architect, PA INSURER B INSURER C: INSURER D: 915 Eaton Street Key West FL 33040 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATOLEVMMUDDATE MMIDD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ ENREI PREMISES (Ea occurence) $ COMMERCIAL GENEF;AL LIABILITY CLAIMS MADE h OCCUR $ MED EXP (Any one person) PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO LOC ECT ' A X AUTOMOBILE LIABILITY ANY AUTO 2158316-4 05/29/07 05/29/08 (LaCOMBINED SINGLE LIMIT CO accident) $ BODILY INJURY (Per person) $ 100000 ALL OWNED AUTOS SCHEDULED AUTOS }( X BODILY INJURY (Per accident) $ 300000 HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ 50000 GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANV AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE" $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY k%.., TORY LI MITS ER E.L. EACH ACCIDENT --' - $ AN PROPRIETOR/PARTNER/EXECUTIVE / { E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? 17l/. If yes, describeunder SEC PIAL PROVISIONS below PRO (� E.L. DISEASE- POLICY LIMIT $ OTHER M IA'1 t DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL OWSIDNS 2005 Porsche Cayenne WP1AA29P75LA22546. Certificate holder is additional insured. CERTIFICATE HOLDER MONBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT101 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management 1100 Simonton St. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR - Key West FL 33040 REPRESENTATIVES. ACORD 25 (200 08) f 1/ V " C ACORD CORPORATION 1988 CC 7��L I � l . t#• 5a75 HORNWIL3 C . t#• 5a75 HORNWIL3 an ACORDTe CERTIFICATE OF LIABILITY INSURANCE 08115107°" "' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 22668 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa, FL 33622.2668 813 289-5200 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: BeaZley Insurance Company, Inc. 37540 William P. Horn, Architect, P.A. INSURER B: 915 Eaton Street INSURER C: Key West, FI- 33040 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT NSR TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE DATE MMIDO/YY POLICYEXPIRATION DATE MMIDD/YY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE DOCCUR EACH OCCURRENCE $ DAMAGE TO RENTED $ $ MED EXP (Any one person) PERSONAL A ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PECTO. LOC PRODUCTS - COMPIOP AGG $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Par accident) $ GAR AGE LIABILITY ANY AUTO \\\ '� AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESSIUMBRELLA LABILITY OCCUR CJ CLAIMS MADE DEDUCTIBLE RETENTION $ �<� r, ( , EACH OCCURRENCE $ AGGREGATE $ $ $ 8 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, desGibe under SPECIAL PROVISIONS be. �yyTORY t .. INd A(7 �� y 'y+/. ( / WC LIMITSTATUOTH- E.L. EACH ACCIDENT $ .L. DISEASE -EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A OTHER Professional Liability V15HXZ07PNPM 08120/07 08/20/08 $1,000,000 per claim $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Professional Liability is written on a claims -made basis. County of Monroe Attn: Risk Management 1100 Simonton Street Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL I_ 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 y IZEDREPREGE[ITATIVE V—% ACORD 25 (2001108)1 of 2 #S149939/M149938 CC: n LU LMS © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). r; DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108) _ Client#: 5675 ACORD- CERTIFICATE OF LIABILITY INSURANCE o8;,s,o;°"""' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ------ -----CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 22668 J �' ER THE CC VERAGE AFFORDED BY THE POLICIES BELOW. Tampa, FL 33622-2668 i `,(_''_Ll 813 289-5200 t INSURER AFFCRDING COVERAGE NAIC # INSURED AUGRA: eazl yInsurance Company, Inc. 37540 William P. Horn, Architect, P.A. U2 1 RB. 915 Eaton Street INSURER C. Key West, FL 33040 RER D: MONROE CO UUVeKAUCJ 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. LTR YPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM D V POLICY EXPIRATION DATE MMIDDIYY LIMITS L LIABILITY GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED $ MED EXP(Any one person) $ CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ 7COMMERCIAL GENERAL AGGREGATE $ GREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ ICY PROJECT it AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUKS ) BODILY INJURY (Par accident) $ HIRED AUTOS NON -OWNED AUTOS v� \\\ _ r/J\WV\/` PROPERTY DAMAGE (Per accident) $ 'v GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHEREA ACC AUTO ONLYN AGG $ ANV AUTO •\ (, J $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR F-1 CLAIMS MADEr'- DEDUCTIBLE / -�( $ S RETENTION $ i(A CarizLfn WC STATU- 6TEEL WORKERS COMPENSATION AND EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE _ OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE- POLICY LIMIT $ If yes, describe under SPECIAL PROVISIONS below A OTHER Professional V15HXZ07PNPM 08/20/07 08/20/08 $1,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Professional Liability is written on a claims -made basis. Project: Conch Key, Big Pine & North Key Largo Fire Stations CC.i ""ilnC.�_ Monroe County Board of County Commissioners Attn: Risk Management 1100 Simonton Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL f40_ 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. AUTHORIZED REPRESS TATIVE /YI WG .a- ACORD 25 (2001108) 1 of 2 #S149942/M149938 LMS © AUUKU L:UKHUKAI IUN Tsss CERTIFICATE OF LIABILITY INSURAN IIYV�V THIS CERTIFICATE IS ISSUE UATE IM MDNYYYI me rollers.Inc L432 Kennedy Draw wy Nast rL 33040 phom:305-294-6671 pax:305-292-4641 teZo },a t 47L� no 1St m 33040 INSURERS AFFORDMG COVERAGE Mws aesl pmtaD ro THE INBUIIm NAMED ABDJE PCRTIE PouGr Pmw INWATm. NOT wTrMSTMlDTM OR TO THE DOCL %TWrMIVaBPEGrro WHIGN TIES GERTMATE MY SE IBM= OR ,� ��HERE"IS SUBAA'r TO ALL THE TERMS.E%CLU6101ISAND CONDITIONS OF SUCH g M S 11L0ENERUUAWUTr 090004962995803 GLAWM�ACE o� 09/21/07 09/21/08 A NAIL A .1 � -- CosaaGDaNGLE UMT S . AUTcam"LEMBlrT tE..A WW) ANY ALTO BODLYIIUURY ' . s ALLoWHEDAUTOG (p.rps..n) SCHEDULOD AUTOS _ �sddmL) _ S HIIUMMTTDB� (P.r WPWWNED AUTOS l/ J� .. IV .. S :: .�dd�gAWM _ AUTOONLr-EA ACCIDENT s GARAGE UABLRr MAGIC pILV: i AHY AUTO AGO i EACH OCdlMMCE i _ SCIEGASERGILLAL"ury 7 CARS MADE AGGREGATE i OIXUR S S D®UCIMLE S . RETINT10141 S xWoRgme L9L LITrT10MMD 01/01/07 01/01/08 El.EAp1ACGMEM $100o00 6.Laf71MU s rTFc31z1siz AHy E.L. DISEASE -EA 2n2m il0oa0o El.TxBEASE-PDucrLHRT :50a0a0 - Nalse.l.. ew°""FRan WHIM D9iCRBRnMa OPd1ATHMM/wuTRHsiro.cw.w..----.....__.—_---_--. arobitoct. certificate holder is additional insarod ondar the liability policy Cn cn THEE]PMTIDN iB0liBOCC aRMI.DwnwTHEAwrEwaMmPouDnreAxeaL®EwoRE DATETIMNW,TIMWMaSMUMHWLLDWAYORTOMAE. 10 DAYSWMITUI NOTICE TO TIE CFATUPWATE HDLDER HAMCD To TNG LEFT, BUT FAILURE TD 8o go BTaLl- Monroe County SOCC MFOMMOOBLMATOMOOMAM1rrOFAWKMUFDETHEEMaERmAMNTBDR_-, 1100 Simonton St. VAPRMFNrATrAM. Key West rL 33040 MMMK®MrREBD TA _ w A . —_ v AG CERTIFICATE OF LIABILITY INSURANCE OP ID N DATE(MMIDDNYYY) PF IDUCER HORNW-1 12 03 07 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fullers, Inc -- ---- ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE --.-HOLDER..IHI CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive f4 ,.1 C I TER THE C VERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 l Li --- Phone:305-294-6677 Fax:305-292- 641 INSURER AFF RDING COVERAGE NAIC# INSURED William DE" Ws RA: Firc commaaicY =asurance Co. -- - --- 13990 P Horn iNSUF{ER a: --- Architect PA, Inc 9111 Horn 915 Eaton St __— INSURER C: Key West FL 33040 PaCI. 1ROF 001 - - -—. RERD: - lijCH MANAGE � ST-)RER 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 CONTRACTOR OTHER DOCUMENT W ITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. RSN LTR NSR TYPE OF INSURANCE POLICY NUMBER TIEYMM/DD/YY PDATE MM/DDm N LIMITS GENERAL LIABILITY X COMMERCIAL GENF_RAL LIABILITY CLAIMS MADE D OCCUR 090004962995603 EACH OCCURRENCE $ 1000000 PREMISES Ea occurence) $ 50000 MED EXP(Any or. person) $ 5000 A BU31ne93 OWller$ Q9�21�Q7 Q9�21/08 PERSONAL B ADV INJURY $1000000 1411E--X GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIESPER: PRODUCTS - COMP/OP AGO — $ 1000000 X POLICY jE� LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accdenI $ ALL OW NED AUTOS BOILYINJURV (Perr person) $ SCHEDULED AUTOS HIRED AUTOS —. BODILY INJURY (Per accident) IS NON -OWNED AUTOS t PROPERTY DAMAGE (Per accident) $ _ GARAGE LIABILITY ANY AUTO / ,T�� AUTO ONLY -EA ACCIDENT 3 OTHER THAN EA ACC $ EXCESS/UMBRELLA LIABILITY -.. _.... _.-.. AUTO ONLY: All $ OCCUR CLAIMS MADE DEDUCTIBLE n j EACH OCCURRENCE $ AGGREGATE $ $ _ RETENTION $ $ _ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? yes, describe under S SPECIAL PROVISIONS below OTHER ' /°j _ TORY LIMITS ER E.L. EACH ACCIDENT _ $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ 1 t 1 PROPERTY 50000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS architect office. Monroe County BOCC listed as additional insured. cam. O__A Q_ CERTIFICATE HOLDER MONBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Risk kk Management oe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Ris 1100 Simonton St. IMPOSE NO OBLIGATION OR LIABILITYOF YKIN UPON THE INSURER, ITS AGENTS OR Key West FL 33040 REPRESENTATIVES. -- IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD Dec 03 07 01:54p William P. Horn (305)296-1033 p.1 UNTYMONROE NET WEBT FLUW!)n 33040do (3D5)297-IM1 Aim Monroe County Risk Management 1100 Simonton Street Key West, FL 33040 (305)2924488 Voice (305)292-4487 Fax November 28, 2007 -- -William P. Hobo-- 915 Eaton St. Key West, Fl. 33040 Re: Zad REQUEST Certificate of Insanoce General Liability Dear Sir or Madam: eouro of coumrr comwmsrm s MaVor Charles "Sang' Mttoy, Dlahid 3 Mayor Pro, TM Mario ct Gennar0, DlSatd 4 lMvk M. Spehar, Dlehid 1 George Neugert, DWct 2 Sylvia J. Murphy, District 5 #70070220000227331940 Per our previous letter on September 10, 2007 requesting Certificate of Insurance. Please forward to our office the corrected documentation to the Risk Management Office within 14 working days of receipt of this letter to avoid the necessity of forwarding this situation to the county Attorneys Office for further handling to protect the County's interests. Monique Diaz Risk Management Assistant I I -Z-/ -�— fif, ACORD. CERTIFICATE OF LIABILITY INSURANCE HORNW-OPID 1J DO15 ATE1/15 YY8 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS&E! IFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive---AL—T. COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33041) Ira C� Phone:305-294-6677 Fax:305-292-4641 INSURED -- INSURER A: COVERAGE NAIC # ER JO I William F> Horn Architect PA, JAN INSU � 'c -- - - Bill Horn INSURER C. I - 915 Eaton St _ IpySUR€Ro�- —� �- --- - Key West FL 33040 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER P L Y FFE TIV LI Y E%PIRA DATE MM/DO/YY GATE MMIDD/YY _ - -__-- - - LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ MED EXP (Any one person) _ $ CLAIMS MADE OCCUR PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG -- $ POLICY PRO- JECT LOC - - AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS- BODILY INJURY $ NON-OWNEDAUTOS ,/�" (Per accident) PROPERTY DAMAGE $ I - - - - (Per accident) GARAGE -- LIABILITY AUTO ONLY -EA ACCIDENT - -- $ ANYAUTO �/ OTHER THAN EA ACC -- $ $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F] CLAIMS MADE - AGGREGATE $ $ DEDUCTIBLE - RETENTION $ $ WORKERS COMPENSATION AND TORV LIMITStEREMPLOYERS'LIABILITYTWC3121812 EACHACCIDENT$1000QQ PROPRIEIOWPARINEF/EXECDTNE 01/01/08 O1ANV l01�09EL FI ERIMEMBEREXCLUDE:D? E.L. DISEASE -EA EMPE If yes, descnbe under $ lOOOOO E.L. DISEASE -POLICY LIMIT $500000 SPECIAL PROVISIONS below OTHER MOP•TOO u:Duniy DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS MONBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe COlinty BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management 1100 Simonton St. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West FL 33040 REPRESENTATIVES. ACORD 25 (2001/08) 0 ACORD -acoxv CERTIFICATE OF LIABILITY INSURANCE IU N DATE IMM/DD/YYYY) The Fullers, Inc 1432 Kennedy Drive Key West FL 33040 Phone:305-294-6677 Fax:305-292 William Horn Architect William Horn 151 Key Haven Rd Key West FL 33040 CfTVFO AlOCC ONLY AND CONFERS NO RIGHTS HOLDER. THIS CERTIFICATE DOE ' ALTER THE -COVERAGE AFFORDE - INSURERS AFFORDING COVERAGE INSURERA. PLq re991Ve h. INSURER.. INSURER Cf ..- INSURERIL IN �1RERE: R MATTER OF INFORMATION UPON THE CERTIFICATE S NOT AMEND, EXTEND OR D BY THE POLICIES BELOW. NAIC # 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MW.1 D/YY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ PREMISES Ea occurenoe $ CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT ECT LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY A X ANY AUTO 02158316-5 05/29/08 05/29/09 CO BIKED (EaCOMBMED SINGLE LIMIT $ ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY ( person) $ 100000 X HIREDAUTOS ._ X NON -OWNED AUTOS BODILY INJURY(Per accident) $ 300000 PROPERTY DAMAGE (Per accident) $SOOOO GARAGE LIABILITY ANY AUTO - AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ — AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY --- ... .. . _ OCCUR CLAIMS MADE EACH OCCURRENCE AGGREGATE $ $ DEDUCTIBLE I RETENTION $ S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY _ TORY LIMITS ER ANY PROPRIETOR/PARTNER/EX.ECUTIVE G`� OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ B yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYEE ---- 8 OTHER .L.DISEASE-POLICYLIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Monroe County BOCC is an additional insured CERTIFICATE HOLDER ,......-.. -_.__. Monroe County BOCC Risk Management 1100 Simonton St. Key West FL 33040 MGNBOCCF,pos D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA HEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTI TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHJ NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR C_� Nr1RYWII 14 Client8: 5ti75 ACORD, CERTIFICATE OF LIABILITY INSURANCE 08/181 s° ' PRODUCER PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION AND CONFERS NO RIGHTS UPON THE CERTIFICATE S t Insurance Associates P.O. Box 22668 ONLY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR FFORDED BY THE POLICIES BELOW. Tampa, FL 33622-2668 813E(' 289.5200 L lrVERAGE . NAIC M nce Company, Inc. 37540 INSURED William P. Horn, Architect, P.A.915 Eaton Street G t- EI Key West, FL 33040 COVERAGES - LT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN I E INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LTR TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY POLICY NUMBER POLICY EFFECTIVE MDATE POLICYEXPIRATI N IMM LIMITS EACH OCCURRENCE $ DAMAGE TO RENTED $ $ CLAIMS MADE ❑ OCCUR MED EXP (Any one perms) PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG E GENL AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea madent) $ ANY AUTO ALLOWNEDAUTOS BODILY INJURY (Per Perron) $ SCHEDULEDAUTOS HIRED AUTOS BODILY INJURY (Per ewdent) $ NON -OWNED AUTOS PROPERTY DAMAGE (Per ecadmt) $ GARAGE LIABILITY AUTO ONLY - EAACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE "' $ $ DEDUCTIBLE RETENTION E ° ( I WC STATU- OTM- $ WORKERS COMPENSATION AND E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY E.L. DISEASE - EA EMPLOYEE $ ANY PROPRIETORPARTNERM.XECUTIVE OFFICERIMEMBER EXCLUDED] E.L. DISEASE -POLICY LIMIT E Wye% deealOe uMer SPECIAL PROVISIONS Oahu A OMER Professional V15HXZ07PNPM 08120/08 $1,000,000 per claim Liability 10860/09 $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Professional Liability is written on a claims made and reported basis. Project: Conch Key, Big Pine & North Key Largo Fire Stations Monroe County Board of County Commissioners Attn: Risk Management 1100 Simonton Kav-West. FL 33040 ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR A OR OIX ES- Eli �s A - cc, ACORD 25 (2001108) 1 of 2 #S170179IM170175 KHK a ACORD CORPORATION 1988 CH nte. 5R15 HORNWILR ACORD- CERTIFICATE OF LIABILITY INSURANCE DTE 08Ans/oa°"""" PRODUCER Suncoast Insurance Associates P.O. Box 22668 Tampa, FL 33622-2668 813 289-5200�1$$BERS ... 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. _. AFF DING COVERAGE NAIC IS INSURED P. Horn, Architect, P.A. 915 Eaton Street Key West, FL 33040 AUG 2 0 INSURER A: eaZI Insurance Company, Inc. 37540 IWUWilliam RER B: I rrrteR C INSURER D: Hlil( X1.10.1A I�tXA �'\IT THE POLICIES OF INSURANCE LISTED BELOW HAVE BE 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. IK3K LTR WO, TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPO DATE I'M LIMBS GENERAL LIABILITY EACH OCCURRENCE $ PREMIDSES IF, AMAGE TORENT, $ COMMERCIILL GENERAL LIABILITY CLAIMS MI\OE OCCUR MED EXP(My we pm n) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ POLICY PELT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea axidenl) $ BODILY INJURY (Per pawn) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per aoddent) $ HIRED AUTOS NON -OWNED AUTOS PROPERTYPERTYDAMAGE (Par t) $ / GAMCE LJABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC $ ANY AUTO $ AUTO ONLY: AGO EXCESWUMBRELL LIABILITY EACH OCCURRENCE $ OCCUR EI CLAIMS MADE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ // CL WORKERS COMPENSATION AND TrIRVWC STIMITS ATUS OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR(PARTNERIEXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED? tt yee deecrlbe urder SPECIAL PROVISIONS below -� E.L. DISEASE -POLICY LIMIT $ A OTHER Professional V15HXZ07PNPM 08/20/08 08/20/09 $1,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS P LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Professional Liability is written on a claims made and reported basis. ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION County of Monroe DATE THEREOF, ME ISSUING INSURER WILL ENDEAVOR TO MAIL 'An DAYS WRITTEN Attn: Risk Management NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL 1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Kehl West, FL 33040 REPRESENTATIVES. � AUTIJORIZED REPRES ATIVE UTWvwvtiGC� A —%; eK OLr A/- 1 n,f 2 8.S17n17R/M17n176 K14K a ACORD CORPORATION 198E ACURD.., CERTIFICATE OF LIABILITY INSURANCE OP ID NF DATE(MM/DD/(YYY) HORNWI1 05 28 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR d ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1432 Kenn= y D iA. Key West FL 33040 Phone:305-294-6677 Fax:305-292-4641 INSURED William & Alma Horn 151 Key Haven Rd Key West FL 33040 rrn%1C0An=c INSURERS AFFORDING COVERAGE I NAIC # INSURER A: Progressive Commercial Div INSURER B: INSURER C: INSURER D: INSURER E: 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ PREMISES (Ea occurence) $ COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ CLAIMS MADE I_J OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO LOC JECT A X AUTOMOBILE LIABILITY ANY AUTO 02158316-6 05/29/09 05/29/10 COMBINED SINGLE LIMIT (Ea accident) $ l O O O O O O BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ EA ACC OTHER THAN $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ $ DEDUCTIBLE RETENTION $ o A$ WORKERS COMPENSATION AND TWC LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 01 E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEEI $ OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below Cc E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS certificate holder is an additional insured CC• CERTIFICATE HOLDER CANCELLATION MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL ,Monroe County BOCC 1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Kly West 33040 REPRESENTATIVES. AUTHORIZED REPRESENTATI Norman Fuller ACORD 25 (2001/08) © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. r.vvr%u Za k4VU HL00/ w""" ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) PRODUCER 08/18/2009 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ISU Suncoast Insurance Assoc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 22668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Tampa, FL 33622-2668 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 813 289-5200 INSURERS AFFORDING COVERAGE NAIC # INSURED William P. Horn, Architect, P.A. INSURER A: BeaZley Insurance Company, Inc. 37540 915 Eaton Street INSURER B: Key West, FL 33040 INSURER C: INSURER D: COVERAGES INSURER E: 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH BY PAID INSR ADD CLAIMS. LTR INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVEPOLICY DAT MM/EXPIRATION LIMITS DATE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO-- LOC PRODUCTS - COMP/OP AGG $ 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 ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ EXCESS/UMBRELLA LIABILITY .- AUTO ONLY: AGG $ , OCCUR CLAIMS MADE EACH OCCURRENCE $ C(� AGGREGATE $ DEDUCTIBLE RETENTION $ (2 _.$ - WORKERS COMPENSATION AND EMPLOYERS' LIABILITY INC STATU- I OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYEE $ A OTHER professional V15V8D09PNPA E.L. DISEASE - POLICY LIMIT I $ 08/20/09 08/20/10 $1,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Professional Liability is written on a claims made and reported basis. Project: Conch Key, Big Pine & North Key Largo Fire Stations CC', 471 na--nC-Q� CERTIFICATE HOLDER CANCELLATION Monroe County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Board of Count Commissioners y DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _.3lIL DAYS WRITTEN Attn: Risk Management 1100 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Simonton IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West, FL 33040 REPRESENTATIVES. AUTIJORIZED REPRESENTATIVE ACURD 25 (2001/08) 1 of 2 #S209074/M209070 DSJ 0 ACORD CORPORATION 1988 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYY1r) PRODUCER 08/18/2009 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ISU Suncoast Insurance Assoc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 22668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Tampa, FL 33622-2668 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 813 289-5200 INSURERS AFFORDING COVERAGE NAIC # INSURED William P. Horn, Architect, P.A. INSURER A: BeaZley Insurance Company, Inc. 37540 915 Eaton Street INSURER B: Key West, FL 33040 INSURER C: INSURER D: COVERAGES INSURER E: 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. LTR INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MM/DD DATE MM/DD LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS MADE OCCUR -PREMISES (Ea- occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO-- LOC PRODUCTS - COMP/OP AGG $ 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 ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: EXCESSIUMBRELLA LIABILITY AGG $ OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE i $ RETENTION $ / WORKERS COMPENSATION AND 4 EMPLOYERS' LIABILITY WC STATU- OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE ✓ OFFICER/MEMBER EXCLUDED? pt)j . E.L. EACH ACCIDENT $ If yes, describe under SPECIAL PROVISIONS below I E.L. DISEASE - EA EMPLOYEE $ A OTHER professional V15V8D09PNPA E.L. DISEASE -POLICY LIMIT $ /20/09 08/20/10 $1,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Professional Liability is written on a claims made and reported basis. c c ; C-71 CERTIFICATE HOLDER CANCELLATION County Of Monroe SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Attn: Risk Management g DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ._30_ DAYS WRITTEN 1100 Simonton Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Key West, FL 33040 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTIJORIZED REPRESENTATIVE • 00'V'L 0&—G& ACORD 25 (2001/08)1 of 2 #S209071/M209070 DSJ 0 ACORD CORPORATION 1988 53 ACORDCERTIFICATE 4F DATE (MM/DD/YYYY) LIABILITY INSURANCE HO°i 09/14/09 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR The Fullers, Inc ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1432 Kennedy Drive Key West FL 33040 Phone : 3 0 5- 2 9 4- 6 6 7 7 Fax : 3 0 5- 2 9 2- 4 6 41 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Progressive Insurance Co William P Horn INSURER B: Architect PA, Inc INSURER C: Bill Horn 915 Eaton St INSURER D: Key West FL 33040 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. P LICY EFFECTIVE POLICY EXPIRATION LIMITS TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LTR NSR GENERAL LIABILITY EACH OCCURRENCE $ PREMISES (Ea occurence) $ COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ CLAIMS MADE El OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ PPROF ILOCOLICY[_-] JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 10 0 0 0 0 0 A X ANY AUTO 0 215 8 316 - 6 0 5/ 2 9/ 0 9 0 5/ 2 9/ 10 (Ea accident) BODILY INJURY $ ALL OWNED AUTOS (Per person) X SCHEDULED AUTOS BODILY INJURY $ X HIRED AUTOS (Per accident) X NON -OWNED AUTOS • PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO � OTHER THAN EA ACC AUTO ONLY: $ AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ 7 OCCUR F-ICLAIMS MADE z $ $ DEDUCTIBLE i $ RETENTION $ WORKERS COMPENSATION AND TORY LIMITS ER E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 2005 Porsche Cayenne SW WPlAA29P75LA22546 CERTIFICATE HOLDER CANCELLATION MONBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County BOCC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Risk Management IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 Simonton St. Key West FL 33040 REPRESENTATIVES. AUTHORIZED REPSENTVVE ACORD 25 (2001/08) / Jv (IOACORD CORPORATION 1988 OP ID N DATE (MMlDDlYYYY) acoRD CERTIFICATE OF LIABILITY INSURANCE Hamel 12 16 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A NUTTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S UPON THE CERTIFICATE The 8ullera, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1432 Kennedy Drive Key West FL 33040 Phone:305-294-6677 INSURED Fax:305-292-4641 William Horn 151 KHFLe33a40 Key West INSURERS AFFORDING COVERAGE NAIC 0 INSURER A: P rogres m iva Comerc i a<l Div INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICYNIS �FICATE D OR DING THE POLICIES OF INSURANCE ER MAY BE ISSU ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER LTR NSTYPE OF INSURANCEEACH DA7tjMppt"TW DA liA LIMITS OCCURRENCE S GENERAL LIABILITY PREMISES (Ea ocwrence t COMMERCIAL GENERAL LIABILITY CLAIMS MADE[:] OCCUR MED EXP (Any one person) S PERSONAL & ADV INJURY $ GENERAL AGGREGATE : PRODUCTS - COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICYr-] PER LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ l a o a o o a 05/29/09 05/29/10 (Ea accident) A X ANY AUTO 0 215 8 316 - 6 ALL AWNED AUTOS BODILY INJURY S (per Peron) X SCHEDULED AUTOS R HIRED AUTOS BODILY INJURY s (Per accident) X NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIOENT $ GARAGE LIABILITY EA ACC 3 ANY AUTO •' OTHER THAN AUTO ONLY: _--,� AGO S EACH OCCURRENCE S EXCESS/UMBRELLA LIABILITY 17 CLAIMS MADE AGGREGATE $ OCCUR DEDUCTIBLE 1 • $ RETENTION S I-TORY LIMITS I I ER WORKERS COMPENSATION AND EMPLOYERS' LIABILITY El. EACH ACCIDENT S ANY PROPRIETOR/PARTNER/EXECUTIVE 1 E.L. DISEASE - EA EMPLOYEE S OFFICER/MEMBER EXCLUDED? E.L. DISEASE - POLICY LIMIT S If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLE31 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate holder is an additional insured. CANCELLATION CERTIFICATE HOLDER THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATiO XONRCON SHOULD ANY OF DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN Monroe County Board of COuuty NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL Courai 8 s f oner s IMPOSE NO OBUGATIQN OR LIABILITY OF ANY KIND UPON THE INSURER, Rs AGENTS OR 1100 Simonton Street RU 266 REPRESENTATIVES. Ivey West FL 33040 AUTHORIZED REPRESENTATIV Norman Fuller m ACQRD CORPORATION 1988 ACORD 25 (2001108) unDuwil 04 Glienta: 56l5 ..........._.. ACORDTm CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 08/18/2009 PRODUCER i U Suncoast insurance Assoc S P.O. Box 22668 Tampa, FL 33622-2668 813 289-5200 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 William P. Horn, Architect, P.A. 915 Eaton Street Key West, FL 33"0 INSURER A: Beazley Insurance Company, Inc. 37MO INSURER B: INSURER C: INSURER D: INSURER E: COVEKAGLS 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. INSRPOLICY LTR N TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY POLICY NUMBER EFFECTIVE POLICY EXPIRATION LIMITS EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occu $ MED EXP (Any one person) $ CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-- MLOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per pennon) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY "C) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ EXCESSIUM13RELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE ` O $ $ DEDUCTIBLE $ RETENTION $ t _ WC STATU- OTH- ITo WORKERS COMPENSATION AND E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY E.L. DISEASE - EA EMPLOYEE $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? .L. DISEASE - POLICY LIMIT $ If yes, describe under SPECIAL PROVISIONS below A OTHER Professional V15V81309PNPA 08/20/09 8/20/10 $1,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Professional Liability is written on a claims made and reported basis. CERTIFICATE HOLDER %0j%N%.c9A.M I IvFI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION County of Monroe DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _..30 DAYS WRITTEN Attn: Risk Management NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West, FL 33"0 REPRESENTATIVES. AU'Mi0RIZED REPREs TATIVE 0*1:0 04ft 0&"hifal J ACORD 25 (2001108)1 of 2 #S209071 /M209070 pSJ © AGUKU GUKrUK#k I IUn 1 V 0 OP ID bi DATE (MM/DDlYYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE Ho�-1 12 1s o9 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PieooucEe ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Tho Fullers, Inc HOLDER, THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED By THE POLICIES BELOW. 1432 Kennedy Drive Rey West FL 33040 _ 2 - 4 6 41 INSURERS AFFORDING OVERAGE NAIC # Phones305-294-6677 Fax:305 29 13990 INSURER A: First Commmity Insurance Cc. INSURED INSURER B: Willta1n P Horn Inc• INSURERC: Architect, INSURER V. 915 Baton St. JIV Rey West FL 33040 rim -SURER E: OVERAGES E LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. BE ISSUED QR NOTWITHSTANDING THE POLICIES OF INSURANCE S ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER HEREIN O EIN IS BJECTR YO EALLL THE TERMS,HEXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN, THE INSURANCE AFFORDED BY THE ��I RE DESCRIBE AI� IMS POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE LIMITS POLICY NUMBER DATE MWD LTR NSR TYPE OF INSURANCE EACH OCCURRENCE $10 0 0 0 0 0 GENERAL LIABILITY $5 0 0 0 0 COMMERCIAL GENERAL LIABILITY 090004962995805 PREMISES Es oocurer�ce X MED EXP (Any one psrs00 $5 0 0 0 CLAIMS MADE D OCCUR 09/21/09 09/21/10 PERSONAL 8ADVWJURY[1s A X Business owners GENERAL AGGREGATE $ 2 0 0 0 0 0 0 1 GEN'L AGGREGATE LIMIT APPLIES PER: K I POLICY F-1 LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY 7 ANY AUTO EXCES&UMSRELLA L"UTY 7 OCCUR El CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY pRopRII TO R E� UDEE D? �UTIVE OFFICERtmIf yes. dow1be under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS ! LOCATIONS I VEHICLES 1 E1UCLUs310NS ADDED BY ENDORSEMENT J SPECIAL certificate holder is an additional insured CERTIFICATE HOLDER Monroe County Board of CouUty Co=ni s s iones 1100 Simonton Street Rm 268 Key West FL 33040 PRODUCTS - COMP/OP AGG $ COMBINED SINGLE UMIT I $ (Es oocldent) BODILY INJURY $ (Per person) BODILY INJURY s (Per aocideM) PROPERTY DAMAGE : (Per a=ident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGO i EACH occURRENCE s AGGREGATE $ 3 s t E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOY $ E.L. DISEASE - POLICY LIMIT i PROPERTY 50000 CANCELLATION CON SHOULD ANY OF THE ABOVE DE3CRISED POLICIES BE CANCELLED BEFORE THE EXPIRATIO �ONR DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO IIAIL 1_ 0 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. AUTHORIZED REP1It9SENTATIV NOl"Atatl FUller 0 ACORD CORPORATION 1988 ACORD 25 (2001108) y ATE OF LIABILITY INSURANCE �i'CC R C E RTI F I CHORRNW11 DATE (MM/DD/YYYY) 0 6 01 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Fullers, Inc ---- �" �-- 1432 Kennedy Drive: - K West FL 33040 •;wv'ry Key _ HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR +` ,ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. .: Phone: 3 0 5- 2 9 4- 6 6 7 7 Fax : 3 0 5- 2 9 - 4 6 _. INSURERS AOFORDING COVERAGE NAIC # INSURED U RER,A: Progressive Conmercial Div MJRER 0: INSURER C: William Horn INSURER D: a -._• V - ' 151 Key Haven Rd. '"" "" r ;- Key West FL 33040 i 'INSURER E: . „w..) CnVFRAGFS 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ PREMISES (Ea occurence) $ COMMERCIAL GENEERAL LIABILITY MED EXP (Any one person) $ CLAIMS MADE F__] OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- LOC F]JEC7 A X AUTOMOBILE LIABILITY ANY AUTO 0 215 8 316 - 7 0 5/ 2 9/ 10 0 5/ 2 9/ 11 COMBINED SINGLE LIMIT (Ea accident) $ 1 0 0 0 O O O BODILY INJURY (Per person) $ ALL OWNED AUTOS X SCHEDULED AUT0:3 BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO aa .� AUTO ONLY - EA ACCIDENT $ EA ACC OTHER THAN $ $ $ ,."..,.. r _.... - AUTO ONLY: AGG EACH OCCURRENCE EXCESS/UMBRELLA LIABILITY 7 OCCUR CLAIMS MADE F-1 AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE ' TORY LIMITS ER E.L. EACH ACCIDENT - $ - E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below A "f k4 DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate holder- is an additional insured CERTIFICATE HOLDER CANCELLATION MONBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Monroe County BOCC IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 Simonton St. Key West FL 33040 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE lkq l* Norman Fuller --� ACORD 25 (2001 /08) 1 IV A © ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID N DATE(MM/DD/YYYY) PRODUCER HORNW-1 09 21 10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fullers, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1432 Kennedy Drive r ICATE DOES NOT AMEND, EXTEND OR COVERA E AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phone 305-294-6677 Fax.305-292-4641 INSURERSAFFORDING OVERAGE INSURED SE INSWlira Comm ity Insurance Co.TF INSURER B: William. P Horn Architect PA INSURER C: _� 915 Eaton St. M NN@61lHYiY Key West FL 33040 RIS COVERAGES THE PO CIEs nr iw,c, ,......� ....--- BELOW -- -- -• .+��+.Rio i ED BELOW nAVt t3EEN 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. R NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE P LI Y EXPIRATION n Arc i�,umn�..... GENERAL LIABILITY X COMMERCIALGENERAL LIABILITY 090004962995806 I CLAIMS MADE L J OCCUR A X Business Owners GEN'L AGGREGATE LIMIT APPLIES PER: i{ POLICY PRO- JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 09/21/10 %TE MM/DD/YY LIMITS EACH OCCURRENCE $ 1000000 PREMISES(Eaoccurence) $ 50000 MED EXP (Any one person) $ 5000 09/21/11 PERSONAL& ADV INJURY $ incl GENERAL AGGREGATE $ 2000000 GARAGE LIABILITY ANY AUTO , EXCESS/UMBRELLA LIABILITY /1 OCCUR ]CLAIMS MADE Y Yu DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE '. CFFICERlMEXCLUDED? EXCLUDED? If yes, describe under Jl SPECIAL PROVISIONS below OTHER t DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS architect CERTIFICATE HOLDER Monroe County Board of County Commissioners 1100 Simonton Street Rm 268 Key West FL 33040 PRODUCTS -COMP/OP AGG I $ 1000000 COMBINED SINGLE LIMIT S (Ea accident) L JURY n) $ JURY$ent)Y DAMAGE$ nt)Y - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EACH OCCURRENCE $ AGGREGATE $ E.L. EACH ACCIDENT I $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ PROPERTY 50000 CANCELLATION MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIA/BJ�LITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. // / ACORD 25 (2001/ 88) Norman Fuller . © ACORD CORPORATION 1988 IMPORTANT If they certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) r OP ID: NF A "' CERTIFICATE OF LIABILITY INSURANCE °"�'""'°°"m'' 11/15110 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND aONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endomems s . PRODUCER 305-294-6677 The Fullers, Inc 305-292-4641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller NAME C7 PHONE �Y• No): ffM ADDRE PRODU cummER jo t.HORNW-1 INSURER(S) AFFORDING COVERAGE NAIL f INSURED Wllllam P Horn Architect PA INSURER A: First Community Insurance Co. 13990 Bill Horn 915 Eaton St. Key West, FL 33M INSURERS: INSURER C : INSURER D : INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCEJIM-wa SUM POLICY NADDL UMBER POLICY EFF POLICY ZXP LIMITS A GENERAL LABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR X Business Owners X 090004962995808 09/21110 09/21/11 EACH OCCURRENCE i 1,000,00 PREMISES (Es a=,,w%6 = 60,00 MED EXP (Any ons person) II 5,00 PERSONAL a ADV INJURY t GENERAL AGGREGATE 111 2,000,00 GENL AGGREGATE LIMIT APPLIES PER X POLICY PRO- -1LOC PRODUCTS - COMPIOP AGG i CSL S 1,000,00 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-oAMED AUTOS COMBINED SINGLE LIMB (Ea acdderd) $ BODILY INJURY (Pw pwson) $ BODILY MNURY (Per sccldent) S PROPERTY DAMAGE (Per soddent) : i i UMBRELLA LIAS EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE i DEDUCTIBLE RETENTION $ 1 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNEREXECUTIVE ❑ OFFK:ERIMEMBER EXCLUDED? (Mandatory in NH) r yes "-r ba under DESCRIPTION OF OPERATION below NIA ASTATLI• IT E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE S E.L DISEASE - POLICY LM11T S PROPERTY DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLE$ (Attach ACORD 101, Additional Rw wAs Sehwlule, If more spsee Is required) Certificate holder]* an additional insured. MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board Of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ty ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1100 Simonton Street Rm 268 AUTHORIZED REPRESENT Key West, FL 33040 Norman Fuller ®1988 2 CORD CORPORATION. All rights reserved. ACORD 26 (2009/09) The ACORD name and logo are registered ma of ACORD OP ID: NF A`ORO- �CERTIFICATE OF TY INSURANCE DATEYYY) 11/15110 -LIABILITY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorseme s . PRODUCER 305-294-6677 The Fullers, Inc 305-2924641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller NCOAME: CT PHONE AM NO FOR HORNWI7 INSU S AFFORDING COVERAGE NAIC 0 INSURED William mom 151 Key Haven Rd. Key West, FL 33"0 INSURERA:Progressive INSURERS: INSURER .0 : INSURER I0 : INSURER E : IN REkF : COVERAGES CERTIFICATE Nt)URFR- Rr-VICInIM Wl IUR=0- THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE Of INSURANCE POLICY NUMBER EFF MUM POLICY EXP MMIDPOLICY LIMrS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE S o= a S MED EXP one ) 3 PERSONAL 6 ADV INJURY $ GENERAL AGGREGATE $ GE N L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMPIOP AGG $ $ A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS X 02158316-7 05/29/10 06129/11 COMBINED SINGLE LIMIT (Easoaderd) $ 1,000,00 X X BODILY INJURY (Per person) 3 BODILY INJURY (Per acddxd) S ((PP-seeddiant)OMIAGE $ X S a UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE r EACH OCCURRENCE 3 AGGREGATE 3 DEDUCTIBLE RETENTION S WORKERS COM"A$ATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mw y In N %DEabs SCRIPTION OF OPERATIONS below N I A VC STATU- OTH- E.L. EACH ACCIDENT I E.L. DISEASE - EA EMPLOYE 3 E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AKwch ACORD 101, AdcNanal Rewerb ScheduK I num apses In ruMmd) 2007 Chevrolet Tahoe C1501GNFC13027R283917. Certificate holder is an additional insured. MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY ty ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1100 Simonton Street Rm 268 AUTHORIZED REPRESENTA Key West, FL 33040 Norman Fuller (ID 1988-2 A ORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of A ORD f`1-444. C127C ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE(MIM/DD/YYYY) 08/20/2010 PRODUCER ISU Suncoast Insurance Assoc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. BOX 22668 Tampa, FL 33622-2668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 813 289-5200 INSURERS AFFORDING COVERAGE NAIC III INSURED William P. Horn, Architect, P.A. 915 Eaton Street INSURER A: Beazle Insurance Company, Inc. 37540 INSURERS: C: Key West, FL 33040 INSURER D: INSURER E: 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. LTR TYPE OF INSURANCE POLICY NUMBER DA Y EFTE(MMM TIVE POLICY rM LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0OCCUR DAMAGE TO RENTED $ MED EXP (Any one person) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JE T LOC 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 EAACC $ $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- O R EMPLOYERS LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ OFFICERWEMBER EXCLUDED? If yes, describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below A OTHER Professional V15V8D100301 08/20/10 08/20/11 $1,000,000 per claim Liability $1,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Professional Liability is claims made and reported. Project: Conch Key, Big Pine 8: North Key Largo Fire Stations Annual Contract for Architectural Services Monroe County Board of County Commissioners Attn: Risk Management 1100 Simonton Key West, FL 33040 c.r J.—mu] T Or L 45250155IM266181 I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 4EREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _.A0 DAYS WRITTEN TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AU'[%O pED REPRES TATIVE - KEB 0 ACORD CORPORATION 1988 OP ID: NF CERTIFICATE OF LIABILITY INSURANCE DAT1 1231D0 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s . PRODUCER 305-294-6677 The Fullers, Inc 1432 Kennedy Drive 305-292-4$41 Key West, FL 33040 Norman Fuller COWNCT NA PHONE FA _ vAr. (A!C No): ADDPRODUCERIDN_HORNW-1 INSURERS) AFFORDING COVERAGE NAIC It INSURED Wiliam P Hom Architect PA INSURER A: Technology Insurance Company Bill Horn 915 Eaton St Key West, FL 33040 INSURER: INSURERG: INSURER D : INSURER E : INSURER COVERAGES CERTIFICATE NUMBER: RPVISInN MLIURPR- THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MID POLICYEXP M LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ID OCCUR EACH OCCURRENCE ; DAMAGE TO RE U PREMISESEa oaaurence ; MED EXP (Any one n) ; PERSONAL & ADV INJURY ; GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER; POLICY PRO LOC PRODUCTS - COMP/OP AGG ; ; AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-0WMEDAUTOS t Y e j1 6 /\ 1 `' COMBINED SINGLE LIMIT (Ea aoetderu) ; BODILY INJURY (Per person) ; BODILY INJURY (Per accident) S PROPERTY (Paraccident) $ ; ; UMBRELLALIAB EXCESS UAB HOCCUR CLAIMS -MADE EACH OCCURRENCE ; AGGREGATE $ DEDUCTIBLE RETENTION ; j _ A WORKERS COMPENSATION AND EMPLOYE' LIABILITY RSYIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑Y (Mandatory In NH) ayee deecr�De under DESCRIPTKN OF ERATIONS below N 1 A TWC3184965 01/01/10 01/01/11 0C STATU- X OTH - LL E.L. EACH ACCIDENT S 1,000,00 E.L. DISEASE - EA EMPLOYE S 1,000,00 E.L. DISEASE -POLICY LIMIT ; 1,000,00 DESCRIPTION OF OPERATIONS I LOCATION31 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board Of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1100 Simonton Street Rm 268 AUTHORdED REPRESENTATIV Key West, FL 33040 Norman Fuller ®1988- 00 C COR06RATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACOR OP ID: NF '`'llk.. "r CERTIFICATE OF LIABILITY INSURANCE DATE(M 05/2/11 7/11YYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, ANDTADN IMPORTANT: If the certificate holder is AL,�y(ies) m t be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, cm ement. statement on this certificate does not confer rights to the certificate holder in lieu of such endorsePRODUCER 677 CONTACT N ME: The Fullers, Inc 64iUN 6 2 cONN Ext: (FAX,No 1432 Kennedy Drive E-MAIL Key West, FL 33040 ADDRESS: PRODUCER - Norman Fuller MONROE Coin rwTOMER ID # ORNWI I RISK MANAcEUPNT INSURERS AFFORDING COVERAGE NAIC # INSURED William &Alma Horn INSURERA: rOgresslye 151 Key Haven Rd. INSURER B : Key West, FL_ 33040 INSURER C INSURER D : INSURER E : + INSURER F : COVFRAGFR RFRTIFI('_ATF Nil IRARFO• oo�nc rnu w nas�ri. THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL UB POLICY NUMBER POLICY EFF MMl0'CA Y POLICY EXP MMIDDrYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE El OCCUR DAMAGE R ENT D PREMISES Ea occurrence MED EXP (Any one person) $ $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECTLOCI PRODUCTS - COMPIOP AGG $ $ - A �AUTOMOBILE LIABILITY ANY AUTO X 02158316-8 05/29/11 05/29/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ HIRED AUTOS X $ NON -OWNED AUTOS UMBRELLA LIAB OCCUR I- - EXCESS LIAB —1_— 1 CLAIMS -MADE DEDUCTIBLE EACH OCCURRENCE AGGREGATE $ 1 $ $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS* LIABILITY Y / N ANY PROPRIETOR/PARTNER/E:KECUTIVE OFFICER/MEMBER EXCLUDED? N / A VYC STA IT- OTRH- E.L. EACH ACCIDENT - - $ E.L. DISEASE - EA EMPLOYEE _ $ (Mandatory in NH) If yes, describe under ♦ E.L. DISEASE - POLICY LIMIT — - $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more rgquired) 2007 Chevrolet Tahoe C150 SUV 1GNFC13027R293917 GAa r MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ty ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1100 Simonton Street Rm 268 AUTHORIZED REPRESENTA Key West, FL 33040 Norman Fuller 01988-2 CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks f A:RD D AC Q' OP ID: NF �-- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. I THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies a - N PR ment. A statement on this certificate does not confer rights to the certificate holder in lieu of such endors s . — _ PRODUCER The Fullers, Inc 1432 Kennedy Drive Key West, FL 33040 Norman Fuller INSURED William P Horn Architect Bill Horn 915 Eaton St. Key West, FL 33040 305-292-4641 SEP 2 1 2011 MOMOE COUNTY HORNW-1 A: First Community Insurance Co B:Florida Retail Federation U: E: 13990 CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR2TYPEOF INSURANCE AD POLICY NUMBER POLICY EFF fWGENYMM/DD/YYYY LIMITS A GENERAL LIABILITY X URRENCE $ 1,000,0 090004962995807 09/21H1 Ea occurrence $ 50,0 RENT MADE OCCUR X wners Any one person) $ 5,0 L & ADV INJURY $ 1,000,01 GENT AGGREGATE LIMIT APPLIES PER: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAB EXCESS LIAB DEDUCTIBLE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY B ANY PROPRIETOR/PARTNER/E) OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under OCCUR YI520-40146 ❑ I N / A I YJ I GENERAL AGGREGATE I $ 2,000.00d PRODUCTS - COMPIOPAGG 1 $ 1 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ EACH OCCURRENCE $ AGGREGATE $ $ 01/01/11 01/01/12 E.L. EACH ACCIDENT $ 1 E.L. DISEASE - EA EMPLOYEE $ 1 E.L. DISEASE - POLICY LIMIT $ 1 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Irchitect G G : %41 4 Girt c MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Rm 268 Key West, FL 33040 AUTHORIZED REPRESE ATIVE Norman Full e ©19 8- ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered makks of ACORD OP ID: NF '4� a' CERTIFICATE OF LIABILITY INSURANCE DAT08/281IYYYY, 08l28H 2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in Ilou of such sndo s . PaooUCERCONTACT 305-294-6677 The Fullers, Inc 305-292-4641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller NAME: PHONE FAX -MAIL PRODUCER HORNW-1 CUSTOMER 1p#; INSU B AFFORDING COVERAGE NAIC Ir INSURE0 William P Horn Architect PA Bill Horn 915 Eaton St Key West, FL 33040 INBURERA: First Community Insurance Co. 13990 INSURER B : INSURER c : INSURER D INSURER E : INSURER F; CAVFRAnFS CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 PERTAJN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, I TYPE OF INSURANCE POLICY NUMBER IMMQD1YYYYI AMMRM= LIMITS GENERAL LIABILITY COMMERCIAL COMMERC. GENERAL LIABILITY CLAIMS•MADE 0OCCUR X Business Owners X 090004962995$07 09/21/11 09/21/12 EACH OCCURRENCE $ 1,000r PREMI E Ea occurrence = litl, MED EXP one son S 5r PERSONAL R ADV INJURY S GENERAL AGGREGATE S 2,000,00 [GE1?L AGGREGATE LIMIT APPLIES PER: POLICY jFcTPRO- LOC PRODUCTS - COMP/OP AGO $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS • R EMWIMM 9.A COMBINED SM10LE LIMIT (Ea accidert) S BODILY INJURY (Per pare0n) S BODILY INJURY (Per ecddert) S PROPERTY DAMAGE (PK vccdNt) S $ $ UMBRELLA LIAS EXCESS LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE S AGGREGATE S DEDUCTIBLE RETENTION IS S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/CUTrVE Y ! N EXE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) Ifgas descrtre ands DES RIP N F OPERATIONS below N I A WC STATU- OTH- I ER E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ,(AKach ACORD 101, AdMaml Remade Bchadule, N mom mme Is regrind) architect MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, Monroe County Board of County ACCORDANCE WITH THEPOLICY PROVISIONSE WILL BE DELIVERED IN Commissioners I Al 1100 Simonton Street AUTHORIZED REPRESE TIVE Key West, FL 33040 Norman Fuller A',-�— a 19 - 60 RD CORPORATION. All rights reserved. ACORD 23 (2009109) The ACORD name and logo are registered marks f AC RD OP ID: NF A�R�* CERTIFICATE OF LIABILITY INSURANCE DATE /281IYYYY) os12s11 z THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require on endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorseme s . PRODUCER 305-294-N77 MTF� CT The Fullers, Inc 305-292-4"1 1432 Kennedy Drive PHONE AA; Mo E-MAIL Key West, FL 33040 Norman Fuller PRooucER HORNW-1 INSURE S AFFORDING COVERAGE NAIC it INSURED William P Horn Architect PA POURER A: Florida Retail Federation Bill Horn 915 Eaton St. Key West, FL 33040 INSURER s : INSURER C INSURER D INSURER E I IN COVERAGES CERTIFICATE NUMRER! RFVLg1ON NIIYAFR- THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRTYPE OF INSURANCE SUER P Y NUMBER POLICY OFF POLICY EXP M LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE DOCCUR EACH OCCURRENCEDAMAGE S 1-151WRTIM p opunerce$ MEP EXP (Any orw ) S PERSONAL 6 ADV INJURY S GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC PRODUCTS - COMP/OP AGG S $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS MON-OWNED AUTOS B �/ l( GE D _ COMBINED SINGLE LIMIT (Es wod@M) S BODILY INJURY (Per Person) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per swkh M) $ S $ UMBRELLA LIAR EXCESS LIAR .. H OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION S $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITYYa ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NN) H yyes describe under DESGtRIPTION OF OPERATIONSbelow N I A 520-40146 01/01/12 01/01113 WC STATU- X OTH- rR E,L.EACH ACCIDENT S 1,000,0 E.L. DISEASE - EA EMPLOYEE S 1,000, E.L. DISEASE -POLICY LIMIT S 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS J VEHICLES (Attach ACORD 1tH, Addllond Rwavus Schedule, N more space Is requlnd) CERTIFICATE HOLDER CANCELLATION MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Of �y ty ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1100 Simonton Street AUTNORDED REPReSENTA West, FL 33040 Norman Fuller U/�Key 1888 D CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks o O OP ID: NF 'A� "' CERTIFICATE OF LIABILITY INSURANCE °"'08128112 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certlHcate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 305-294-6677 The Fullers, Inc 305-2924641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller CONTNAMIE�T PHONE FAX A� NO' .MAIL ADDRESS: cuSTpmEgIpp.H0RNW11 NSUR S AFFORDING COVERAGE NAIL F INSURED William Hem 151 Key Haven Rd. Key West, FL 33040 INSURER A:P r6eelVe INSURER B : INSURER C INSURER D : ZINSUREltE: t RERF: COVERAGES CERTIFICATE NUMRER- RFVISIfm WI IIU112FR- THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADM POLICY NUMBER LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR B EACH OCCURRENCE $ ENTEU ES Ea oocunence $ MED EXP one $ PERSONAL & ADV INJURY S GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER. POLICY PRO. LOC PRODUCTS - COMPIOP AGG $ S A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X 2158316-9 05/29/12 05/29113 COMBINED SINGLE LIMIT (Ea acciderd) = 1,0�,00 X BODILY INJURY (Per person) S BODILY INJURY (Per amideM) S PROPERTYDAMAGE (Par ��I) : X X S S UMBRELLA LIAR EXCESS LAB OCCUR CLAN84AADE EACH OCCURRENCE S AGGREGATE 3 DEDUCTIBLE RETENTION S S WORKERS COMPENSATION AND EMPLOYERS' UABr ITYT. YIN ANY PROPRIETORIPARTNER/EXECUTNE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) I ees s, describe under DESCRIPTION OF OPERATIONS bel N I A WC STATU- OTH- E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Amch ACORD 101, Additional Remarks Schedule, R more aped Is rogWred) CERTIFICATE HOLDER CANCELLATION MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board County tY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Of ty ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1100 .Simonton Street Key West, FL 33040 AUTHORIZED REPRESEwATI Norman Fuller ®1989-20�ACORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks o ACOR OP ID: NF r4� �' CERTIFICATE OF LIABILITY INSURANCE °" �M02113 THIS CEATWATE W MUM AS A MATTER OF WFORRIATNON ONLY AND CONFM NO RIMTS UPON THE CEt11FICATNi HOLDER THIS CERTIFICATE DOES NOT AFRR11IA7NI3.Y OR NEGATIMY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE FOLICIES BQOW. THIN CERTWATE OF WSURAI CE DOES NOT COIISTRUTE A COKMAt.'T BETWON TIIs I WJM MUNWF44 JW1 W1 11E1RESENTATM ON PRDDUCER. AND THE CERTIFICATE HOLDER IMPORTANT: lT the csr-0, 1 IwWw Y on ADDITIDNAL WBURED6 do polk a) n 1 be etldorestl. 0 SUBROGATION E WAIVED, autim Is the terms and coadllaa alum pacy. Larhln poades mq rerpin an srtdoemtent A s1alelmwtt tLM 11i eer0kni s does not eonfir dads ID Ow oMMNoatr Noldsr in lieu of such PmR."FM n The FRdlere. Inc 300. N4641 1432 Kennedy Ddve Key Wiest, FL 33M Norman Fuller WEIFIQRNYM-1 HMO mo s William P Ham Amblieet PA BIN Horn 915 Eaton St. Key WW 4 FL 33040 wMupMtA:Florida RSWI Federation s: anwNt C: : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELAW HAVE BEAR IBBAIED TO THE I1GLIM NNYED ABOVE FOR THE POLICY PERIOD INDICATEOI NOTMMTHI TANOWO ANY REQUI19ENT, TEIW ON CONDITION OF ANY CONTRACT OR OTHER DOCLXIE! T MMTH RESPECT TO WHEN T418 CERTIFICATE MAY BE 18BUED OR MAY PERTAIN, THE N4$LN M AFFORDED BY THE POLICES DESCRM HEREIN IS SUBJECT TO ALL THE TERMSI, EIICWBIONS AND CONDITIONS OF SUCH POLICIES. LBWTS SHOWN MAY HAVE BEEN REDUCED BY PAW GRAINS. rimaps rtelAltcs tans ONOMALLavrM I esrswtelLCLALOpium LWLm7 CLAN04VpE ❑OCCUR � I LealOCCLNBtCE s tt6D OIN one PaLSDNALaAovwuRM s eNLLIfMLAoeR[OIU6 s OWLAOLWcM''MLWrAPPLWIPHt Lac PrAMA t•CarllOrAGG i s ArrOMOseA L WAR M ANVAUTO ALLOMeEDAUTOG SCHOXILO AUM IMLeD AUTOS NOW MEDAIM LAM 0 � c L r s 90MV I AW(Pffirs I $ BODLYPUtW(Pee 3 PROPIRR1Y OMIAGE f r s urLeLLsuwuAs QLOOe um Lam M� ! SAatocota i Hoccm AaOFE91►rE S DmLlcraLe s A rraatms cos�LSAnot72=1 AIO s�ors�LaLsurM IT" Tin �L�M A!M Ian i �nir MIA 520-40149 OU01HS 01HBU14 X LLsAwA00 06NT s 1 E.L ONENE • P.A 1 E.L_ t smnsarTiDNoPoPrmArowrLOCAMgNe/YeleiLp(MretfA101mtat.Afa1Ns1wwas"sesmod%W. P—ueeqd» NIONRCON SHOULD ANY OF THE ABOVE DEsclsaen POLICIES B! CANCBl5D BEFORE Monroe County Board of Cou ACCOTHE ExPNAT10N DATE THEREOF, NOTICE MILL M ORLIVERED IN RDANCE WrTHE POLICY PROVISIONS. Commissioners 110031 iordeS Street AutNomeso Key Wset. FL UM Norman O 1 CORPORATKM AN #%Io reserved. ACORD 25 9000I49) The ACORO moms and logo am reSbte ed wtub C`, OP ID: NF 'n"� Rom'- CERTIFICATE OF LIABILITY INSURANCE DATE051291"YYYI 05/29/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poilcy(les) must be endorsed. If SUBROGATION IS WANED, subject to the terns and conditions of the policy, certain policies may require an endorsement A statement on this Certificate does not confer rights to the certificate holder In lieu of such endorsemen s . PRODUCER 305-2946677 The Fullers, Inc 305-292-4641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller N PHONE AIC No EMAIL ADDR HORNWII MISU S AFFORDING COVERAGE NAIC t INSURED William Horn 151 Key Haven Rd. Key West, FL 33040 INSURER A: Pro resslve INSURIBR e ; Natom C : INSURER D : e1SURER E : IN F • GUVtKAG1-S CFRTIIWW!ATF UI IYIiCQ• n�nQu�u w runrs. THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR1 TYPE OF INSURANCE ER POLICY NUMB POLICY EFF MM POLICY E%PYYYI LIMITS GENERAL LJAB1uTY COMMERCIAL GENERAL LIABILITY CLAIMS•MADE OCCUR i EMU (1twis. AP EACH OCCURRENCE $ cr- I S MED EXP (My orn ) f PERSONAL a ADV INJURY S GENERAL AGGREGATE S GEN'L AGGREGATE LIMB APPLIES PER: POLICY PRO.LOC PRODUCTS - COMPIOP AGG S $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEOAUTOS HIRED AUTOS NON -OWNED AUTOS X 2158316.6 05129/13 05129114 COMBINED SINGLE LIMIT (Ea aoddent) S 1,000,000 BODILY INJURY (Per Person) S X BODILY INJURY (Par accident) S X PROPERTY DAMAGE (Peraoddsnt) S M S $ UMBRELLA LJAB EXCESS LIAR HCLA*A-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIASLITY Y I N ANY PROPRIETORIPARTNEA/EXECUTIVE OFFICEMMEMBER EXCLUDED? (Mandatary In NH) N yye�sr dseabe under DESdRIPTION OF OPERATIONS below NIA I WC STATU- OTH EL EACH ACCIDENT S E L DISEASE - EA EMPLOYEd S E.L. DISEASE - POLICY LIMIT I S DESCRIPTION OF OPERATM' I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Sah"U*, It mom space Is regolred) 2012 Nissan Frontier 8 PU 1NGADOERSCC464279 CERTIFICATE FIOLBFR &AutTcl I AT MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board Of County ty ty THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CommissionersAl ACCORDANCE WITH T E POLICY PROVISIONS. 1100 Simonton Street AMORIZED RA RESI3JT Norman Fuller Key Wes L 33040 C� = 01988-- AC RD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of COJD Client#: 1049512 WILLIP4 DATE (MM/DD/YYYY) ACORD, CERTIFICATE OF LIABILITY INSURANCE 08/22/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: USI Insurance Services, LLC PHONE 813 321-7500 ac No : 813 321-7525 A/C No Et): 1715 N. Westshore Blvd. Suite 700 EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # Tampa, FL 33607 INSURER A: Liberty Insurance Underwriters 19917 INSURED INSURER B : William P. Hom, Architect, P.A. INSURER C : 915 Eaton Street INSURER D : Key West, FL 33040 INSURER E: RFVIRION NUMBER: COVERAGES �,cic nrla.i+IG nv,a.r�.. THIS IS TO CERTIFY THAT 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 CONTRACTOR 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NS�R ADDL SUB POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE IN WVD POLICY NUMBER MM/DD MM/DD GENERAL LIABILITY I I I t - - EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE1:1 OCCUR A DA WWI —GENERAL �' ` -- MED EXP (Any one person) $ PERSONAL & ADV INJURY $ AGGREGATE $ PRODUCTS - COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY CT LOC AUTOMOBILE LIABILITY ANY AUTO All OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR n AIMS -MADE EACH OCCURRENCE $ AGGREGATE $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN N E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) H yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below AEA1015530001 8/20/2013 08/20/201 $2,000,000 per claim A Professional $2,000,000 annl aggr. Liability DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) N o —n Professional Liability coverage is written on a claims -made basis. ZZ Project: Stock Island Fire Station. -= r• far fT1 D 1 r- G-) CA) O � CD CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCFt I PID BWRE Monroe County THE EXPIRATION DATE THEREOF, NOTICE --WILL BE VERFa IN Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Risk Management AUTHORIZED REPRESENTATIVE 1100 Simonton Street Key West, FL 33040 wn�on rnoOnoAT1/1[U All rinhfa rasarvad_ ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD KEBEW #Sl0837684IM10837680 Client#: 1049512 WILLIP4 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 08/22/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Insurance Services, LLC 1715 N. Westshore Blvd. Suite 700E-MAIL CONTACT NAME: PHONE g13 321-7500FAX Exc: A/c N°: 813 321-7525 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Tampa, FL 33607 INSURERA: Liberty Insurance Underwriters 19917 INSURED William P. Horn, Architect, P.A. 915 Eaton Street INSURER B INSURER C Key West, FL 33040 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 CONTRACTOR 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR UB WVD POLICYNUMBER POLICY EFF M/DD POLICY EXP MM/DD LIMITS GENERAL LIABILITYpEACCHp�OECTCURRREENCE $ PREMISES Ea o"courD $ COMMERCIAL GENERAL LIABILITY 'PhENT EXP (Any one person) $ HCLAIMS-MADE F—IOCCURMED W*.-* PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- JECTLOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR DED RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / NFIR ANY PROPRIETOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) ff yS describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional AEA1015530001 8/20/2013 08/20/201 $2,000,000 per claim Liability rs "rt $2,000,000 annl aggr.FM 3 0 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) - C a M Professional Liability coverage is written on a claims -made basis. � r- tD Project: Conch Key, Big Pine & North Key Largo Fire Stations Annual Contract for Architectural Services r - wo 0 s M Monroe County Board of County Commissioners Attn: Risk Management 1100 Simonton Key West, FL 33040 ACORD 25 (2010/05) 1 of 1 #S10837685/M10837680 MLJ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 990 - t. 0&-W- A06----- ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KEBEW Ar'�70t�• OP ID! NF CERTIFICATE OF LIABILITY INSURANCE °"N'�'°°""'" THIS CERTIRCATE IS Nl M AS A MATTER OF INFORMATION ONLY AND CONFERS No ffllilff's UPoN THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRNIATIVBY OR NEOATNELY AURA EXTEND OR ALTER THE COWNItAOE AFFORDED BY THE POLICIES BELOW' THE CERT FICATE OF INSURANCE DONE! NOT CONSTITUTE A CONTRACT BETWEEN THE 13SWN0 INSURER(Bj AIITHOIl M IWRESENTATWB OR PRODUCER, AND THE CERTIFICATE HOLDER. theterms and it jW a Iffiloffhe e—, holder Is an ADDITIONAL MURW the POReY(IM) must be widoraad. If SUBROOAYMN IS WAWED, aubjea to Poky, oaWR po kha may n rs qu an endorsement A slaMnhaht on this GWOCate don not cerdm rWo to the cwdfkab holderin lieu of such andowm s . rRo The FFullullers. Inc 30�944Wr? 1432 Kennedy Cries 306-2024M Key Went. FL 33040 Norman FuNer . HORNW-1 R® William P Horn Archlboct PA s WN Nord A, FImt Conan Insurance Co. 139" 913 Eabon fit. INSUhla ■ s Key VWss% FL 33040 819UNER03 MIhIR� D s NIe1N1lR ! i THIS M TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE PE BEEN ISSUED lb THE INSURED NAMED ABOVE FOR THE POLICPERIODMr1DICAT ED. NOT1AlTIIBTANOINO ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NTH RESPECT TO VVHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HERIBN 11 SUBJECT TO ALL THE TEFW^ DGCLUSIONd AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN IIfAY HAVE BEEN REDUCED BY PAD CLAIMS. 111IR OP McW1ANDa LaeM elNhuAL h.MNINTY cMIMERC1ALeSIIEIIALLIAaaITY x A 09000011211111111111010 OW21113 OW 14 001OCCUaRISINCIS 1�Oo CIA0104ADE ❑ U • s OCCUR x Batloeee Ownwe MED EW wo " PMYONALLADVINJURY e aeNWALAOSMOA,! s OWL AflOREBATE 1J1lTAFPL1Ea IBC PRDoucTa-COMPIOP AGO xPoLW = Lao AWYOaONaa UPa m comm D enaE Lair ANYAUTO IEeemtd o S ALL OWNEDAUTDS AP BOOILY I NURYIPWPew) N OCFIEDIRiDAUrO! lODLYNNUIYIPraeeWOnq N HNIED DA A PROPERTY DArrAOE AUTOe NON-DNN WAUTOS = OCCUR EACHOGGWo710E e lxcEfe Les CwIS MADG AGGREGATE , DEDUCTIBLE YhOltlfalM oDMP11MAT10N ANDANY LYaaJ1Y YIN WC RA ! OfFICOVLINMBERl70CLIIDm'► NIAJ L.LEACHACCIDEWT Is N ae� www E L DOEM -!A F>I! EL poUCYuw I s architect OF OpeRAT1011e I LOCAMONS I VeNOLES Oft* ACORO L1, AdMO W Rowft b waft I1 Tile SpM M I"W" cm �T7 � 4t .�_ C; �r FT1 CERTIFMMHOLoEg NCELLATION MONRCON N SHOULD ANY OF THE ABOVE OEScmwc.PoLICIRS BRUNC REFORM EO Monroe County Board of County THE W(PIRATION DATE TNERF, VaftE WILL BE DBE I IN ACCORDANCE WITH TFIE LILY PROVISION. —0 A Commissioners _ � 3 1100 Simonton Street rn AUTWRIM IMPaESaIr N Key West, FL 330e0 Norman FUller o 0 491 9 AJIWW CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo an registered marks p OP ID: NF °" '°l""'"' CERTIFICATE OF LIABILITY INSURANCE - 01102 olrozrl3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: If the oerlMcate holder is an ADDITIONAL INSURED, the policy(Ies) must be endorsed, If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certMeate does not confer rights to the certificate holder in lieu of such endorseme s . PRODUCER 305-29"677 The Fullers, Inc 305-2924641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller CONTACT P"°"E IE4WL P wHORNW-1 INSURE S AFFORDING COVERAGE NAIL r INSURED William P Horn Architect PA Bill Horn 915 Eaton St. INSURER A: Florida Retail Federation INwRER B : INsuRERC: Key West, FL 33M INSURER D : INSURER E IN F V V V CRAtiCii CERTIFICATE Nt1MBER` REVISION N UMBER. THIS 1S TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER 11111MIDDrefm 1 LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE f PREL41SES Wit e f MED EXP (Arty one perwnI, $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE f GENL AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMPIOP AGO $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NO"WNED AUTOS COMBINED SINGLE LIMIT (Eaac*1W) f BODILY INJURY (Par person) f BODILY INJURY (Par socidwtt) S PROPERTY Y ROPERTDAMAGE $ $ S UMBRELLA UAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE f DEDUCTIBLE RETENTION S $ f A WORKERS COMPENSATION AND EMPLOYERS' LIAeXJTY YIN ANY PROPRiETORIPARTNEP/EXECUTIVE OFFICEROMEMSER EXCLUDED? ❑ (Weds!" in NN) Nyywwdesaibourdar DF_SCRIPTIO OF RATIONS below N I A 20-40146 01/01/13 01/01114 I STATU- OTH- WC X E.L EACH ACCbENT $ 1,000,00 E.L. DISEASE - EAEMPLO f 1.000,00 E.L. DISEASE - POLICY LSAT f 11000, DESCRIPTION OF OPERATIONS I LOCATORS I VEHICLES (Apah ACORD 101, AddlpwW Rarnaft Sdwduls, K mon apau Is rpukad) MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDAN$EEOLICY PROVISIONS. Commissioners 1100 Simonton Street AUTHORIZED R Key West, FL 33040 Norman Fu ®ORD CORPORATION. AN rights reserved. ACORD 26 (2000109) The ACORD name and logo are registered RD ,a►c CERTIFICATE OF LIABILITY INSURANCE °AT"1WD°^^"r' o9rta13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOER NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(ft AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: M the certificate holder Is an ADDITIONAL INSURED, the poNey(Iee) must be andorsed. If SUBROGATION IS WAIVED, subject to the terms and condition of the pollcy, cartaln policies may require an endorsement. A Sleftw ft on this certificate does not confer r1oft to the AwMents holder In Ilan or weh ■ndn, --,dl-i PRODUClut 306-2944877 The Fuilers, Inc 306-292.4641 1432 Kennedy Drive Key Weak FL 33040 Noonan Fuller 1N0YR M WRIMM P Hom Amhfteet PA Bill Horn 913 Eaton St. Key West, FL 33040 rgQ ERAGE8 CERTIFICATENUMBER.- . 12Tn rroT,— �„-� - REVISION NUMBER: INDICATED. NOTWITHSTANOING-ANY RECUIREIMENn T yTERM OR CONDITION OFBEEN ISSUED ANY CONTRACT R OTHTHE HEEREDOCUMENT NAMEDNTH FRE�SPEECCT To WHICH TPOLICY HIS 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 POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. TYPB OPsswRANos uWrs GOVAL UOMUTY A COMMEIUML684EI LLIABILI Y CLOAGA ADE X 090004962025809 0921M3 09MM4 EACH occuRRENca i 1,000,00 PROMISES We gganmiod a 5010 001 $ 5100( OCCUR X eBehlns Owners MEDEXP one non POWNAL aADV INJURY e GENERALAGGREOATO f 0001 GENLAGGREGATELIMITAPPLIESPER: X Pat= LOG AUTOMOBLE LlAaarrY AWAUTO t 'l PRODUCTS -COMPIOPAGO e COMeUED BINDLE LIMN' IE@aooM.r4 i i ALL OWNED AUTOS AP 9wLYBIJURvpwPw" S SCHEDULED AUTOS HIRED AUTOS NON•OWNEDAUTOS DA WA A 'si B0DXY1NAMY1Mr+�^4 e lPPOPERTY DALSACE e • �°"°W LIAs i?JICgeLJAa occua CWMSMADE EACH OCCURRENCE e AGGREGATE i DEDUCTIBLE i wollKap LATION AND WWLOVMW LNBLJTYAW YI9 OFFICIMMEMBCREXCL� IWnallNq In NHI B dnaanwdr NCw NIA VYC STATU• 071i- e F.L. EACHAOCIDENT $ EL. DISEASE-EAEMPLOYEE S EL DISEASE- POUCY LIMIT i BEaORIPTIDN OF OPERATIONS / LOCATN)NB I VEMLU (A Mb ACORD IGI, Addronal Rlnrdn aohoftd@, It NNME ipBE b r@qUftq amhltact d-=Emvfk MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board Of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE MATH THE LN:Y PROVISIONS. 1100 Simonton Street AUTHONZED afPaaaaNr 11 Key Weak FL 33040 Yw Norman Fuller mFO CORPORATION. All right reserved. ACORD 25 (20W08) The ACORD name and logo are registered mart D '4A r'' CERTIFICATE OF LIABILITY INSURANCE17029113"' �F. THIS CERTIFICATE is ISSUED AS A MATTER OF INFORMATION ONLY AND CODERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER4$j, AUTHORIZED REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER. IMPORTANT: If the certiNwte holder is an ADDITIONAL INSURED, the polk ") must be endorsed, If SUMROGATION IS WANED, subject to the terms and conditions of the Polley, certain policies may require an endorsemenL A statement on thls ar8llcate does not confer rights to the PRODUCER 305-2944 The Ruilere, Inc 305-2924641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller INW91) William Horn 1$1 Key Haven Rd. Key West, FL 33040 COVFR,r;ER flown w-Aim an a d. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN tSSUEO 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 PERTAiK THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT To ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAW. TYPE OP O OUnANCE FOUCTMW LIMIT! OOaeRN LJAeILIY COMMERCIAL GENERAL LVAUTY CLAIM 4AADE OCCUR ' ^� EACH OCCURREWX S Eg -rn wr MED E� ne op" i S PERSDNAL A AIN KR RY S GENERALAGQMOATE $ GEN'L AWAIWATE UWTAMI58 PER: LOC PRODUCTS - COWYOP AOG S S A AUT0900E LMIMUTY myAuTo ALLOWNEDAUTOS X sa+EouLEOAUTD! X NIIED AUTOS X NOM4WN MnW )( 0215831U 05/29N3 06129114 CO eww mom Uwr $ Y KUtY (Per Peron) S EDDILYINJURY(Pwaeoidnd) S PROPI R DAMAGE : "►BAIL" u" OCCUR axcm u" M EACH OCW BCE f AooREOATE s DEDUCTIBLE s rYMEN OOMPIENZ ►TION AND ENPLOYOW L1AAIITY DFFlIN AMYR,,CPR MBER EXCLA� Y❑ (( In � oPERAn N 1 A vVC A O E.L. EACH ACCIDENT S E L DISEASE - EA EMPLO s - POLICY LW201 S OBSCRIPTIDN OP OPEMITIDN! I LACA�IOW r VM"MM t��a�, ACORD M, AdWaW RwuM lchadW*, If mom span I. wAWrsdj 2 Nissan Frontier PU iNSADOERSCC4"279 MONRCON SHOM D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 89NM Monroe County Board Of County THE EXPbtATION DATE THEREOF, NOTICE WILL BE DELIVOW IN ty ACCORDANCE WITH T P PROVISIONS. COrnmisBiOneB 1100 Simonton &rest AUTHOMM RORRO T Key West, FL 33040 Norman Fuller cis AdIRD CORPORATION. AN right► reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of COFM Client#:16 ,12 1ir._JP4 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDlYYYI� 08/(MM/DD 3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION'' ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: USI Insurance Services, LLC PHONE g13 321LAX,-7500 1715 N. Westshore Blvd. Suite 700 E-MAILo Ext . A/c No : 813 321-7525 Tampa, FL 33607 INSURED William P. Horn, Architect, P.A. 915 Eaton Street Key West, FL 33040 INSURER(S) AFFORDING COVERAGE I NAIC # INSURER A: Liberty Insurance Underwriters 119917 D: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 CONTRACTOR 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR UB WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MWDD LIMITS GENERAL LIABILITY EACHOCCURRENCE $ COMMERCIAL GENERAL LIABILITY I. r PREMISES Ea occurrence $ CLAIMS -MADE OCCUR BY MED EXP (Any one person) $ PERSONAL & ADV INJURY $ Wt/YES Ir GENERAL AGGREGATE $ .GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY D PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per ccident a $ NON -OWNED HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- OR `Clli)d AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ A Professional AEA1015530001 08/20/2013 08120/2014 $2,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Professional Liability coverage is written on a claims -made basis. Project: Stock Island Fire Station. l'9ill I il Loy-, III Monroe County Board of County Commissioners Attn: Risk Management 1100 Simonton Street Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE VA:0 kL O&W., . a ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S10837684/M10837680 KEBEW e- .; 14`o�n° CERTIFICATE OF LIABILITY INSURANCE °" 09 20113 THIS CERTIFICATE Is ISSUED AS A MATTER OF INFORMATION ONLY AND CONFOM NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERft AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: M the Certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION 19 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement: A statement on this certlfieats does not confer rights to the certMeahl holder In lieu of aueh andorsemen s . PRODU"A 305-29"677 The Fullers, Inc 305-29246 1 1432 Kennedy Drive Key West, FL 33040 Noonan Fuller CONTACT PHONK S.M.No . PRODUCatHORNW-1 a W COVERAoe NA1C INSURED William P Mom Architect PA Bill Mom 913 Eaton St. Key West, FL 33040 eNIUReR A: First Community Insurance Co. 139" MOLIREII a ; OMRORC: INWRU D : INSURER E : COVFRACFR 1`11:I7TIFII`ATO UI UCk mmnernu L"um�s THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. LTR TYPOOF# WPANCE I= wwn I POLICY NUMBER 09t21114 LIMITS A 0"Iff I. LIMUTY CMNERCNLGENERAL LMILITY CLASM-NIADE OCCUR X Business Owners X 090004962995809 09111113 EACH OCCURRENCE ! i'mi.0001 PREMISES! 60,0 MEDEXP oft• ! 5,00( PBUONALHLADVRUJRY ! OaEN'LAGGREGATE LIMIT APPLIES PER: X 1 POLICY PRD- LOC GENERAL AGGREGATE ! 2,000,00( PRODUCTS -COMPIOPAGG ! ! AUTONIUSILA LIAaafTY ANY AUTO ALL AUTOOWINED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS AP DA WA*N/A '\ COMSiNED SINGLE UNIT (Ex wddeM ! BODILY RUURY Mw pwwrq ! BODILY INJURY (Pr wederd) ! PROPERTY DALME (PwR=MW ) ! ! ! UMORSAA LM EXCESS LAID OCCUR CLAIMFrMADE EACH OCCURRENCE ! AGGREGATE ! DEDUCTIBLE ! VIKIMeRe Cou"J AT" AND EaU PLOYERe ASK rrY Y I N ANY PROPRIETORIPAR7NER/EXECUT1VE 7 OFFICIR MEMBER EXCLUDED? (�>dMery In NHI H dgtrfie undw F RA N below N / A NIC STATU- 0TI1- EL EACH ACCIDENT E.L. DISEASE - EA RrLO 3 E.LDISEASE-POLICY LMIT s DESCIII►TION OF OPEMT*M I LOCATIONS I VEHICLES (AItmh ACORD 101, Addtloul Rmurks Bctw WR IT mm ipm b rwauirW) architect CERTIFICATF Hni nFR a ALIf r-I I ATIMI MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County tY tY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE LICY PROVISIONS. 1100 Simonton Street Aureomm RHsr� Noonan Fuller / /// Key West, FL 33040 01011-2 FID CORPORATION. All rights reserved. ACORD 25 (2009l09) The ACORD name and logo are registered marks D � - cwa tcdc 191 _ DATE (LIVOIDWYYYY) ,c�TE I1 ISSUED AS A mATTER OF INFORMAT10?l ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FOLDER. THIS DOES NOT AFFIRMATIVELY OR NEaATIIJELY AMEND, EXTEND OR ALTER THE GOVERAGE AFFORDED BY THE POLICIES THIS CERTIFICATE OF INSURA€�CE DOES NOT CONSTITUTE I�ONTIZIJACT BE`i"IWEEN THA ISa�IIf�0 IMSURER(S), AUTHORIZED 1.1j�'RESENTATPVE CAR PRODUCER, AMD THE CERTIFICATE HOLDEN, - IMPORTANT: if the co fogate holder is an ADDITIONAL INSURED, the polleypes) must be end essd, If SUSROGAnON is WAIVED, subject to the terms and conditions of the WILY, COOPRIF, pollrkl -rre s gy ee quire an andorsement. A eUdemerwYE Sea this es�It�@sfs d s r&t torlfw ei¢has to the cerVficate holder in lieu of such endoesen. ont(s). PRODUCER 305_294-6677 SAME CT PH NE FAX The Fullem, Inc 305-292�• 1 Are N €sac NaI; IA-'fl W mnn d Drive E-MAIL__ Key West, ILL 33040 Norman Fuller INSURED William P Horn A I_i6,��PA. Bill Horan 915 Eaton St. Ivey West, FL 33040 I : Florida Retail ngvua�thi%Ui cal MAPIF2• 2 COVERAGES _ Lo�PB E Y�l�d�e ae�aaara�a�: THIS IS TO CERTIFY THAT THE POLICIES OF 1NS4JRAhICE LISTS© BELOW HATE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NbTWITHSTRNDING ANY i2EQUIREMIENT, IIEI ti OR CONDITION OF ANY C0 TRACT OR OTHER DOCUMENT VI!lTfi RESPECT T€7 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE 6hSSUTiANt:E RFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUIJEGT TO ALL TIDE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. L14flITS SHOWN MAY HAVE BEEN FtEDUCEb 8Y PAID CLAIMS. lL?R TYPE OF INSU!@ANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAtM"ApE El OCCUR U POLICY NUP"ER f�M/DD YY EY l Y bPtPOA YE — LIMITS EACH OCCURRENCE $ DAM G PREMISES Ea ccxurrance MED EXP (Any one Person} S PERSONAL& ADV INJURY I GENERALAGGREGATE $ PRODUCTS _ COMPtOP AGG $ GEHL AGGREGATE LIMIT APPLIES PER; RO- LOC POLICY PFQT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (per accident) S PROPERTYDAMAGE (Per accident) S S A UMBRELLA UAB EXCESS LIAR OCCUR CLAIMS -MADE 520�946 9�` IIG.L. EAC>iOCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION S WORKERS COMPENSATION ANDEMPLOYIERS'LIABILtY9Y� ANY PROPRIETORIPARTNERIEXgCUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NW) If as, describe under DESCRIPTION OF OPERATIONS below WC STATU- O T H- T - g EACH ACCIDENT $ 9,Q00,Qa E.L DISEASE - EA EMPLOYEE $ 1,00010010 ,� QtIQc� E.L. DISEASE - POLICY LIMIT 8 , DESCRIPTION OF OPERATIONS I LOCATIONS I VIRMfiCLES (Attach ACORD 101, Addittonal RariavUs Schadula, N more apace is t-4ulrod) Moetres County Board of Counly Commissioners I100 Simonton Street Key West, FL 33040 NIONRCON SHOULD ANY OF THE ABOVE DESCRIED FOUGIES BE CANCELLED BEP43Rrc THE EXPIRATION DATE T&i OF, NOTiCE wLL BE DELIVERED IN ACCORDANCE U11H THE �POLI Y PROVISIONS, — — AUTHORIZED REI Norman Flat COR PORAT910N..All uIi htS VC-SGFVGd- CORD 26 (2000t09) The ACORD nartge and Iogo act rogiv,Wr m-d OP IL coRo CERTIFICATE OF LIABILITY INSURANCE DAT05129/13YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsemen s . PRODUCER 305-294-6677 The Fullers, Inc 305-292-4641 1432 Kennedy Drive Key West, FL 33040 Noonan Fuller NAME CT PHONE E-MAIL ADDRESS: PR TUMeRI r HORNWl1 INSURERS AFFORDING COVERAGE NAIC r INSURED William Horn 151 Key Haven Rd. Key West, FL 33040 INSURER A: Pro ressive INSURER B : INSURER C : INSURER D : INSURER E : INSURER F CERTIFICATE NUMBER REVISION NUMBER: COVERAGES THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I NSR T OF INSURANCE ADDLISUIFR POLICY NUMBER POLICY EF MMJDDfYYYY MMIDDf EXP POLICYTYPE LIMITS GENERAL LIABILITY pP v �I GEME �vtG EACH OCCURRENCE $ PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y ATE AI MEEXP {Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ $ POLICY PRO JFCT LOC A AUTOMOBILE LIABILITY ANY AUTO X 02158316-6 05/29/13 06/29114 COMBINEDSINGLE LIMB (Ea accident) $ 1,000,Ot} BODILY INJURY (Per parson) $ BODILY INJURY (Per accident) $ ALL OWNED AUTOS X X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ NON -OWNED AUTOS X UMBRELLALIHB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DEDUCTIBLE $ WC STATU- OTH- I RETENTION WORKERS COMPENSATION E.L. EACH ACCIDENT $ AND EMPLOYER$' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N / A E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below 1 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) 2012 Nissan Frontier S PU 1N6ADOERSCC464279 MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of County ACCORDANCE WITH T E POLICY PROVISIONS - Commissioners 1100 Simonton Street AUTHORIZED REPRESENT E Key West, FL 33040 Norman Fuller I ©1988- O AJKqRD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of COID OP ID: NF ,d►coRa CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/16/15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER 305-294-6677 NAME: The Fullers, Inc 305-292-4641 PHONE FAx A/C No Ext : A/C No 1432 Kennedy Drive E-MAIL ADDRESS: Key West, FL 33040 PRODUCER Norman Fuller CUSTOMER ID #: HORNW-1 INSURERS AFFORDING COVERAGE NAIC # INSURED William P Horn Architect PA INSURER A: First Community Insurance Co. 13990 Bill Horn INSURERB: 915 Eaton St. INSURER C Key West, FL 33040 INSURER D INSURER E : INSURER F rOVFRAf;FR CFRTIFICATF NIIMRFR• REVISION NUMBFR: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDPOLICY /YYYY MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A COMMERCIAL GENERAL LIABILITY X 090004962995811 09/21 /15 09/21 /16 DAMAGE TO RENTED PREMISES Ea occurrence $ 50,00 CLAIMS -MADE F—IOCCUR MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ Inc X Business Owners GENERAL AGGREGATE $ 2,000,00 I GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,00 $ X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS VED�Y ISK M BY DAT GEMENT _ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ NON -OWNED AUTOS WAIVER N/ S •-� $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAR CECUOT— $ $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE STATU- H- TWC RY I IT OTR E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E.L. DISEASE - WMPLOYEEV, -� E.L. DISEASE - AMICY LIMIT If yes, describe under DESCRIPTION OF OPERATIONS below J t^ C3 7 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) +-7' �n architect C_-) C-) 'U -a C_ T1 CERTIFICATE HOLDER CANCELLATION MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe Count Board of Count THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y y ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1100 Simonton Street AUTHORIZED REPRESENTATIVCy .1' Key West, FL 33040 Norman Fuller /i © 1988-2009 AC D CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of AC RD OP ID: NF .4COR0 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) F 05/29/17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 305-294-6677 The Fullers, Inc 305-292-4641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller CONTACT NAME: PHONE FAX A/C No Ext : A/C No E-MAIL ADDRESS: PRODUCER cusroMERID#:HORNWI1 INSURERS AFFORDING COVERAGE NAIC # INSURED William Horn 151 Key Haven Rd. Key West, FL 33040 INSURER A: Progressive INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR NUMBER POLICPOLICY MM/ DY EFF POLICMM/ DYEXP /YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F—IOCCUR EACH OCCURRENCE $ DAMAGE TO RENTED ccurrence PREMISES Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMP/OP AGG $ $ AANY AUTOMOBILE LIABILITY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X 02158316-6 05/29117 05/29/18 COMBINED SINGLE LIMIT (Ea accident) $ 1 000�00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ xi $ UMBRELLA LU1B EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC STATU- OTH- T RY LIMITSER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) R Ir T A MONRCON Monroe County Board of County Commissioners 1100 Simonton Street Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPREI Norman Fuller 01988-200 ACOKD CORPORATION. All rights reserved. ACORD 25 (2009/09) / The ACORD name and logo are registered marks of ACORD Gc��