04/18/2001 Service Order
CLERK OF THE CIRCUIT COURT
MONROE COUNTY
BRANCH OFFICE
MARATHON SUB COURTHOUSE
3117 OVERSEAS HIGHWAY
MARATHON, FLORIDA 33050
TEL. (305) 289-6027
FAX (305) 289-1745
MONROE COUNTY COURTHOUSE
500 WHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
FAX (305) 295-3663
BRANCH OFFICE
PLANTATION KEY
GOVERNMENT CENTER
88820 OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-7145
FAX (305) 852-7146
MEMORANDUM
DATE:
May 14, 2001
TO:
Reggie Paros, Director
Public Safety Division
FROM:
Norm Leggett, Senior Director
Emergen(;y Management
Pamela G. Hanco~
Deputy Clerk a
ATTN:
At the April 18, 2001, Board of County Commissioners meeting the Board granted
approval and authorized execution of E911 Phase I - Service Order Form between Monroe
County and VoiceStream Wireless for compliance with the Federal Communications Commission
(FCC) requirements for E911 Wireless Phase I implementation in Florida.
Enclosed is a duplicate original of the above mentioned for your handling. Should you
have any questions please do not hesitate to contact this office.
Cc: County Administrator w/o document
Risk Management wlo document
County Attorney
Finance
Filev'
E911 PHASE I - SERVICE ORDER FORM
Name: VoiceStream Wireless
Address: 12920 SE 38th Street
City: Bellevue
State: W A
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Zip: 98006
CARRIER CONTACT (24x7x365)
Name: Law Enforcement Relations Group
Phone Number: (973) 872-5711
Fax Number: (973) 872-5729
CARRIER NOTIFICATION:
Name: Jim Nixon
Address: 12920 SE 38th Street
City I ST I ZIP: Bellevue, W A 98006
Name:
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CUSTOMER CONTACT (24x7x365)
Name: G. Nonn Leggett
Phone Number: 305- ~'-f 3- '15'1D
Fax Number: 3 C 5 - ~ 'ir 0, - u (Yly-
CUSTOMER NOTIFICATION:
Name: Cr. t'-\O.(V"Y\ L~~e.*+
Address: \DLJOu Pr\l\AJ-; lSV\ ~\\1 A.-
City I ST I ZIP: ffio...x ~<N\ \ ~ C. 3?>c. S1J
Service Description: Pursuant to this Service Order ("Order"), Carrier shall provide E911 Phase I Service ("Service"), in compliance
with Phase I of the Federal Communications Commission ("FCC") Order in Docket 94-102, as amended and the laws of the State of
Florida, but only in such portions ofPSAP Service Jurisdictions that Carrier operates its wireless service. A copy of functional
specifications of such Service is attached hereto as Exhibit A, along with plans for the testing and implementation process as agreed to
by Carrier and PSAP ("Implementation Plan").
Confidential Information: The confidentiality of any information provided by Carrier to PSAP shall be governed by the Florida
Public Records Act, chapter 119, Florida Statutes. The parties acknowledge that Florida law protects trade secrets from disclosure
pursuant to Fla. Stat. ~~ 365.174 and 812.081.
Term: This Order is effective on the date ofPSAP's signature, ("Effective Date") and shall remain effective for one (1) year ("Initial
Term"). This Order shall automatically renew for successive one (1) year terms ("Subsequent Term") unless written notice of
termination is given to the other party not less than ninety (90) days prior to the expiration of each Subsequent Term.
Limitation of Liability: The parties acknowledge their respective immunities from liability are or may be granted by Federal and
state laws, as amended from time to time. Each party will honor the other party's immunity to the full extent required by law.
De1ayIForce Majeure: Carrier shall perform services pursuant to Federal law, state law, and the Implementation Plan, but, to the
extent allowed by Federal or state law, Carrier shall not be liable for any delays resulting from acts of third parties and acts of God.
APPROVED AS T FORM
AN EG Nev. Florida Wireless 9-1-1 Board Model Contract 5/5/00
8
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The parties further acknowledge that successful and timely provision of Service is contingent upon the timely performance of actions
by and cooperation of many third parties, including, but not limited to, actions that must be completed by the 9-1-1 Provider/LEC,
PSAP, and the Host ALl Provider. Federal law establishes the deadline for implementation of Service. Nothing herein shall be
construed to extend the deadline as established by governing Federal and state law, if applicable.
No Third-Party Beneficiary Relationship or Liability Created: Carrier offers Service to PSAP solely as an aid in PSAP's
provision of E911 Service. Carrier's provision of Service to PSAP does not create any relationship or obligation, direct or indirect, to
any person or entity other than PSAP.
DISCLAIMER OF WARRANTIES (OPTIONAL:EXCEPT MANUFACTURERS' WARRANTIES): THE PARTIES
ACKNOWLEDGE THAT THIS ORDER IS A CONTRACT FOR THE PROVISION OF SERVICES (OPTIONAL: AND THAT
ANY GOODS PROVIDED HEREUNDER ARE ANCILLARY TO THE PROVISION OF THE REQUESTED SERVICES).
(OPTIONAL:WITH THE SOLE EXCEPTION OF ANY EXPRESS WRITTEN MANUFACTURER'S WARRANTY, WHICH
MAY BE APPLICABLE TO PARTICULAR GOODS, ALL GOODS ARE PROVIDED "AS IS".) THE PARTIES AGREE THAT
THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE AND ALL OTHER
WARRANTIES, EXPRESS OR IMPLIED, ARE EXCLUDED FROM THIS TRANSACTION AND SHALL NOT APPLY TO ANY
(OPTIONAL: GOODS OR) SERVICES PROVIDED HEREUNDER. CARRIER AND ITS SUBCONTRACTORS EXPRESSLY
EXCLUDE AND DISCLAIM ANY AND ALL WARRANTIES, GUARANTEES OR REPRESENTATIONS WHATSOEVER,
EXPRESS OR IMPLIED, ORAL, WRITTEN OR OTHERWISE RELATED TO ANY EQUIPMENT, FACILITIES, FEATURES,
REPAIR, MAINTENANCE AND TO ANY AND ALL GOOD~ AND SERVICES PROVIDED OR TO BE PROVIDED TO PSAP
BY CARRIER OR ITS SUBCONTRACTORS. THERE ARE NO WARRANTIES THAT EXTEND BEYOND THE
DESCRIPTION ON THE FACE HEREOF.
Independent Contractor: Carrier's relationship with PSAP under this Order is that of an independent contractor.
Assignment: The parties to this Order may not assign any of their rights nor delegate any of their obligations under this Order
without the prior written consent of the other party (which consent shall not be unreasonably withheld), except that Carrier may assign
its rights or delegate its duties under this Order to any of its affiliates, to the surviving entity in a merger or consolidation or to a
purchaser of substantially all of the assets of the business to which this Order relates without PSAP's written consent. All the terms
and provisions of this Order will be binding upon and inure to the benefit of and be enforceable by the parties and their respective
permitted successors and assigns.
Amendment/Modification: Any provision of this Order may be amended upon mutual agreement of the parties, executed in writing,
and the observance of any provision may be waived only in writing signed by a duly authorized representative of the parties. In
addition, the Parties may also modify this Order upon thirty (30) days written notice if there is a change in an applicable law or if
Carrier should sell or otherwise dispose of all or part of its wireless communications service license for the provision of wireless
communication service in any portion of the PSAP Service Jurisdictions. Upon such event, this Order may be modified only as
appropriate to reflect such disposition. This shall include removal of the relevant area from this Order.
Governing Law: The laws of the State in which the Service is provided govern this Order except as otherwise provided for herein,
except for matters within the exclusive jurisdiction of the FCC.
Entire Agreement: This Order, together with the Service Acceptance Form, constitutes the entire agreement between the parties and
supersedes all prior agreements or understandings, whether written or oral, with respect to the provision ofE9!! Phase I Service.
Responsibilities of Carrier: Carrier shall implement Service pursuant to Federal law, state law, and the Implementation Plan,
attached hereto as Exhibit "A", as agreed to by the parties. Nothing in Exhibit "A" herein shall be construed to extend the deadline as
established by governing Federal and state law, if applicable. In addition, Carrier shall not initiate Service without written
acknowledgment from PSAP of completion of testing and acceptance of Service, including but not limited to date and time of Service
activation. Carrier shall reasonably cooperate with PSAP and all necessary third-parties in all aspects of implementing, scheduling,
testing, verifying and operating Service, including notifying any and all parties of any network changes or changes in data to be
delivered to premise equipment.
Responsibilities of PSAP: PSAP shall:
· have sole responsibility to answer, respond to, transfer, terminate or otherwise handle E911 telephone calls, to dispatch or arrange
to dispatch emergency services;
· furnish Carrier, at PSAP's reasonable expense, all technical matter, data and information as reasonably necessary under this
Order;
· provide reasonable access to PSAP's premises, as needed by Carrier or its subcontractors;
Florida Wireless 9-1-1 Board Model Contract 5/5/00
. provide written acknowledgment of completion of testing and acceptance of Service to Carrier, including but not limited to date
and time of activation of Service, prior to commercial use;
. reasonably cooperate with Carrier and all necessary third-parties in all aspects of implementing, scheduling, testing, verifying and
operating Service, including notifying any and all parties of any PSAP jurisdiction area changes or changes in data to be delivered
to premise equipment.
Acknowledgements: The parties acknowledge that:
. These terms and conditions are for the parties' mutual benefit and should encourage the efficient and cooperative deployment of
the Service
. Carrier's reasonable costs for Service shall be paid pursuant to Florida Statutes Sections 365.172 and 365.173. The parties
acknowledge that PSAP shall not be responsible for payment of Carrier costs, pursuant to governing law.
Florida Wireless 9-1-1 Board Model Contract 5/5/00
MAR-29-2001 09:04
EMERGENCY COMM. DEPT.
305 289 6078 P.01
EXHIBIT A
CONFIDENTIAL AND PROPRIETARY INFORMATION
VoiccStream Phase I Implementation Plan for Monroe County, Florida
February 21,2001
VoiceStream will implement Phase I wireless E9-1-1 service in Monroe County, Florida,
according to the plan outlined below. Because VoiceStream recently completed mergers ith
Omnipoint, this plan applies to all Omnipoint service in the County.
A. VoiceStream intends to use the BellSoutb hybrid Phase I solutioll.
B. The BellSouth hybrid solution wireless E9-1-1 solution allows us to deliver Phase 1 d ta to
the selective router via an SS7 trunk (digital trunk) using FGD signaling (one o.fthe dard
signaling fonnats). BellSouth then splits this data into an NCAS (voice and data trav I
separate paths to the PSAP) format for delivery to the PSAP. This solution will be d. loyed
in Monroe County.
c. This section left blank per Florida Wireless Board rules. It will contain cost informati fl for
review by the Board but review of this infonJlation is not thc responsibility of the indi idual
counties.
D. This section left blank per Florida Wireless Board rules. Tt will contain cost informal" n for
review by the Board but review of this infonnation is not the responsibility of the indi idual
counties.
The VoiceStream point of contact for this plan is James A. Nixon, Senior Manager ofRe
Affairs, 12920 SE 38tlt Street, Bellevue. W A 98006, 452-378-4417. Pricing information i
included on this copy of the plan lAW Florida Wireless 911 Board rules.
E. This section left blank pt:r Florida Wireless Board rules. It will contain cost infonnati
review by the Board but review of this information is not the responsibility of the indi
counties.
Monroe County Endorsement
Date: cj Ii ~~ /
I I
SignatUre below indicates that Monroe Cuunty agrees with the technical aspects oFthis
deployment plan. The review by Monroe County did not include cost data. Review and proval
of cost data is the responsibility ofthe Florida Wireless 9 1 1 Board.
:'~,e _ ~~ct
GeOrge Neugen \.j
Mayor, Monroe COllIlb;;, ,:-- ---'_
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CERTIFICATE OF INSURANCE
DATE (MM/DDIYY)
4/30/2002
PRODUCER
Aon Risk Services, Inc. of WA
1420 5th Avenue, Suite 1200
Seattle, WA 98101
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
INSURED INSURER A:
St Paul Fire & Marine Ins
VoiceStream Wireless Corp, a Delaware Corporation & its INSURER B:
subsidiaries & Affiliates incl. Cook InleWS GSM Subsidiaries
12920 Southeast 38th Street INSURER c:
Bellevue, WA 98006
Lumbermans Mutual Casualty Company
INSURER 0:
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. THE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE
L TR DATE (MMIDDNY)
POLICY EXPIRATION
DATE (MMlDDIYY
LIMITS
A
GENERAL LIABILITY
~ COMMERCIAL GENERAL LIABILITY
[J CLAIMS MADE ~ OCCURRENCE
~ OWNER'S & CONTRACTOR'S PROT
[J
D
TE08400984
5/1/2002
5/1/2003
GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMP/OP AGG $ 2,000,000
PERSONAL & ADV INJURY $ 1 ,000.000
EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Any One Fire) $ 1,000,000
MED EXP (Any One Person) $ 25,000
COMBINED SINGLE LIMIT $ 1,000,000
BODILY INJURY $
(Per person)
MlNfI1NJURY $
(Per accident)
PROPERTY DAMAGE $
AUTO ONLY - EA ACCIDENT $
N AUTO ONLY:
EACH ACCIDENT
AGGGREGATE
EACH OCCURRENCE 2,000,000
AGGREGATE 2,000,000
~ WC STATU- OTHER
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EL. EACH ACCIDENT $ 1,000,000
EL. DISEASE - POLICY LIMIT $ 1,000,000
E_L. DISEASE - EA EMPLOYEE $ 1,000,000
Certificate Holder is an
Addt'l. Insd.
A
AUTOMOBILE LIABILITY
~ ANY AUTO _
D ALL OWNED AUTOS
D SCHEDULED AUTOS
~ HIRED AUTOS
~ NON.OWNED AUTOS
D
D
TE08400984 AOS
TE0840098401 TX
MA08400002 MA
5/1/2002
5/1/2003
GARAGE LIABILITY
D ANY AUTO
WAIVER
A
EXCESS LIABILITY
~ UMBRELLA FORM
D OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR!
PARTNERS/EXECUTIVE
OFFICERS ARE:
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5/1/2002
5/1/2003
~ INCL
o EXCL
5BA 129653-02 AOS
5BA 129654-02 AZlLA
5BA129655-02 WI
5/1/2002
5/1/2003
B
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS VS /46/3/ 849
SITE LOCATION: 6MM2001-A 500 WHITEHEAD STREET, KEY WEST, FLORIDA 33040
KEY WEST COURTHOUSE AND THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, ITS EMPLOYEES AND OFFICIALS ARE ADDED
AS ADDITIONAL INSUREDS WITH RESPECT TO PREMISES lEASED TO THE NAMED INSURED FOR A BASE STATION/ANTENNA SITE.
KEY WEST COURTHOUSE MONROE COUNTY,
FLORIDA
500 WHITEHEAD STREET
KEY WEST, FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 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.
AUTHORIZED REPRESENTATIVE
ACORD
TM
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYY)
5/01/01
PRODUCER
Aon Risk Services. Inc. of WA
1420 5th Avenue. Suite 1200
Seattle, WA 98101
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
206-749-4800
COMPANY
A St Paul Fire & Marine Ins
INSURED
VoiceStream Wireless Corp, a Delaware
Corporation & its subsidiaries & Affiliates
incl. Cook Inlet/VS GSM Subsidiaries
12920 Southeast 38th Street
Bellevue, WA 98006
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.
COMPANY
B National Union Fire Ins. Co.
COMPANY
C Lumbermans Mutual Casualty Company
COMPANY
co
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EfFEC riVE
DATE (MM/DOIYY)
i='OUC'( EXPIRATiON
DATE (MMlDDIYY)
LIMITS
GENERAL LIABILITY
A X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR
OWNER'S & CONTRACTOR'S PROT
X Contractual Liab.
TE08400984
Certificate
Holder is an
Addt'l. Insd.
5/01/01
5/01/02
GENERAL AGGREGATE
PRODUCTS. COMP/OP AGG
PERSONAL & ADV INJURY
EACH OCCURRENCE
FIRE DAMAGE (Anyone fire)
MED EXP (Anyone person)
$
$
$
$
$
$
2,000,000
2,000,000
1,000,000
1,0001000
1,000,000
25 000
1,000,000
AUTOMOBILE LIABILITY
A X ANY IIUTO
, ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON,OWNED AUTOS
TE08400984
TE0840098401 TX
MA08400002 MA
TE08400988 VA
TE08401112 OH
5/01/01
5/01/02 COMBINED SINGLE LIMIT
$
GARAGE LIABILITY
ANY AUTO
BODILY INJURY
(Per person)
:,h ;",: ., H.~-,~" BODILY INJURY
! ~ (Per accident)
, PROPERTY DAMAGE
$
EXCESS LIABILITY
B X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
BE 739-7346
.
[',-, _- -.::;;J. - AUTOONLY-EAACCIDENT $
/ OTHER THAN AUTO ONLY'
,.._"rQ ,,~.":_ "\:<; -~.EACHACCIDENT S
AGGREGATE $
5/01/01 5/01/02 EACH OCCURRENCE $
AGGREGATE $
$
2.000,000
2,000,000
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR/
P ARTNERS/EXECUT1VE
OFFICERS ARE
X INCL
EXCL
5BA12965301
$100,000 SIR
5BA1296540J. AZ
5BA12965501 WI
5/01/01
5/01/02
x WC STATU- OTH-
TORY LIMITS ER
EL EACH ACCIDENT $
EL DISEASE. P0L1CY LIMIT $
EL DISEASE. EA EMPLOYEE $
1,000,000
1,00.0,000
1,000,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
SITE LOCATION: MM2002-B 5525 COLLEGE ROAD. STOCK ISLAND, KEY WEST, FLORIDA 33040
MONROE COUNTY BOCC IS ADDED AS AN ADDITIONAL INSURED ATIMA WITH RESPECT TO LIABILITY ARISING OUT OF
PREMISES LEASED TO THE NAMED INSURED FOR A BASE ST~TION/ANTENNA SITE.
CERTIFICATE HOLDER
MONROE COUNTY BOCC
5100 COLLEGE ROAD
ATTN: RISK MANAGEMENT
KEY WEST, FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will
ENDEAVOR TO MAil 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE
HOLDER, BUT FAilURE TO MAIL SUCH NOTICE SHAll IMPOSE NO
OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS
OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
423510000
ACORD 25-S (1/95)
@ ACORD CORPORA nON 1988
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CERTIFICATE OF INSURANCE
DATE (MMlDDIYY)
4/28/2003
PRODUCER
Aon Risk Services, Inc. ofWA
1420 5th Avenue, Suite 1200
Seattle, WA 98101
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
INSURED
INSURER A:
St Paul Fire & Marine Ins
T -Mobile USA, Inc.
(formerly VoiceStream Wireless Corporation)
12920 Southeast 38th Street
Bellevue, WA 98006
INSURER B:
Travelers Indemnity Company of Illinois
INSURER C:
INSURER 0:
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. THE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
TE08400984
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE (MMIDDIYY) DATE (MMlDDNY
511/2003 51112004 GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMP/OP AGG $ 2,000,000
PERSONAL & ADV INJURY $ 1,000,000
EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Any One Fire) $ 1,000,000
MED EXP (Any One Person) $ 25.000
5/1/2003 5/1/2004 COMBINED SINGLE LIMIT $ 1,000,000
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
A
GENERAL LIABILITY
~ COMMERCIAL GENERAL LIABILITY
o CLAIMS MADE ~ OCCURRENCE
~ OWNER'S & CONTRACTOR'S PROT
o Contractual Liability Included
o
Certificate Holder is an
Addt'!. Insd.
A
AUTOMOBILE LIABILITY
~ ANY AUTO
o ALL OWNED AUTOS
o SCHEDULED AUTOS
~ HIRED AUTOS
~ NON-OWNED AUTOS
o
o
TE08400984 AOS
TE0840098401 TX
MA08400002 MA
TE08400988 VA
GARAGE LIABILITY
o ANY AUTO
A
EXCESS LIABILITY
~ UMBRELLA FORM
o OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE;
TE08400984
5/1/2003
511/2004
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY;
EACH ACCIDENT
AGGGREGATE
EACH OCCURRENCE
AGGREGATE
$
$
$
$
$
2,000,000
2,000.000
\
APP',\
BY
DAT
WAI ER N/A
DESCRIPTION OF OPERA TIONSlLOCA TIONSNEHICLES/RESTRICTlONSlSPECIAL ITEMS
SITE lOCATION; MM2002-B 5525 COllEGE ROAD, STOCK ISlAND, KEY WEST, FLORIDA 33040
MONROE COUNTY BOCC IS ADDED AS AN ADDITIONAL INSURED A TIMA WITH RESPECT TO lIABILITY ARISING OUT OF PREMISES lEASED TO THE NAMED INSURED
FOR A BASE STATION/ANTENNA SITE.
C c::J ey r-O: h',.., Q.. V1 C. -L.
~ INCL
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5/1/2003
5/1/2004
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EL. EACH ACCIDENT
OTHER
B
OTHER
EL DISEASE-. POLICY LIMIT
$
$
$
1,000,000
1,000,000
1,000,000
EL DISEASE - EA EMPLOYEE
TM / Tmobile / T-MDbileStandard 1 850
MONROE COUNTY BOCC
5100 COLLEGE ROAD
AITN: RISK MANAGEMENT
KEY WEST, FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 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.
AUTHORIZED REPRESENTATIVE
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