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Certificates of Insurance.... PR.ODUCER 0 KEY WEST INSURANCE INC. ?.0. BOX 9108 KEY WEST FL 33041-9108 INSURED BAETZ, DOUGLAS 1101 CASA MARINA COURT KEY WEST, FL 33040 ............... ISSUE DATE (MM/DD/YY) CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES A FORDING COVERAGE COMPANY A CASUALTY NITY EXCHANGE LETTER COMPANY B Received LETTER COMPANY _ C '23 LETTER J DATED COMPANY D 1INITIAL - LETTER COMPANY E LETTER THE INSURED NAMED ABOVE FOR THE POLICY PERIOD OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, O TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE ATE (MM/DDNY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY COMPREHENSIVE FORM PREMISES/OPERATIONS UNDERGROUND ENPLOSION & COLLAPSE HAZARD PRODUCTS/COMPLETED OPER. CONTRACTUAL INDEPENDENT CONTRACTORS BROAD FORM PROP DAMAGE PERSONAL INJURY GL 0 4 4 6 4 4 0 2/ 2 3/ 9 3 0 2/ 2 3/ 9 4 BODILY INJURY OCC. $ BODILY INJURY AGG. $ PROPERTY DAMAGE OCC. $ PROPERTY DAMAGE AGG. $ BI & PO COMBINED OCC. $ 5 0 O O O BI & PD COMBINED AGG. $ 5 0 O O O PERSONAL INJURY AGG. $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS (Priv. Pass.) ALL OWNED AUTOS ( Other Than Priv. Pass. ) HIRED AUTOS NON —OWNED AUTOS GARAGE LIABILITY BODILY INJURY (Per person) $ BODILY INJURY (Per accidenq $ PROPERTY DAMAGE $ BODILY INJURY & PROPERTY DAMAGE COMBINED $ EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE $ AGGREGATE $ WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY LIMITS EACH ACCIDENT $ DISEASE —POLICY LIMIT $ DISEASE —EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS ERTIFICATE HOLDER IS ADDITIONAL INSURED MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ATTN: RISK MGT 5100 COLLEGE ROAD 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 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 THE COMPANY, ITS AGENTS OR REOESENTATIVES. �//"ICI'® `��\rI ■:���: t�M'. ISSUE DATE (MM/DD/1"n ..,.. 05/09/94 PRODUCER 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 EY WEST INSURANCE INC. POLICIES BELOW. .0. BOX 9108 COMPANIES AFFORDING COVERAGE EY WEST FL 33041-9108 COMPANY A SPHERE DRAKE/PROGRAM UNDERWRITERS LETTER INSURED COMPANY LETTER B APPROVED BY RISK MANAGEMENT OUGLAS BAETZ 101 CASA MARINA COURT COMPANY LETTERBY LETTER EY WEST, FL 33040 COMPANY D DATE LETTER COMPANY E WAIVER: %/A YES LETTER 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 SSUCONDITD OR MAY SUCH THIPOLN IES� INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLU3 ONE AND BE ISSUED 10 TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL UABIUTY PU 7 713 4 0 2/ 2 3/ 9 4 0 2/ 2 3/ 9 5 80DILY INJURY OCC. $ BODILY INJURY AGG. $ COMPREHENSIVE FORM PROPERTY DAMAGE OCC. $ PREMISESIOPERATIONS UNDERGROUND EXPLOSION & COLLAPSE HAZARD PROPERTY DAMAGE AGG. $ BI & PD COMBINED OCC. $ 500,00( PRODUCTS/COMPLETED OPER. 81 & PO COMBINED AGG. $ 500,000 PERSONAL INJURY AGG. $ INDEPENDENT CONTRACTORS ,CONTRACTUAL BROAD FORM PROP DAMAGE PERSONAL INJURY AUTOMOBILE LIABILITY BODILY INJURY ANY AUTO Receivec (Per person) $ BODILY INJURY ALL OWNED AUTOS (Priv. Pass.) Risk Mgmt. & Loss C ontr 1 ALL OWNED AUTOS ( Other Than ) Priv. Pass. HIRED AUTOS NON —OWNED AUTOS DATE IM 1lAL ��— y (Per accident) $ PROPERTY DAMAGE $ G BODILY INJURY & PROPERTY DAMAGE COMBINED $ GARAGE LIABILITY EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ ]UMBRELLA FORM OTHER THAN UMBRELLA FORM STATUTORY LIMITS WORKER'S COMPENSATION AND EACH ACCIDENT $ DISEASE—POUCY LIMIT $ EMPLOYERS' LIABILITY DISEASE —EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS ERTIFICATE HOLDER IS ADDITIONAL INSURED . T1r HOLD CANCELLA: N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MONROE COUNTY BOARD OF MAIL _J_OL_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE COUNTY COMMISSIONERS LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR RISK MANAGEMENT LIABILITY OF ANY KI UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. 5100 COLLEGE ROAD WEST FL 33040 uTHORI DREPRES 71VEKEY Zc ACQRp cxi 1 6A . R0JC�RATM I ; ERTIsEsE �F�Fww SCI�T'` E/�= �Fw .Of NSUR N V ` JMW00.378... ISSUE DATE (MM/DD/YY) 07/05/94 PRJDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE EY WEST INSURANCE INC. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. .0. BOX 9108 COMPANIES AFFORDING COVERAGE EY WEST FL 33041-9108 COMPANY A SPHERE DRAKE/PROGRAM UNDERWRITERS LETTER COMPANY B INSURED LETTER OUGLAS BAETZ 101 CASA MARINA COURT COMPANY C LETTER Risk Mgmt. & ss Control EY WEST, FL 33040 COMPANY D DATE LETTER COMPANY E Q1'e cAzw //��''�� LETTER OVERAGES 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 OCCLUSIONS AND CONDITIONS OF SUCH THIPOLN IE3� INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, O TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY PU 7 713 4 0 2/ 2 3/ 9 4 0 2/ 2 3/ 9 5 BODILY INJURY OCC. $ BODILY INJURY AGG. $ COMPREHENSIVE FORM PROPERTY DAMAGE OCC. $ PREMISESIOPERATIONS UNDERGROUND EXPLOSION & COLLAPSE HAZARD APP OVFD Py RISK MA .AGFMF_NT PROPERTY DAMAGE AGG. $ I COMBINED OCC. $ 500,000 PRODUCTS/COMPLETED OPER. CONTRACTUAL FY / i — — b BI & PD COMBINED AGG. $ 5 0 0 0 0 CONTRACTORS DATE 2 eJ PERSONAL INJURY AGG. $ PINDEPENDENT BROAD FORM PROP DAMAGE PERSONAL INJURY WAIVER N/A YES AUTOMOBILE LIABILITY BODILY INJURY ANY AUTO (Per person) $ BODILY INJURY ALL OWNED AUTOS (Prly. Pass.) ALLOWNED AUTOS ( Other Than ) Priv. Pass. (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY BODILY INJURY & PROPERTY DAMAGE COMBINED $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS EACH ACCIDENT $ AND DISEASE-POUCY LIMIT $ EMPLOYERS' LIABILITY DISEASE -EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS ERTIFICATE HOLDER IS ADDITIONAL INSURED �, FICATE HIDLD CANCELLATION . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MONROE COUNTY BOARD OF MAIL _10_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE COUNTY COMMISSIONERS LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR RISK MANAGEMENT LIABILITY OF AN KI UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. 5100 COLLEGE ROAD KEY WEST FL 33040 uTHo IZED REP SENTATIVE ACOFIp x5 (7t94) is �IICt)�#p C�I�P�i'iRA7'IQl'E tI�9i0 CC: TMr ! t/1�v7 W ISSUE DATE (MM/DDM1 .T�ET�r1;�R 05/04/95 y THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND PROOUCk9 CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE KEY WEST INSURANCE INC. POLICIES BELOW. .0. BOX 9108 COMPANIES AFFORDING COVERAGE KEY WEST FL 33041-91081, 9ved Risk mf.4 ?R MPANY A SPHERE DRAKE/PROGRAM UNDERWRITERS LETTER DATE ZAMPANY B INSURED INITIAL _. _ __. - — trr ER OUGLAS BAETZ COMPANY C 101 CASA MARINA COURT LETTER EY WEST, FL 33040 COMPANY D LETTER COMPANY E LETTER COVERAGE _ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CONDITION OF POLICIES DESCRFIBED HEREIN T ALL THE TIERMS IS CERTIFICAtE MAY BESISSUED OR MAY PERUTAINMTH� INSURANCE IS SUBJERESPECT BYTHE TO EXCLUSIONS AND CONDITIONS OF SUCH POLIdIES. p POLICY EFFECTIVE POLICY EXPIRATION TR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY PU 7 9 6 0 5 0 4/ 13 / 9 5 0 4/ 13 / 9 6 BODILY INJURY OCC. $ BODILY INJURY AGG. $ COMPREHENSIVE FORM PROPERTY DAMAGE OCC. $ PREMISES/OPERATIONS PROPERTY DAMAGE AGG. $ UNDERGROUND EXPLOSION & COLLAPSE HAZARD BI & PD COMBINED OCC. $ 500, Q Q PRODUCTS/COMPLETED OPER. BI & PD COMBINED AGG. $ 500,00( NTRACTUAL PERSONAL INJURY AGG. $ INDEPENDENT CONTRACTORS BROAD FORM PROP DAMAGE PERSONAL INJURY AUTOMOBILE LIABILITY APPROVED BY RISK MA A6EMENT BODILY INJURY ANY AUTO (Per person) $ BODILY INJURY ALL OWNED AUTOS (Priv. Pass.) BY O/e/G ALL OWNED AUTOS ( Other Than ) Priv. Pass. C(�C7�� (Per accident) $ HIRED AUTOS DATE ---- PROPERTY DAMAGE NON —OWNED AUTOS $ BODILY INJURY & PROPERTY DAMAGE GARAGE LIABILITY COMBINED $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM OTHER THAN UMBRELLA FORM STATUTORY OMITS WORKER'S COMPENSATION EACH ACCIDENT $ AND DISEASE—POUCY LIMIT Is EMPLOYERS' LIABILITY DISEASE —EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS ERTIFICATE HOLDER IS ADDITIONAL INSURED MONROE COUNTY BOARD OF COUNTY COMMISSIONERS RISK MANAGEMENT 5100 COLLEGE ROAD 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_ 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 F'/"__ BOARD OF COUNTY COMMISSIONERS MAYOR, Shirley Freeman, District 3 O U N Y1(of M O N R O E �� Mayor Pro Tem, Jack London, District 2 t Wilhelmina Harvey, District 1 KEY WEST FLORIDA 33040 Mary Kay Reich, District 5 (305) 294-4641 Keith Douglass, District 4 Monroe County Risk Management 5100 College Road Key West,.FL 33040 May 1, 1995 Douglas Baetz 1101 Casa Marina Court Key West, FL 33040 Re: Certificate of Insurance - Binder #1265 Dear Mr. Baetz: Risk Management has received subject binder of insurance for your agreement with Monroe County. However, the Binder does not notate Monroe County Board of County Commissioners as additional insured as required in your contract. Please have your agent forward a corrected certificate of insur- ance notating a policy number and additional insured verbiage to the Risk Management office at above address as soon as possible. If you have any questions, please contact me at 305) 292-4542. Thank you. Sincerely, Kay Miller Risk Management cc: Key West Insurance, Inc. Wendy Key -Buxton File !� MAY 21995 AC��RD ERTI FI ATE D3F LIABILITY I N IJR N DATE(MM/DDIYY) T7-1 05/08/96 PGJDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Rey West Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. 0. Box 5487 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Rey West FL 33045-5487 COMPANIES AFFORDING COVERAGE Rey West Insurance, Inc. Phone No. 305-294-1096 Fax No. COMPANY A Sphere Drake Ins Co INSURED COMPANY Received B Baetz , Douglas COMPANY C [)ATh ✓ [� 1101 Casa Marina Court Rey West FL 33040 COMPANY D INITIAL ZAZ 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 GENERAL AGGREGATE $ 5010000 A X COMMERCIAL GENERAL LIABILITY PU79605R11 04/13/96 04/13/97 PRODUCTS - COMP/OPAGG $ 0 CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ 0 EACH OCCURRENCE $ 500000 OWNER'S& CONTRACTOR'SPROT FIRE DAMAGE (Any one fire) $ 0 MED EXP (Any one person) $ 0 AUTOMOBILE LIABILITY ANY AUTO APPROVED BY RISK MAN,GEh'FNT &e I6 COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BY_ [!;5 T E _ _ _ C !i BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM $ OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU- OTH- TORY LIMITS ER EL EACH ACCIDENT $ THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE EL DISEASE - POLICY LIMIT $ EL DISEASE - EA EMPLOYEE $ OFFICERS ARE: EXCL OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESISPECIAL ITEMS Certificate Holder is Additional Insured CERTIFICATE HOLDER CANCELLATION MOC.•OBDC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Board of County Commissioners 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Ray Miller 5100 College Road BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Rey West FL 33040 OF ANY KIND UPON THE COMPANY, V&-AG NTS OR PRESENTATIVES. AUTHORIZED REPRESENTATIVE Rey West Insurance,,Tric. It ACORD 26-S (1104) �C . ©ACORD CORPORATION 1988 m 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 DATE MM/DDm DATE MM/DD/YY LIMITS A GENERAL LIABILITY Xl COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR BINDER PU93751 ! 04/13/01 1' 04/13/02 EACH OCCURRENCE II FIREDAMAGE(Anyonefire) $ 500000 $EXCLUDED MED EXP (Any one person) $ EXCLUDED PERSONAL & ADV INJURY I $ EX CLUDED -- --- GEN'L AGGREGATE LIMIT APPLIES PER: POLICY f PRO JECT LOC i GENERAL AGGREGATE $ 500000 PRODUCTSCOMPOPAGG $EXCLUDED AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS B ODILY INJURY (Per accident) $ _ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO II / AUTO ONLY - EA ACCIDENT $ EA ACC OTHER THAN _ AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE RETENTION $ _ �� —v'` $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY _ I TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT 1 $ OTHER A Commercial Applica BINDER PU93751 04/13/01 04/13/02I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS BEACH CHAIRS AND UMBRELLAS RENTED TO OTHERS CERTIFICATE 1401 DER _ __ _ CERTIFICATE " I X 1 ­1 IVKAL IKAUKEU; INN UKEK LETTER: CANCELLATION Monroe County Board of County Commissioners Monroe County Risk Mgmt 5100 College Road Key West FL 33040 MCBDCOM I 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 Oqjk�GATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 25-S (7/97) v ©ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE1-10/20/00 DATE(MM/DDfYY) IDTZZ---1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Key West Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P . 0. Box 5487 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33045-5487 Phone:305-294-1096 Fax:305-294-8016 INSURERS AFFORDING COVERAGE INSURED Douglas Baetz 110i Casa Marina Court Key West FL 33040 INSURER A: London Companies 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. LI TR TYPE OF INSURANCE POLICY NUMBER P LY E FIE IVE DATE MMlDDlYY LI XPI I N DATE MM/DDM' LIMITS A rNERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE �] OCCUR PU93751 04/13/00 04/13/01 ; EACH OCCURRENCE $ SOOOOO FIRE DAMAGE (Any one fire) $EXCLUDED MED EXP (Any one person) _ $ EXCLUDED PERSONAL & ADV INJURY $EXCLUDED �I GENERAL AGGREGATE $ 500000 J -- — — -- GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECTLOC PRODUCTS - COMP/OP AGG $ EXCLUDED AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS - n R %L- BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS i Y DATE BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ --" -- ----- GARAGE LIABILITY ANY AUTO YCS AUTO ONLY - EA ACCIDENT j $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY I r—� OCCUR �i CLAIMS MADE ( " EACH OCCURRENCE $ AGGREGATE $ $ I DEDUCTIBLE III RETENTION $ r(� �-� e $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS ! ER_ j _ E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE. $ E.L. DISEASE - POLICY LIMIT_$_ OTHER A Commercial Applica PU93751 04/13/0004/13/01 DESCRIPTION OF OPERATIONS/LOCATIONSfVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS BEACH CHAIRS AND UMBRELLAS RENTED TO OTHERS; Insured is additional insured and certificate holder CFRTIRIr1AT= 14f%l nrn ., ......_....... ..._.._-- .----_-- - - MONROEC Monroe County Board of Commissioners -Risk Management Maira De1Rio Room #207 5100 College Road Key West FL 33040 /11�v GGLM 1 1 V IY 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 REPRESOTATIVES. , / / i z n ACORD 25-S (7/97) CACORD CORPORATION 1 - "CO-"D CERTIFICATE OFLIABILITY II�SURI�I�LC&oln BF DATE NY) PRODUCER BAETZ; 1 05/05/99 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Key West Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. 0. Box 5487 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33045-5487 COMPANIES AFFORDING COVERAGE Key West Insurance, Inc. COMPANY PnoneNo. 305-294-1096 Fax No. 305-294-8016 A London Companies INSURED COMPANY B Baetz, Douglas COMPANY C 1101 Casa Marina Court COMPANY Key West FL 33040 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 POLICY EXPIRATION DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY PU91257 04/13/99 04/13/00 GENERAL AGGREGATE $ 500000 PRODUCTS - COMP/OPAGG $ 0 CLAIMS MADE D OCCUR PERSONAL & ADV INJURY $ 0 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 500000 one fire) $ 0 erson) $ 0 AUTOMOBILE LIABILITY ANY AUTO 'N -^ �,. t,-, LIMIT zfff $ ALL OWNED AUTOS ILY $ SCHEDULED AUTOS "Y- HIRED AUTOS BODILY INJURY (Per accident) $ NON -OWNED AUTOS 1.s., Sit. -__ ----- � -� -- iii �• - / , -- PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO %�l AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY VV EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE 1� $ t WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU- OTH- TORY LIMITS ER a THE PROPRIETOR/ INCL EL EACH ACCIDENT $ PARTNERS/EXECUTIVE EL DISEASE - POLICY LIMIT $ OFFICERS ARE: EXCL OTHER EL DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Certificate holder is additional insured CERTIFICATE HOLDER CANCELLATION MONROEC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County Board of County Commissioners EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ATTN: Risk Management 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 5100 College Road BUT FAILURE TO MAIL SUCH NOTI SHALL IMPOSE NO OBLIGATION OR LIABILITY Key West FL 33040 OF ANY KIND UPON THE CO A , ITS AGENT O RESENTATIVES, AUTHORIZED REPRESENTATI DATE - ACORD 25-5 (lw) ', West Ins ce,_ Ll " ACID 0 CORPORATION 9988'' 'I ACORD PRODUCER Rey West Insurance, Inc. P. O. Box 5487 Rey West FL 33045-5487 Rey West Insurance, Inc. Phone No. 305-294-1096 Fax No INSURED Baetz, Douglas 1101 Casa Marina Court Rey West FL 33040 L j II 11MU ID BP DATE (MM/DD/YY) Tz-1 THIS CERT04/23/98 IFICATE IS ISSUED AS A MATTENF R OF IORMATION 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 Sphere Drake Ins Co COMPANY ✓V// 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 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 POLICY EFFECTIVE I POLICY EXPIRATION LTR POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS GENtERCIAL LIABILITY A GENERAL LIABILITY LAIMS MADE D OCCUR R'S & CONTRACTOR'S PROT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY -1 ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL OTHER GENERAL AGGREGATE $ 500000 PIOP PU89288 04/13/98 04/13/99 PRODUCTS-COIAGG $ 0 PERSONAL & ADV INJURY $ 0 EACH OCCURRENCE $ 500000 FIRE DAMAGE (Any one fire) $ 0 MED EXP (Any one person) $ 0 COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ ppsROVED IS AGEME T BODILY INJURY (Per accident) $ RY PROPERTY DAMAGE $ Certificate holder is additional insured. AUTO ONLY- EA ACCIDENT $ OTHER THAN AUTO ONLY: i H ACCIDENT $GGREGATE $EACH OCNCE $AGGREGA$ EL EACH ACCIDENT $ EL DISEASE - POLICY LIMIT $ EL DISEASE - EA EMPLOYEE $ MONROECLBUTFAILURE F THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County Board of County TE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Commissioners WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ATTN: Risk Management 5100 College Road O MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATIONOR LIABILITY Rey West FL 33040 PON THE COMPANY, ITAGENTS OR REPRESENTATrVFc ACCERTII=DATE OF LIABILITY' 1�,�41 $p DATE(MMIDD/YY) PRODUCER Tz" 09/22/97 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rey West Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 5487 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Rey West FL 33045-5487 COMPANIES AFFORDING COVERAGE Rey West Insurance, Inc. COMPANY Phone No. 305-294-1096 Fax No. A Sphere Drake Ins Co INSURED COMPANY B COMPANY Baetz, Douglas ;�/ C 1101 Casa Marina Court 1 Rey West FL 33040 COMPANY D COVERAG457777777777 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. LTR T TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MMlDDlYY) DATE (MMlDDlYY) LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY p1379605R12 04/13/97 04/13/98 GENERAL AGGREGATE $ 500000 PRODUCTS CLAIMS MADE � OCCUR - COMP/OPAGG $ 0 PERSONAL & ADV INJURY $ 0 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 500000 FIRE DAMAGE (Any one fire) $ 0 MED EXP (Anyone person) $ 0 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per Person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ R BY MA MENT PROPERTY DAMAGE $ GARAGE LIABILITY ANY ` C r AUTO ONLY - EA ACCIDENT $ AUTO ATE OTHER THAN AUTO ONLY: 7777777777 EACH ACCIDENT $ MIA Yfq EXCESS LIABILITY AGGREGATE $ UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU- OTH- TORY LIMITS ER THE PROPRIETOR! INCL-- EL EACH ACCIDENT ---- --- -- ..— --- $ - ------------- PARTNERSIEXECUTIVE EL DISEASE - POLICY LIMIT -- $ OFFICERS ARE: EXCL OTHER EL DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONSILOCATIONSJVEHICLES/SPECIAL ITEMS Certificate Holder is Additional Insured CANCELLATfON CERTIFICATE HOLDER MOCOBDC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Board of County Commissioners 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 5100 College Road BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Rey West FL 33040 O ANY KIND N T COMPANY, I S AGENTS O EP SEN ATIVES. At! R P ESENTATI pp at nsu n nc. OACQttt? ORPORATION 79$8<>