Certificates of Insurance
A COR' nTM "'..,.;S,tf,tilffi'll,iSj,.ioItf'y;sI...".j?I\IB'........,.....lioI~)I..k.,1i...iJI.iliStf'.,......,.,..,...,'./u...,yy..,'.......,..,'.',,'...,.......'.'."'" DATE IMM/DDIYVI
IJ ::::::::u=cn(,t =Ii= :[\i~iM(.~:~:E::::::U::F~:::;::L: M: ',' '; :Il. tl~~t:J:~~r::: :1":O:U:nM:f.:V:\~~il;r::::::::::::::::::::}}:::::;.;:;:-:-""'"
,,'.....'..................................................,............'............................'.'.................,..'...........,........,......,........'.'..........'....'.,...'...............'.,.,.'.,.....'.,.'.......'....,.....,..'.',..'..,..'.'.....,.,.'.......'.'."..",'....",'.','.....','..,'....",'.....'"",'...""",,'...........'.'."',.., 08/25/1999
PRDDUCER ,.. ""i15~i55:iooo THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Aon Risk Services, Inc. of Pennsylvania ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
One Liberty Place, Suite 1000
1650 Market Street
Philadelphia PA 19103
COMPANY
A
LUMBERMENS MUTUAL CASUALTY CO
INSURED
AmeriGas Propane, L.P. and Subsidiaries
P.O. Box 965
Valley Forge, PA 19482
COMPANY
B AMERICAN PROTECTION INS CO
COMPANY
C
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 TYPE OF INSURANCE POLICY NUMBER
LTR
A GENERAL LIABILITY 5AA038013-00
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ~ OCCUR
OWNER'S & CONTRACTOR'S PROT
A AUTOMOBILE LIABILITY F5D00688100-AOS
A X ANY AUTO F5D00688200-HI
A All OWNED AUTOS F5D00688400- TX
A SCHEDULED AUTOS X3P08375200-MA
A X HIRED AUTOS F5D00688300- Y A
X NON-OWNED AUTOS
GARAGE LIABILITY
ANY AUTO
V
L"..
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE IMM/DDIYYI DATE IMM/DDIYY)
07/01/1999 07/0 I /2000 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 (Anyone fire) 1,000,000
M ED EXP (Anyone person) 10,000
07/01/1999 07/01/2000
07/01/1999 07/01/2000 COMBINED SINGLE LIMIT 1,000,000
07/01/1999 07/01/2000 BODILY INJURY
07/01/1999 07/01/2000 (Per person)
07/01/1999 07/01/2000 BODILY INJURY
(Per accident)
PROPERTY DAMAGE
rnE
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
l-..I. '1.TI'):
B WDRKERS COMPENSATION AND
B EMPLOYERS' liABILITY
B THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
5BR00204301-AOS
5BR00204501-ILNYORWI
INCl 5BR00204601-AZLA
07/01/1999
07/0 I /1999
07/01/1999
EL DISEASE - POLICY LIMIT
El DISEASE. EA EMPLOYEE
1,000,000
1,000,000
1,000,000
EXCL
DESCRIPTION DF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Additional Insured: Monroe County Board of County Commissioners but only
with respect to the negligence of AmeriGas Propane, L.P. Under no circwnstance is Additional Insured provided
coverage under the above policies for their own negligence.
COUNTY OF MONROEINITIAt
MONROE COUNTY RISK MANGEMENT
5100 COLLEGE ROAD
KEY WEST, FL 33040
EXPIRATIDN DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
BUT FAILURE TD MAIL SUCH NOTICE SHALL IMPOSE NO DBLlGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
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(11836)
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.........,............,..
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Aon Risk Services, Inc. of Pennsylvania
............................,............................'.............'.............'...................................................................................................................................................'.'........................,'..........................,..........'..,...........,.............................................,........................................................'.....'..................
.................................................................................................................,..,............,.......................................................,..................................
A CO'DD"J;ii?mrl".'.I#.I'~A?ti#If\r;11 AiBil'?I~~(I".K'~lliii^,t\II$I#}.Ui)>.................,.,.,',',",
fl. ™ ">....'*.!5g~fl....Nt~n~F:~w...F....!J?..,.........iF...]!f...,~MS!N!q-MtM~~i'.'."""" 06/24/1999
2i5~i5S~2000 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
DATE IMM/DD/YY)
One Liberty Place, Suite 1000
1650 Market Street
Philadelphia PA 19103
COMPANY
A
INSURED
AmeriGas Propane, L.P. and Subsidiaries
P.O. Box 965
Valley Forge, PA 19482
COMPANY
B
AMERICAN PROTECTION INS
COMPANY
C
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 REOUIREMENT, 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 TYPE DF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM/DDIYY) DATE IMM/DDIYY)
A GENERAL LIABILITY 5AA038013-00 07/01/1999 07/01/2000 GENERAL AGGREGATE 2,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG 2,000,000
CLAIMS MADE D OCCUR PERSONAL & ADV INJURY 1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE 1,000,000
FIRE DAMAGE (Anyone fire) 1,000,000
MED EXP (Anyone person) 10,000
A AUTOMOBILE LIABILITY F5D00688100-AOS 07/01/1999 07/01/2000
A X F5D00688200-HI 07/01/1999 07/01/2000 COMBINED SINGLE LIMIT 1,000,000
ANY AUTO
A ALL OWNED AUTOS F5D00688400- TX 07/01/1999 07/01/2000 BODILY INJURY
A SCHEDULED AUTOS X3P08375200-MA 07/01/1999 07/01/2000 (Per person)
A X HIRED AUTOS F5D00688300- V A 07/01/1999 07/01/2000 BODIL Y INJURY
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE
GARAGE LIABILITY ..Y. AUTO ONLY - EA ACCIDENT
ANY AUTO OTHER THAN AUTO ONLY:
DATE
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM
B WORKERS COMPENSATIO~J AND 5BR00204301-AOS 07/01/1999 07/01/2000 OTH-
ER
B EMPLOYERS' LIABILITY 5BR00204501-ILNVORWI 07/01/1999 07/01/2000
1,000,000
B THE PROPRIETOR/ INCL 5BR0020460 l-AZLA 07/01/1999 07/01/2000 EL DISEASE - POLICY LIMIT 1,000,000
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE 1,000,000
DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLES/SPECIAL ITEMS The certificate holder is Additional insured for General and Auto Liability
but ony as respects the negligence of AmeriGas employees while perfonning work under the contract at the
Monroe County Detention Center.
MONROE COUNTY BOARD OF COUNTY COMMISSIONER
MONROE COUNTY DETENTION CENTER
5501 COLLEGE ROAD
KEY WEST, FL 33040
(11720)
SHDULD 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 TD THE LEFT.
EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
BUT FAILURE TO MAIL SUCH NDTICE SHALL IMPDSE ND OBLIGATION OR LIABILITY
OF ANY KIND UPON THE CDMPANY. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
@ds#201110
A CORDTMeERmlell!IIEmEI.I.lXBII.I:lI':illmB.lXNIE::" DATE IMM/DD/YY)
,"'/., .."",/"""""""""""""""""""""""""""""':""""""":"':"""""':' "":'":"'.", : ""'" , ...., ",,', ',,' "/""""','>,,,"""'/,,,'" <""""""", ,""', "'/,,,',',','" """.""" ""'/" """" OS/25/2000
PRoDucER'2i5~i55~iooo THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Aon Risk Services, Inc. of Pennsylvania 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
One Liberty Place, Suite 1000
1650 Market Street
Philadelphia PA 19103
COMPANY
A
LUMBERMENS MUTUAL CASUALTY CO
INSURED
AmeriGas Propane, L.P. and Subsidiaries
P.O. Box 965
Valley Forge, PA 19482
COMPANY
C
COMPANY
B
COMPANY
o
C.:~:TE
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"."'.'."THisls'Toc:ERTIFyTH.A.TTHEpoLidf~:bpriNsu~:A~CE.:t~YIi[O\\;IIA~/EBEEN'lssuEDTOTHE 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 TYPE DF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATlDN LIMITS
LTR DATE (MM/DDIYY) DATE (MM/DDIYYI
A GENERAL LIABILITY 5AA038013-00 07/01/2000 07/01/2001 GENERAL AGGREGATE $
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $
CLAIMS MADE W OCCUR PERSONAL & ADV INJURY
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE
FIRE DAMAGE (Anyone fire)
MED EXP (Anyone person)
A AUTDMOBILE LIABILITY F5D00688100-AOS 07/01/2000 07/01/2001
A X F5D00688200-HI 07/01/2000 07/01/200 1 COMBINED SINGLE LIMIT
ANY AUTO
A ALL OWNED AUTOS F5D00688400- TX 07/01/2000 07/01/2001 BODILY INJURY
A SCHEDULED AUTOS X3P08375201-MA 07/01/2000 07/01/2001 (Per person)
A X HIRED AUTOS F5D00688300- V A 07/01/2000 07/01/2001 BODILY INJURY
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM
B WORKERS COMPENSATION AND 5BR00204302-AOS 07101/2000 07/01/2001 OTH-
ER
B EMPLOYERS' LIABILITY 5BR00204502-ILNVORWI 07/01/2000 07/01/2001
EL EACH ACCIDENT
B THE PROPRIETOR/ INCL 5BR00204602-AZLA 07/01/2000 07/01/2001 EL DISEASE - POLICY LIMIT
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE
DESCRIPTION DF OPERATIONS/LDCATIONSNEHICLES/SPECIAL ITEMS Additional Insured: Monroe County Board of County Commissioners but only
with respect to the negligence of AmeriGas Propane, L.P. Under no circumstance is Additional Insured provided
coverage under the above policies for their own negligence.
COUNTY OF MONROE
MONROE COUNTY RISK MANGEMENT
5100 COLLEGE ROAD
KEY WEST, FL 33040
2,000,000
2,000,000
1,000,000
1,000,000
1,000,000
10,000
1,000,000
1,000,000
1,000,000
1,000,000
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHDRIZED REPRESENTATIVE
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INITIAL
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...........;.:.................;.:.:.:.:...........:.:.:.:.:.;.:.......:.:.:.:.:.:.;.;.:.;...:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:....
ACORDTM
DA TE(MIWDDIYY)
03/11/02
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
PRODUCER
Aon Risk SeNices, Inc, of Pennsylvania
One Liberty Place
1650 Market Street
Suite 1000
Philadelphia PA 19103
PHONE .(215) 255-2000 FAX - (215) 255-1893
INSURED
AmeriGas Propane, L.P, and Subsidiaries
460 N, Gulph Rd.
P,O, Box 965
Valley Forge PA 19482 USA
COMPANY
A
Lumbermens Mutual Casualty Co
COMPANY
B
American Protection Ins Co
COMPANY
C
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 IMTH 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 I POll e\' EFFE eTIn POLle\'EXPIR.~TION LIMITS
LTR TYPE OF INSURANCE POLICY ~DI BER DATE (MM/DDNY) DATE ~L\IIDDIl'\')
A GENERAL LIABILITY 5AA 038 013-00 GENERAL AGGREGATE $2,000,000
07/01/01 07/01/02
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $2,000,000
CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000
FIRE DAMAGE(Anv one fire) $1,000,000
MED EXP (Anv one person) $10,000
A F5D 006 881-00-AOS 07/01/01 07/01/02 COMBINED SINGLE LIMIT $1,000,000
A ALL OWNED AUTOS F5D 006 884-00-TX 07/01/01 07/01/02
BODILY INJURY
SCHEDULED AUTOS ( Per pers on)
A X3P 083-752-02-MA 07/01/01 07/01/02
HIRED AUTOS BODILY INJURY
A NON-OWNED AUTOS F5D 006 882-00-HI 07/01/01 07/01/02 (Per accident)
A F5D 006 883-00-VA 07/01/01 07/01/02 PROPERTY DAMAGE
AUTO ONLY - EA ACCIDENT
OTH ER THAN AUT 0 ONL Y
EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM WAIVER AGGREGATE
OTHER THAN UMBRELLA FORM
B WORKER'S COMPENSATION AND 5BR 1)02 /)4~_n~ AOS
EMPLOYERS' LIABILITY 07/01/01 07/01/02 $1,000,000
B THE PROPRIETOR/ INCL 5BR 002 046-03-AZ,LA
PARTNERS/EXECLfTIVE 07/01/01 07/01/02 EL DISEASE-POLICY LIMIT $1,000,000
OFFICERS ARE: EXCL 5BR 002 924-01-ILNVORWI EL DISEASE-EA EMPLOYE $1,000,000
DESCRIPTION OF OPERA TlONSlLOCA TIONSNEHICLES/SPECIAL ITEMS
Additional Insured: certificateholder but only with respect to the negligence of AmeriGas Propane, L.P. Under no circumstance is additional insured
provided insurance under the above policies for their own negligence.
COUNTY OF MONROE
BOARD OF COUNTY COMMISSIONERS
1100 SIMONTON STREET
KEY WEST FL 33040 USA
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 Aon Risl. Services, In,-. of Pennsylvania
r:..rtifi""t.. Nn'
!'i7000?11A1AQ
~nlrl..r IrI..ntifi..r"
ACORDTM
DA TE(MM/DDIYY) i
07/29/02
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
PRODUCER
Aon Risk Services, Inc. of Pennsylvania
One Liberty Place
1650 Market Street
Suite 1000
Philadelphia PA 19103
PHONE - (215) 255-2000 FAX - (215) 255-1893
INSURED
AmeriGas Propane, L.P. and Subsidiaries
P.O, Box 858
Valley Forge PA 19482 USA
COMPANY
A
Lumbermens Mutual Casualty Co
COMPANY
B
American Protection Ins Co
COMPANY
C
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 INITH RESPECT TO V\lHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS,
XClUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOINN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
lYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRA no LIMITS
DATE (MM/DDIYY) DATE (MM/DDI\"\')
A 5AA038013-01 07/01102 07/01/03 GENERAL AGGREGATE $2,000,000
COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $2,000,000
CLAIMS MADE o OCCUR PERSONAL & ADV INJURY $1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000
FIRE DAMAGE(Anv one fire) $1,000,000
MED EXP (Anv one person) $10,000
A F5D 006 881-01 07/01/02 07/01/03 COMBINED SINGLE LIMIT $1,000,000
AOS
A ALL OWNED AUTOS F5D 006 882-01 07/01/02 07/01/03
BODILY INJURY
HI ( Per person)
A F5D 006 883-01 07/01/02 07/01/03
VA BODILY INJURY
A F5D 006 884-01 07/01/02 07/01/03 (Per accident)
1)(
A X3P 083 752-03 07/01/03 PROPERTY DAMAGE
MA
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY'
EACH ACCIDENT
AGGREGAT
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
B WORKER'S COMPENSATION AND 5BR 002 043-04 07/01/02
B EMPLOYERS' LIABILITY 5BR 002 045-04 07/01/02 07/01/03
B THE PROPRIETOR! INCL 5BR 002 046-04 07/01/02 07/01/03
PARTNERS/EXECUTIVE EL DISEASE-POLICY LIMIT
OFFICERS ARE EXCL EL DISEASE.EA EMPLOYEE
DESCRIPTION OF OPERA TlONS/LOCA TlONSNEHICLESlSPECIAL ITEMS
Additional Insured: certificateholder but only with respect to the negligence of AmeriGas Propane, L.P. Under no circumstance is additional insured
provided insurance~nd,er the above policies for their own negligence.
c.c:~
COUNTY OF MONROE
BOARD OF COUNTY COMMISSIONERS
1100 SIMONTON STREET
KEY WEST FL 33040 USA
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 Aon Risk Ser>'ices.. Inc, of Penns.yl,.ania
11_1-'__ I-I__...~.e:__.
1 -- --.:.::--:::--::
'.1:.:\ ~
PRODUCER
Aon Risk services, Inc. of Pennsylvania
One Liberty place
1650 Market Street
Suite 1000
Philadelphia PA 19103
DATE (MM/DD/YV)
03/25/04
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
PHONE - (215) 255-2000 FAX - (215) 255-1893
INSURED
AmeriGas propane, L.P. and subsidiaries
P.O. Box 858
valley Forge PA 19482 USA
COMPANY
A
ACE American Insurance Company
;,;
~
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COMPANY
B
COMPANY
C
COMPANY
o
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, UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
CO TYPE OF DiSlR\:\CE POLICY :\DIBER POLICY EFFECTIVE POLICY EXPIR"'TlO:\ LIMITS
LTR OA TE (MMIOO/YY) OATE (M~llOo/n') m
04/01/04 07/01/04 r-...
A GENERAL LIABILITY HDOG20586278 GENERAL AGGREGATE $2,000,000 .-t
2003-2004 General Liability/p 00
PRODUCTS-COM~OPAGG $2,000,000 m
X COMMERCIAL GENERAL LIABILITY .-t
0\
o OCCUR PERSONAL & ADV INJURY $1,000,000 0
CLAIMS MADE 0
$1,000,000 0
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE r-...
U"I
FIRE DAMAGE(Any one fire) $1,000,000
MED EXP (Anyone Derson) $10,000 i
:;
A ISAH0767613A 04/01/04 07/01/04 -;
COMBINED SINGLE LIMIT $1,000,000 :.J
03-04 Automobile - All States =:
;::
ALL OWNED AUTOS BODILY INJURY :;
1 ( Per person) U
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGAT
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM
A WORKER'S COMPENSATION AND SCFC43977313 04/01/04 07/01/04
EMPLOYERS' LIABILITY 03-04 wc Non-Deductible: WI
A THE PROPRIETOR! INCL WLRC43977301 04/01/04 07/01/04 EL DISEASE-POLICY LIMIT
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL 03-04 workers Compo - AOS
EL DISEASE-EA EMPLOYEE
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DESCRIP;rION 9F OPERATIOIIIS/lOCATIONSIVEHICLESl.SPECIAL ITEMS . .
AOOltlona Insureo: certlilcatenolOer but only wlth respect to the negllgence of AmeriGas propane, L.P. under no
circumstance is additional insured provided insurance under the above policies for their own negligence.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
COUNTY OF MONROE
BOARD OF COUNTY COMMISSIONERS
1100 SIMONTON STREET
KEY WEST FL 33040 USA
,/
CC'~
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 ~~.9'_.9m., c;Cg>~
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PRODUCER
Aon Risk services, Inc. of pennsylvania
One Liberty place
1650 Market Street
suite 1000
philadelphia PA 19103
DATE (MM/DD/YV)
06 28 04
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
PHONE. (866) 266-7475 FAX - (866) 467-7847
INSURED
AmeriGas propane LP and subsidiaries
PO Box 858
valley Forge PA 19482 USA
COMPANY
A
ACE American Insurance company
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B
COMPANY
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COVERAGe
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 SHOVliN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
co TYPE OF INSURANCE POLICY l'iUI\IBER POLICY EFFECTI\'E POLICY EXPIRA no L1'IITS
LT DATE (MMIDD/YY) DATE (MM/DDI\'Y) U"l
HDOG21707478 07/01/04 07/01/05 N
A GENERAL AGGREGATE $2,000,000 <0
04-05 General Liabili'ty/prod M
PRODUCTS - COMP/OP AGG $2,000,000 '<t
COMMERCIAL GENERAL LIABILITY ......
0
~ OCCUR PERSONAL & ADV INJURY $1,000,000 ......
CLAIMS MADE 0
$1,000,000 0
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE r--
U"l
FIRE DAMAGE(Anv one fire) $1,000,000 Q
MED EXP (Anv one person) $10,000 Z
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A AUTOMOBILE LIABILITY ISAH07842600 07/01/04 07/01/05 co
COMBINED SINGLE LIMIT $1,000,000 ...
X ANY AUTO 04-05 Automobile - All States !E
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ALL OWNED AUTOS BODILY INJURY ..
U
SCHEDULED AUTOS ( Per person)
HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE
AUTO ONLY - EA ACCIDENT
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ANY AUTO OTHER THAN AUTO ONLY:
\N/Wf\NEH EACH ACCIDENT
AGGREGAT
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM
A WORKER'S COMPENSATION AND WLRC43983076 07/01/04 07/01/05
EMPLOYERS' LIABILITY 04-05 workers Compo - AOS
A THE PROPRIETOR! INCL SCFC43983155 07/01/04 07/01/05 EL DISEASE-POLICY LIMIT
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL 04-05 wc Non-Deductible: WI
EL DISEASE-EA EMPLOYEE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
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DESCRIP;nON OF OPERATlOIllS/LOCATlONS/VEHICLEstSPECIAJ,.ITEMS . .
Aooltlonal InsureO: certlrlcateholOer out only wlth respect to the negllgence of AmeriGas propane, L.P. under no
circumstance is additional insured provided insurance under the above policies for their own negligence.
COUNTY OF MONROE
BOARD OF COUNTY COMMISSIONERS
1100 SIMONTON STREET
KEY WEST FL 33040 USA
, q 7.fJ04
,Ii \',
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 Aon Risl. Sen'..,e,.., Inc. of Penn:>'J'Il'ania
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ACORD,
TE(MM DD/YYYY)
06/25/2007
PRODUCER
Aon Risk services, Inc. of pennsylvania
One Liberty place
1650 Market Street
sui te 1000
philadelphia PA 19103 USA
PHONE- 866 283-7122
THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY
AND CONFERS NO RIGIITS UPON TIlE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER TIlE
COVERAGE AFFORDED BY TIlE POLICIES BELOW.
INSURED
AmeriGas propane, L.P.
and subsidiaries
P.O. Box 858
valley Forge PA 19482 USA
ERB
Indemnity Insurance Co of North America
ACE American Insurance Company
NAIC#
43575
22667
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INSURERS AFFORDING COVERAGE
1HE POUCIES OF INSURANCE LISTED BELD HA VB BEEN I
ANY REQUIREMENT, TERM OR CONDmON RESPECT TO WHICH TIllS CERTIFICAlE MAY BE ISSUED OR MAY
PERTAIN. THE INSURANCE AFJFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlL TIlE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POlJCIES.
AGGREGAlE LIMITS SHOWN II/lAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR INS
RECEIVED
INSURER A
JUL
TYPE OF INSURANCE
POLlCY NUMBER
POLICY EFFECTIVE POLICY EXPlRA nON
DATE(MM\DD\VY) DATE(MM\DD\YY)
07/01/07 07/01/08
LIMITS
B r~-- HDOG23726701
X COMMERCIAL GENERAL LIABll..ITY
CLAIMS MADE [~ OCCUR
GEN'L AGGREGATE LiMIT APPLIES PER
~ POLICY 0 PRo.- 0 LOC
JECT
B AUTOMOBILE LIABILITY ISAH08230705
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON OWNED AUTOS
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurence)
(Anv one person
$1,000,000
$1,000,000
GENERAL AGGREGATE
$1,000,000
$2,000,000
$2,000,000
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PERSONAL & ADV JNJURY
PRODUCTS - COMP/OP AGG
07/01/07
07/01/08
COMBINED SINGLE LIMIT
(Eaaccident)
$1,000,000
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BODILY INJURY
(Perperson)
BODILY INJURY
(Per accident)
GARAGE LIABILITY
B ANY AUTO
EXCESS /UMBRELLA LIABILITY
D OCCUR D CLAIMS MADE
PROPERTY DAMAGE
(Per accident)
AUTO ONLY - EA ACCIDENT
OlllER THAN EA ACC
AUTOONLY'
AGG
EACH OCCURRENCE
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AGGREGATE
DDEOUCTiBLE
DRETENTJON
B
WORKERS COMPENSATION AND
EMPLOYERS' LlABILny
ANY PROPRIETOR I PARTNER I EXECUTIVE
OFFICERlMEMBER EXCLUDED~
If yes, describe under SPECIAL PROVISIONS
below
WLRC
AOS
SCFc44465140
WI
WlRC44465139
CA
07/01/07
07/01/07
07/01/08
E.L EACH ACCIDENT
A
DESCRIPTION OF OPERATIONSiLOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
A~ditional In~ured: .c~rtifi~ateholder but only with respect to the negligence of AmeriGas propane, L.P.
Clrcumstance lS addltlonal lnsured provided insurance under the above policies for their own negligence.
under no
$1,000,000 _
$1,000,000 ::
$1,000,000 iiii
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07/01/08
E.L DISEASE-EA EMPLOYEE
EL DISEASE-POLICY LIMIT
OTHER
COUNTY OF MONROE
BOARD OF COUNTY COMMISSIONERS
1100 SIMONTON STREET
KEY WEST FL 3304() USA
C.C: ?;.....t:l..'1 c L
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, TIlE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITIEN 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 REPRESENTATIVE
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