Certificates of Insurance
- CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIODIYY)
12/06/2006
IPROOuCER AND THE NAMED INSURED THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
I.E.B.S. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE
RECEIVED AFFORDED BY THE POLICIES BELOW.
8722 South Harrison Street
Sandy, Utah 84070 INSURERS AFFORDING COVERAGE
NSURED INSURER A: The Prime Insurance Syndicate. Inc.
DEe 1 3 INSURER B-
Arnold's Towing .. -
INSURER c:
INSURER 0:
5540 3rd Ave MONROE COUNTY INSURER E
Key West , FL 33040 RISK MAN/\GEMENT INSURER F:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY INDICATED. NOTWITHSTANDING ANY
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TQWHICH THIS CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES D1SCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NS Pg~T1:Y(~~~g~ POUCY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDNY) UMITS
~NERAL LIABILITY EACH QCCURANCE , $500,000.00
COMMERCIAL GENERAL LIABILITY IRE DAMAGE (Anyone fire) N/A
f-- CLAIMS MADE D OCCUR SP0611224
1111712006 11/17/2007 iMED exp (Anyone person) N/A
Ir.;
fll'c Commercial Liability PERSONAL ADV INJURY N/A
f- Manuscript Policy bENERALAGGREGATE $1,000,000.00
~'LAGGRE~IMlT APrl ~ER: "LIMITS SHOWN ARE PRODUCTS
PRO- $250,000.00
POLICY ECT LOC Per Person
~TO lIABILITY THOSE IN EFFECT AS OF f?'NNUAL AGGREGATE
f- ANV' AUTO POLICY INCEPTION" I~DILY INJURY
f- All QIIoJNED AUTOS !PerPerson)
f- SCHEDULED AUTOS BoDILY INJURY
f- HIRED AUTOS Per Accidenl)
f- NON-OWNED AUTOS r PROPERTY DAMAGE
(Per Accidenl)
GARAGE lIABIUTYfMANUSCRlPT FORM X1)_.\O 01 ~ PER PERSON
SCHEDULE AUTO
f-
GKl.l. Il\-CY PER ACCIDENT 5
f- \d-
DRIVE AWAY - PHYSICAL DAMAGE
f- ). f"'GGREGATE
f- D,O,C. Oti
CARGO PROPERTY DAMAGE
f-- ~ ,
f-- ON HOOK
f- CONTRACTUAL LIABILITY ~(ia
OTHER
EXCESS LIABILITY .11. ffi~URANCE
r- OCCUR D CLAIMS MADE
f- DEDUCTIBLE MY\ GATE
f- RETENTION .
I 5
LIMITATION OF COVERAGE FOR ADDITIONAL INSURED
Liability Coverage is only provided to the Additional Insured with respect to Accidents otherwise covered under the Policy/Coverage Contract where the Insured is found directly
liable and not where the Additional Insured is found independently negligent of the Insured.
DESCRIPTION OF OPERATION/lOCATlONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISION
Coverage is limited to only insured activities or operations identified in the Policy, Boats ~not for rent- Per Vessel., Boats ~ Scheduled Driver., Boats _ Towing,
Salvation Operation., (Exludes Wind and All Named Storms).. (Exludes All other Drivers). Includes $7,500 Hull Coverage and $20,000 Bailees Coverage
~ I CERTIFICATE HOLDER I [;i] I ADDITIONAL INSURED I LOSS PAYEE
Monroe County Board of Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TtiE EXP!RA TlON
305-2954342 DATE THEREOF, THE ISSUING INSURER WILL MAIL 30 DAYS WRITTEN NOTICE TO THE
1100 Simonton Street/Room 268 CERTIFICATE HOLDER NAMED TO THE LEFT.
Key West, FL 33040
AUTHORIZED REPRESENTATIVE.. .. ~ ..L...- '" -
-50 Z' Jii. , <: T'j,
.
UDA-F-030 0~C'2005 U 'e :.1 /V '- "'"' ~
c:::..~~ "----'
ADDITIONAL NAMED INSURED ENDORSEMENT
PAP-99-12
This Endorsement changes the terms and conditions of the Policy issued. Please read it carefully!
The following requirements govern coverage under the Policy and must be adhered to for coverage to be
provided to the Insured under the Policy. No activities conducted by the Insured are covered under the Policy
unless they are conducted in full compliance with all of the requirements specified below and in the Policy. The
Insured must advise its employees, agents, contractors, and/or subcontractors of these requirements and
ensure that they also abide by them for coverage to be provided. The Insured agrees and understands that any
noncompliance with the following specified requirements and/or the terms and conditions set forth in the Policy
will result in the denial of coverage under the Policy meaning the Insurer will not be obligated to indemnify or
defend you.
Policy Number: SP0611224
Insured:
Arnold's Towing
Effective Date:
12/6/2006
Additional Named Insured: Monroe County Board of Commission.ers
305-295-4342
1100 Simonton StreeURoom 26&
Key West, Fl33040
Generating an additional premium of: $0.00
The ''Who is a Insured" provision of the Policy, for the limit purpose of liability arising from Your Work and
subject to all other terms and conditions of the Policy and this Endorsement, shall include as an additional
Named Insured, the persons or organizations scheduled in this Endorsement.
The coverage provided by this Endorsement only extends to cover the Additional Named Insured for allegations
of liability based upon alleged, actionable conduct of the Insured and only to the extent the Insured would have
been liable and coverage would have been afforded under the terms and conditions of this Policy had such
Claim been made against the Insured.
The Policy expressly provides that coverage is to be construed and enforced in accordance with the laws of the
State of Utah, and the Insured has consented to the jurisdiction of the courts of the State of Utah to hear and
decide disputes constitution or relating to coverage issues.
Any Additional Named Insured is subject to all of the terms, provisions, conditions, exclusions, definitions,
limitations, representations, and Endorsements of the Policy issued to the Insured, the Policy, and all related
documents providing coverage to the Insured.
A copy of the Insured Policy may be obtained from the Insured or by contacting the Insurer office in Salt lake
City, Utah, during normal business hours.
Endorsement No.:
r" "'/
r-}; ..,...".. ?-:
.~~ _. s:&f......".,,...;.re~.A..
,f" ~ t(.:
,
Jose E. Figueroa
D002028
Surplus Lines Tax
Surplus Lines Fee
PAP-9!>-1217JUL2006
Page 1 of 1
ACORD.
CERTIFICATE
DATE(MMIDDIYYYY)
4 23/2007
RTIF ATE is ISSUED AS A MATTER OF INFORMATION
ONLY AND ONFERS NO RIGHTS UPON THE CERTIFICATE
LD R. TH S CERTIFICATE DOES NOT AMEND, EXTEND OR
TER THE OVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCER
ATIG
207B W STATE RQ;lU) 434
WINTER SPRINGS, FL 32708
407-327-5850
INSURED ARNOLD I S TOWING SERVICE I Ie.,
AUTO & MARJ:NE REPAIR, INC.,
5540 3RD AVENUE KEY WEST FL 33040
KEY WEST, FL 33040
305-296-3832
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
I~~: ,?sD~~ TYPE OF IN I NeE POLICY NUMBER I b~~~YM~b5~VE! P8k+~Y~~f~~J~pN I
GENERA..,LlAB1LlTY i
X CO~ERCIAL GENE~,IABILlTY I
' I CLAIMS MADE I X I OCCUR
r-L u 1
[--I 'lOAEOTT-I01l56CA02
~N'L AGGREGATE LIMIT APPLIES PER:
! X POLICY rsr8r ] LOC
AUTOMOBILE LIABILITY
,
S AF ORDING COVERAGE
sa INSURANCE COMPANY
NAIC#
-~
JNSURER C
INSURER D
! INSURER E
LIMITS
EXCESS/UMBRELLA LIABILITY
~I OCCUR 'I CLAIMS MADE
I DEDUCTIBLE
I ! I i RETENTION $
11 WORKERSCOMPENSATIONAND
I I FJvlPLClYFRS' LIABILITY
I I ANY PROPRIETORlPARTNERlEXECUTIVE
OFFICEklMEMBl:OR EXClUDED?
Jfyes,descnbeunder
, SPECIAL PROVISIONS below
I' A I ~GKEEPERS IIOAEOTT-I01l56CA012
ION-HOOK lOAEOTT-I01l56CA02
DESCRIPTION OF OPERATJONS I LOCi\ TlONS {VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
EACH OCCURRENCE , 1,000,000
PREMISES Ea occurence "
MED EXP (An\.' one person) , 5,000
I PERSONAL & ADV INJURY , 1,000 000 I
I
04/28/07 i 04/28/2008 GENERAL AGGREGATE , 3,000 000
PRODUCTS-COM~OPAGG , Included
COMBINED SINGLE LIMIT , 1,000,000
(Eaaccidenl)
BODILY INJURY .
(Per person)
04/28/2007 04/28/2008
BODILY INJURY .
(Per accident)
PROPERTY DAMAGE 1
(Peraccidenl) .
AUTO ONLY - EA ACCIDENT . 1,000,000
04/28/2007 04/28/2008 EAACC .
OTHER THAN
AUTO ONLY AGG .
EACH OCCURRENCE .
AGGREGATE '.
.
.
A
A X
ANY AUTO
ALL OWNED AUTOS.
,U
I X SCHEDULED AUTOS
~i HIRED AUTOS
~I NON-OWNEOAUTOS
I
lOAEOTT-IOl156CA02
AI
IIOAEOTT-I01l56CA02
.
H-,
ER :
.
EL DISEASE - EA EMPLOYE $
EL DISEASE - POLICY LIMIT' $
$100,000
$100 000
PE~: VEHICLE SCHEDULE ON FILE W/COMPANY
ON-HOOK/MOTOR TRUCK CARGO 100,000/1000 OED; PHYSCIAL DAMAGE INCLUDED STATED
FIRE, THEFT /COL,LISION DEDUCTIBLE $1000; INC BASIC PIP FL NO FAULT;
cc: ~"'Ol."C..e.-
CERTiFICATE HOLDER
I
1
,
I
I
AMOUNT
CANCELLATION
MONROE coum,y BOARD OF COUNTY
502 WHITEHEAD STREET
KEY WEST I~LORIDA 33040
ATTN MARIJ~
ADDITIONAJ~ INSURED
COMMISION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI01'
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL~ 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 i
REPRESENTATIVES
AUTHORIZED REPRESENTATIVE
ACORD2S'2001/08)