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Certificates of InsuranceCERTIFICATE OF INSURANCE € ISSUE DATE (MM/DD/YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE r; , k-t; a i rl u r a r c e I r c DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE rC-t F, �_ I� I`. 1 n 5 u r :a rt c e A s s o c. POLICIES BELOW. _ S E+ c r N t B L d. COMPANIES AFFORDING COVERAGE t3c.'rtt�ll Feach. F1. 3{ti33 INSURED Universal Beach Service Corp. P. C' . B o t. 7 1 i 1 COMPANY A LETTER Pr'E COMPANY B LETTER R COMPANY C APPROVED BY RISK MANA6CMt �1 At o LETTER COMPANY DBYNRO G� 3 19'yy5 LETTER " COMPANY EF 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 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 POLICY EFFECTIVE POLICY EXPIRATION LIMITS _TR DATE (MM/DD/YY) DATE (MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ CLAIMS MADE OCCUR. PERSONAL & ADV. INJURY $ OWNER'S & CONTRACTOR'S PROT. I EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ ti MED. EXPENSE (Any one person) $ AUTOMOBILE LIABILITY, COMBINED SINGLE $ ANY AUTO Received LIMIT ALL OWNED AUTOS :Mgmt. & Loss Control BODILY INJURY SCHEDULED AUTOS Q q (Per person) $ HIRED AUTOS _" BODILY INJURY $ NON -OWNED AUTOS (Per accident) . GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $ > UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM a WORKER'S COMPENSATION - - i STATUTORY LIMITS AND EACH ACCIDENT $ DISEASE —POLICY LIMIT $ ` EMPLOYERS' LIABILITY _ DISEASE —EACH EMPLOYEE $ IOTHER ..,.__,.-__.__._.._....Y..».�....._.......a.. i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS I il FAN'; ,,_; AI\TFNANCF CERTIFICATE HOLDER CANCELLATION _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE i 1 T Y t 1 F K r Y W E T EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO € f _ 'b 0 ��' 8 0 C MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE F. F I LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR I i LIABILITY OF ANY KIND OfON THE COMPANY, ITf AG NTS OR REPRESENTATIVES. I I AUTHORIZED REPRE N fATIV J� ACORD 25-S (7/90) iCD ORPORATION 1990 CC BOA" OF COUNTY COMMISSIONERS MAYOR Shirley Freeman, District 3 OUNTY SO�MONROE Mayor Pro tern Jack London, District 2 C KEY WEST FLORIDA 33M Wilhelmina Harvey, District I C (M5) 294-4CAI Keith Douglass, District 4 ZJ6 Mary Kay Reich, District 5 Monroe County Risk Management 5 100 College Road Key West, FL 33040 (305)292-4542 Voice (305)292-4564 Fax Uni'versd ftfth Service Corporation P.O. Box 2151 Dezray Beach, FL 33444 Enk A November 14, 1995 Re: GENERAL LIABILITY POLICY #CPP0509298 Dear Sir/Madam: Risk Management has received a Certificate of Insurance for subject policy. However, it does not comply with contract requirements in the following areas: 1. Certificate holder is City of Key West instead of Monroe County. 2. Additional insured is City of Key West instead of Monroe County. Please have your agent forward a corrected Certificate of Insurance as soon as possible. If you have any questions, please call. Sincerely, Ka Miller Risk Management cc: Beth Leto ubslett.do 14 CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED. UNIVERSAL BEACH SERVICE CORP P 0 BOX 2151 DELRAY BEACH, FL 33444 COMPANIES AFFORDING COVERAGES: Company Letter A. Florida Farm Bureau General Ins. Co. Company Letter. B: Florida Farm Bureau Casualty Ins. Co. The policies of insurance listed below have been issued to the Insured named above ana are In Tome aT mis ume. I mains anaing any requlremenT, 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. 00• LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE 1MM/DOrM POLICY EXPIRATIONALL DATE (MM/DD/YY) LIMITS IN THOUSANDS LIABILITY:GENERAL $ 2 000 �IOCCU°RRENCE CPP 0509298 2-ENERAL4-95 2-4-96 OPERATIONS AGGREGATE $ INCL FORM) TFISM rAluRv $ i ono AcroRB ❑ $ 1,000 i PROTECTIVE FIRE DAMAGE VM one firel $ D FARMER'S PERSONAL LIABILITY EXPENSE (Any — P-1 $ 5 i AUTOMOBILE LIABIE177-- ❑ ANY AUTOBODIL COMBINED LIMIT SINGLE$ k KJURv $ ❑ ALL OWNED AUTOS Poo") eODDLY $ ❑ SCHEDULED AUTOS Aoeid�nl HIRED AUTOS ❑ $ NON -OWNED AUTOS ❑ DAMAGE EXCESS LIABILITY: OCCURRENCE ❑ UMBRELLA FORM $ $ ElOTHER THAN UMBRELLA FORM EMPLOYERS LIABILITY, $ FARM EMPLOYERS >: (EachOccurt�rrnl LIABILITY FARM EMPLOYEE'S MEDICAL EmWoy�e t DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: CITY OF KEY WEST- ADDITIONAL INSURED -- CANCELL�I(ON: Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail V days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: County Code 050 Date Issued 10-19-95 CITY OF KEY WEST Serviced by — County Farm Bureau P 0 BOX 140 KEY WEST, 33041 �AUTHOR�DREPRE 9 ENTATIVE 93.7.692 (Rev. 5/93) CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES COMPANIES AFFORDING COVERAGES: P.O. BOX 147030 Company Letter A: GAINESVILLE, FLORIDA 32614-7030 Florida Farm Bureau General Ins. Co. Company ecetvea NAME AND ADDRESS OF INSURED: Risk Mgmt. & Loss Co Le;ter B: trot — UNIVERSAL BEACH SERVICE CORP Florida Farm Bureau Casualty Ins. Co. P 0 BOX 2151 DATE - DELRAY BEACH, FL 33444 INITIAL The policies of insurance listed below have been issued to the insured named above and are in force at this time. 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. CO. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YV) ALL LIMITS IN THOUSANDS GENERAL LIABILITY: GENERAL AGGREGATE $ 2 000 COMERCIAL GENERAL ® IABILITY(OCCURRENCE CPP 0509298 2-4-95 2-4-96 PRODUCTS-COPERATIONS AGMPLETED GREGATE $2,000 A FORM) PERSONAL & ADVERTISING $ 1 000 INJURY , PR OWNER— 1Ep TIVE CONTRACTOR'S EACH OCCURRENCE $ 1 , 000 FARMEH'S PERSONAL LIABILITY FIRE DAMAGE (Any one Fire) $ 50 MEDICAL EXPENSE (Any one person) $ 5 AUTOMOBILE LIABILITY: ANY AUTO APPROVED BY RI K MANAGEMENT COMBINED SINGLE LIMIT $ BODILY INJURY (Per Person) $ ALL OWNED AUTOS BY_ i �( �p , L SCHEDULED AUTOS DATE ��y � i �_ BODIINJULY (Per $ El HIRED AUTOS WAIVER: N/A �/ YFS Accident) NON -OWNED AUTOS PROPERTY DAMAGE $ EXCESS LIABILITY: EACH OCCURRENCE AGGREGATE UMBRELLA FORM ❑OTHER THAN UMBRELLA FORM I MPLOYERS LIABILITY: $ FARM EMPLOYER'S LIABILITY (Each Occurrence) FARM EMPLOYEE'S MEDICAL (Each Em In p y OTHER: $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: MONROE COUNTY— ADD'L NAMED INSURED I C;ANUELLATION: 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 below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: COUNTY OF MONROE MONROE COUNTY RISK MANAGEMENT 5100 COLLEGE ROAD KEY WEST, FL 33040 County Cod 05 Date Issued 11-28-95 Serviced b PALM BE H/DELRAY BEACH County Farm Bureau N W. STRAG AUTHORIZED REPRESENTATIVE C_ -692 (Nv. 5/93) ` CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: UNIVERSAL BEACH SERVICE CORP PO BOX 2151 DELRAY BEACH, FL 33447-2151 COMPANIES AFFORDING COVERAGES: Company Letter A: Florida Farm Bureau General Ins. Co. Company Letter B: Florida Farm Bureau Casualty Ins. Co. The policies of insurance listed below have been issued to the insured named above and are in force at this time. 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. CO. POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) ENERAL LIABILITY: GENERAL AGGREGATE $ 2.000 A X❑ L LIIAABILITY [OCCURREGENENCE FORM) ❑ OWNERS PROTECTIVE CONTRACTOR'S S GL 0509298 01 0 2/ 0 4/ 9 6 0 2/ 0 4/ 9 7 PRODUCTS -COMPLETED OPERATIONS AGGRGA E $ INC PERSONAL JURDYVERTISING $ 1,000 EACH OCCURRENCE $ 1,006 FARMER'S PERSONAL ❑ LIABILITY FIRE DAMAGE (Any one fire) $ 50 MEDICAL EXPENSE (Any one person) $ 5 AUTOMOBILE LIABILITY: ANY AUTO ❑ APPROVE B RISK MANAGEMENT COMBINED SINGLE LIMIT $ ❑ ALL OWNED AUTOS gY D el G - LC'/=�/� BODILY INJURY (Per Person) $ ❑ SCHEDULED AUTOS ❑ HIRED AUTOS n -F _ a — — BODILY INJURY (Per Accident) $ ❑ NON -OWNED AUTOS PROPE DAMAGE $ OCCURRENCE ❑ UMBRELLA FORM $ $ THAN UMBRELLA ❑OTHER FORM EMPLOYERS LIABILITY: $ FARM EMPLOYER'S :.. Each Occurrence LIABIL ITY $ F ARM EMPLOYEE'S MEDICAL ❑ _................................................ ii lFwrh Fmnlnvenl DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: 94225 - FARM MACHINERY OPERATION BY CONTRACTORS ADDITIONAL INSURED - SEE FORMS CG2010 & CG2012 CANCELLATION: 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 below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: County Code 5 Date Issued 12 / 11 / 9 5 ATTN : SANDRA HIGGS Serviced by PAT, R F. JT4 County Farm Bureau MONROE COUNTY PO BOX 866 LFN W RTRQ�N���&:=� KEY WEST FL 33041 AUTHORIZED REPRESENTATIVE Cc -- - - - G — S , v C W07 s— POLICY NUMBER: CPP 0509298 01 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS -PERMITS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE State or Political Subdivision: MONROE COUNTY ATTN: SANDRA HIGGS (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured any state or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. 2. This insurance does not apply to: a. ''Bodily injury," "property damage," "personal injury" or "advertising injury" arising out of operations performed for the state or municipality; or b. "Bodily injury'' or "property damage" included within the "products -completed operations hazard." 1y,. ,.. 12 / 11 / 9 5 W 0 7 PAB CG 20 12 1185 Copyright, Insurance Services Office, Inc., 1984 0 CERTIFICATE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION OR ALTER THE O ERAGE AFFORDED BY THE POLICIES LISTEDABELOW TE DER. THIS CERTIFICATE DOES NOT AMEND, EXTENDFORDING COVERAGES: BUREAU INSURANCE COMPANIES FLORIDA FARM P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: /_ C UNIVERSAL BEACH SERVICE CORP DA'1 �, iN[Z'lAL PO BOX 2151 RAY BEACH FL 33444 COMPANIES AF Company Letter A: Florida Farm Bureau General Ins. Co. Company Letter. B: Florida Farm Bureau Casualty Ins. Co. DEL with respect to which this certificate may be issued or may p ertain, the insurance a orded by the policies Iicies of insurance listed below have been issued p to the inserm or ured named above and are in forcer this time. Notwithstanding any requirement, th , o The po contract or other documer ff condition of any described herein Is subject to all the terms, exclusions and conditions of such po Ides. POLICY ExPIRATION ALL LIMITS IN THOUSANDS POLICY EFFECTIVE DATE IMM/00/YYI DATE IMM/0Dir i � R TYPE OF INSURANCE POLICY NUMBER � A EMFNT G N A $ $ N AL LIABI I ���� OPERATIONS AGGREGATE COMMERCIALGENERAL LIABILITY (OCCURRENCE BY— 1` k AI A 1 INJURY $ FORM) I F � ^� � $ OWNER'S & CONTRACTORS pgOTECTNE DATE _ U FI ny ors fire) $ FARMERS PERSONAL , YF. M N (Any one Pen°^) $ LIABILITY w W �� COMBINED $ SINGLE LIMIT AU M 1 A I ANY AUTO LY INNJJUIRY (PO( $ 100 Peron( ■ ALL OWNED AUTOS B AB 0989936 BODILY INJURY (psr $ 300 SCHEDULED AUTOS Accldenl) PROPERTY $ 100 HIRED AUTOS DAMAGE NON -OWNED AUTOS 93 H OCCURRENCE EXCESS LIABILITY: $ $ UMBRELLA FORM OTHER THAN UMBRELLA $ $ FORM EMPLOYERS UABILrrY: $ FARM EMPLOYERS 1a LIABILITY DICAL ' MED AL RM E M PL O YEE S FARM k>s $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: Occurrence) I an will endeavor CANCELLATION: Should any of the above described policies be cancelled mail such notice shall before the expiration date thereof, the issuing come mail ___aQ_ days written notice to the below named certificate holder, but failure to hall impose no obligation 2 liability 20-95f any kin upon the company. County Code 050 Date Issued NAME AND ADDRESS OF CERTIFICATE HOLDER: COUNTY OF MONROE MONROE COUNTY RISK MANAGEMENT 5100 COLLEGE RD I KEY WEST, FL 33040 — ATT: KAY MILLER r ALM BEACH :7-69 y Farm Burea Serviced by LEN W S 0 AUTHORIZED REPRESEN�IVE Rev. •A FLORIDA FARM BUREAU INSURANCE COMPANIES ME11, • N.s Palm Beach County Farm Bureau + 13121 N. Military Trail, Delray Beach, FL 33484 Phone: (407) 498-5200 — Delray; (407) 655-5795 — West Palm Received March 3. 1995 Risk Mjmt. & Loss Control DATE, INITIAL , 0- Ms Kay Miller Monroe County Risk Management 5100 College Rd Key West, Fl. 33040 Re: John Peart and Universal leach Sjer�vi cce Corp, lino Bu-s,iness Auto ABF9899;36 Dear Ms Miller, Please be advised the Florida Farm Biireai..i Casualty Insurance ("om- pany nor the Florida .Farm Bureati General Insiirance Company, he=aci- quartered in Gainsville, Florida will issue an additional insured endorsement, on a Busine:-;'- Ai. t,.) pol i.cy. According to our records there i.,:�i no TS0 endorsement arlproved for thi.S, purpose - The lan!-tiage.. of the ornnilluc, ins uranoe clause provides covera?--'e fo.r tltis type without the need for additional endorsement_ I am attaching a p,%c, of the Farm Ptireati omnibus clause for your file- i have h:i_-lited the appropriate language- We. wi l.i. be more than happy to issue a certificate of inSu.iranc.e on ,your behalf if we haven't already done so. Tf you have any further gtiP.s t i on reTerpnce. this u-1ease do not hesitate to contact me. Y A-gency Manager i'alm Reaoh County Farm eau acuuiie will be a covered "auto ioi that wroi- age only if: a. We already cover all "autos" that you own for that coverage or it replaces an "auto" you previously owned that had that coverage; and b. You tell us within 30 days after you acquire it that you want us to cover it for that coverage. C. CERTAIN TRAILERS, MOBILE EQUIPMENT AND TEMPORARY SUBSTITUTE AUTOS If Liability Coverage is provided by this Coverage Form, the following types of vehicles are also covered "autos" for Liability Coverage: SECTION II—LIABILIT` A. COVERAGE We will pay all sums an "insured" legally must pay as damages; except punitive or exemplary damages, because of "bodily injury" or "property damage" to which this insurance applies, caused by an "acci- dent" and resulting from the ownership, main- tenance or use of a covered "auto". We have the right and duty to defend any "suit" ask- ing for these damages. However, we have no duty to defend "suits" for "bodily injury" or "property damage" not covered by this Coverage Form. We may investigate and settle any claim or "suit" as we consider appropriate. Our duty to defend or settle ends when the Liability Coverage Limit of Insurance has been exhausted by payment of judgments or WfIMS AN INSURED The following are "insureds": a. You for any covered "auto". b. Anyone else while using with your permis- sion a covered "auto" you own, hire or bor- row except: (1) The owner or anyone else from whom you hire or borrow a covered "auto". This exception does not apply if the covered "auto" is a "trailer" connected to a cov- ered "auto" you own. (2) Your employee if the covered "auto" is owned by that employee or a member of his or her household. (3) Someone using a covered "auto" while' he or she is working in a business of selling, servicing, repairing or parking "autos" unless that business is yours. (4) Anyone other than your employees, partners, a lessee or borrower or any of their employees, while moving property to or from a covered "auto". (5) A partner of yours for a covered "auto" owned by him or her or,4 member of ft.-his or her household. 1. .. Irailers" with a load capacity of 2,000 pounds or less designed primarily for travel on public roads. 2. "Mobile equipment" while being carried or towed by a covered "auto". 3. Any "auto" you do not own while used with the permission of its owner as a temporary substi- tute for a covered "auto" you own that is out of service because of its: a. Breakdown; b. Repair; c. Servicing; d. "Loss"; or e. Destruction. a. Supplementary.Payments. In, addition to the Limit of Insurance, we will pay for the "insured": (1) All expenses we.incur. (2) Up to $250 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (3) The, cost of bonds to release attach- ments in any "slit" we defend, but only for bond amounts within our Limit of Insurance. ' (4) All reasonable expenses incurred by the "insured" at our request, including ac- tual loss of earning up to $100 a day be- cause of time off from work. (5) All costs taxed against the "insured" in any "suit" we defend. (6) All interest on the full amount of ahy judgment that accrues after entry of the judgment in any "suit" we defend; but our duty to pay interest ends when we have paid, offered to pay or deposited in court the part of the judgment that is within our Limit of Insurance. b. Out of State Coverage Extensions. While a covered "auto" is away from the state where it is licensed we will: (1) Increase the Limit of Insurance for Lia- bility Coverage to meet the limits speci- fied by a compulsory or financial A responsibility law of the jurisdiction where the covered "auto" is being used. R&SEIVED JAN r :'.':' :;: DATE:.MM .. DD ( / /YY) Ol 19 96 / /........................................:::._:::::::::::::::::::::::::::::::::::::::. :.:......................................................................................................................... PRODUCER;:.;: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Causeway Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hayes -Mack Insurance Assoc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 3653 S. Seacrest Blvd. COMPANIES AFFORDING COVERAGE Boynton Beach, FL 33435-8662 COMPANY 407-737-6464 A Professional Business Owners SIF INSURED COMPANY Universal Beach Service Corp. B P.O. Box 2151 Delray Beach FL 33444-2151 COMPANY 7 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 PEF[fiSiS 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 $ PRODUCTS - COMP/OP AGG $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE 71 OCCUR PERSONAL & ADV INJURY $ EACH OCCURRENCE $ OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fir,) $ MED EXP (Any one person) $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS APPROVED BY RISK NANAGEWENT BY--��=�" DATE ER: N/A _YES �t DPI GL g:r,—W COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ 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 FORid WORKERS COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY LIMITS EACH ACCIDENT $ 100,000 A THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE WC96 113900 Ol/Ol/96 12/31/96 DISEASE - POLICY LIMIT $ 500,000 DISEASE - EACH EMPLOYEE $ 100,000 OFFICERS ARE: X EXCL OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS BEACH CLEANING & MAINTENANCE STATE OF FLORIDA OPERATIONS ONLY >wANly 1'1.................................................. . .................................................................................. CITY OF KEY WEST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE P.O. BOX 866 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL KEY WEST, FL 33401 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 KIN5 UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHOR D EP SENTATIV ;::7:::ii::ii::::i:>::::;::::<:;:;:::;:::i;::;::;:>::;:;:::::;:;>;»:»>:;�:.;:.:;<.;::.;:;;;;:�i::i::>.Y::;::;::::;::>:�::;;:;:;::;:;:;:;;:;;:;::::; t<P ............... ............. ................................ :::>>:::::: DATE:.MMDD::::::::::.::: :::::::................................::.:.: ;:::;i:;;:i::ii:::i:;::i::::i::::::i:::: i :::i::i::::i::::r ;::: ;: 3::>::::: : i:;:2; ::: :::::::....: ; ....:::i:2:: ::::::::::...................:::::::::::::::::::::::::::::Y:::::::.....::::::::........ ..... :: :::::::::::: N. ...........:::::::::::......:::.::.............. . ..,..:..:..:.::.:..::.:......:.:..:.................................. .........:.........::: 02/06/96 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Causeway Insurance, Inc. Hayes -Mack Insurance Assoc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 3653 S. Seacrest Blvd. COMPANIES AFFORDING COVERAGE Boynton Beach, FL 33435-8662 407-737-6464 COMPANY A Professional Business Owners SIF INSURED Universal Beach Service Corp. COMPANY .ece1Ve .: B Risk Mgrnt. & L )SS control P.O. Box 2151 Delray Beach FL 33444-2151 — 7 COMPANY DA L — — — C COMPANY INIffIAL _-------- -- D . ... i. FtA a .......... �:...........:::;:.;::....:::::;.::.:...:.::.:;.:;.:.......................................:..:..:.:......:..:.:..:..:.:.:.:..:..:::::::::::.::.:..:..:..:..:........::..:.::::::.;..;..:::::.;...:.;::..;:.::.;::..:.;:.:. :..:..:::. : 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 n OLICY-NUM9ER POLICY EFFECTIVE UAfE (iWMiDDi-,-r, POLICY EXPIRATION DATE (MRi;DDi M LIMITS I GENERAL LIABILITY GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE ElOCCUR PERSONAL & ADV INJURY $ EACH OCCURRENCE $ OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS APPROVED Y RISK MANA RY EMENT —BODILY / C� � l 6 /\_ COMBINED SINGLE LIMIT $ (Per person) INJURY $ HIRED AUTOS NON -OWNED AUTOS AiE j--' Y .S 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 STATUTORY LIMITS EMPLOYERS' LIABILITY EACH ACCIDENT $ 100,000 A THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE PX WC96 113900 01/01/96 12/31/96 DISEASE - POLICY LIMIT $ 500,000 DISEASE - EACH EMPLOYEE $ 100,000 OFFICERS ARE: EXCL OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS State of Florida operations only. .:.. H.... CI ...�E:AhI ih�'I N...................................................................................... MONROE COUNTY - RISK MANAGEMENT DIVISION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ATTN: KAY MILLER EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 5100 COLLEGE ROAD KEY WEST, FL 33040 30_ DAYS WRITTEN NOT IC TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUC NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON E COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED ESENT E IINSURED DATE (MM/DD/YY) 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. 33435-8662 COMPANIES AFFORDING COVERAGE Universal Beach Service Corp. P.O. Box 2151 Delray Beach FL 33444-2151 COMPANY A Professional Business Owners SIF COMPANY B 3 b! COMPANY- C COMPANY D... 7 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOPTHE 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. O ' I POLICY EFFECTIVE POLICY EXPIRATION' LTR I TYPE OF INSURANCE POLICY NUMBER I DATE (MM/DD/YY) I DATE (MM/DD/YY) I LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADEEl 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) $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ---- COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE Is AGGREGATE $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: RX EXCL WC97 113900 01/01/97 01/01/98 X WC STATU- I OTH- TORY LIMITS ER EL EACH ACCIDENT $ 100,000 EL DISEASE - POLICY LIMIT $ 500,000 EL DISEASE- EA EMPLOYEE $ 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS State of Florida operations only. MONROE COUNTY - RISK MANAGEMENT DIVISION ATTN: KAY MILLER 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 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 REPRESENTAT CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES COMPANIES AFFORDING COVERAGES: P.O. BOX 147030 Company Letter A. GAINESVILLE, FLORIDA 32614-7030 Florida Farm Bureau General Ins. Co. Company NAME AND ADDRESS OF INSURED: Letter B: UNIVERSAL BEACH SERVICE CORP Florida Farm Bureau Casualty Ins. Co. AND/OR JOHN F PEART PO BOX 2151 DELRAY BEACH, FL 33447-2151 1 CORRECTED The policies of insurance listed below have been issued to the insured named above and are in force at this time. 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. CO. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY: GENERAL AGGREGATE $ 2,000 LIABILITY AGGREGATE $ 2,000 (OCCURRENCE FORM) OPEERATIO S- PERSONAL $ 1,000 OWNA ❑ PROTECTIVEENTRACTOR'S CP P 0509298 05 0 2/ 0 4/ 19 9 9 0 2/ 0 4/ 2 0 0 0 JURDYVERTISING EACH OCCURRENCE $ 1,000 FARMER'S PERSONAL FIRE DAMAGE (Any one fire) $ 50 ❑ UABIUTY MEDICAL EXPENSE $ram (Any one person) AUTOMOBILE LIABILITY: COMBINED $ ❑ ANY AUTO SINGLE LIMIT ❑ ALL OWNED AUTOS BODILY INJURY (Per $ 1rFr RI. '^Idr FM` 1 Person ❑ SCHEDULED AUTOS BODILY Y INJURY (Per $ ❑ HIRED AUTOS Accident) ❑ NON -OWNED AUTOS ['n'E ��_ 'G PROPERTY DAMAGE $ EXCESS LIABILITY: EACH AGGREGATE YFS OCCURRENCE ❑ UMBRELLA FORM $ $ OTHER THAN UMBRELLA ❑ FORM EMPLOYERS LIABILITY: FARM EMPLOYERS S LIABILITY C Each Occurrence) FARM EMPLOYEE'S MEDICAL 'i' $ .?«` (Each Employee) (E OTHER. $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: SEE FORM CG 20 10 & CG 20 12 ADDITIONAL INSUREDS CANCELLATION: 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 below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: County Code 5 0 — 0 Date Issued 12 / 31 / 19 9 8 MONROE COUNTY RISK MANAGEMENT Serviced by PAT,M BEACH County Farm Bureau MONROE COUNTY BOCC AND TDC 5100 COLLEGE RD LEN W STRONG CP U, ATC KEY WEST FL 3 3 0 4 0- 4 319 AUTHORIZED REPRESENTATIVE DATE W 0 6 93-7-692 (Rev. 5/93) INITIAL POLICYNUMBER: CPP 0509298 05 COMMERCIAL GENERAL LIABILITY CG20101093 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: MONROE COUNTY RISK MANAGEMENT MONROE COUNTY BOCC AND TDC (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section ll) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that in- sured. CG 2010 10 93 Copyright, Insurance Services Office, Inc., 1992 0 CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES COMPANIES AFFORDING COVERAGES: Company P.O. BOX 147030 Letter A: GAINESVILLE, FLORIDA 32614-7030 Florida Farm Bureau General Ins. Co. Company NAME AND ADDRESS OF INSURED: Letter B: UNIVERSAL BEACH SERVICE CORP Florida Farm Bureau Casualty Ins. Co. PO BOX 2151 DELRAY BEACH, FL 33447 The policies of insurance listed below have been issued to the insured named above and are in torce at tnis time. INotwimstanaing 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. CO. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY: GENERAL AGGREGATE $ COMMERCIAL GENERAL ❑ LIABILITY (OCCURRENCE FORM) OWNER'S & CONTRACTOR'S ❑ PROTECTIVE ❑ LIABILITY FARMER'S PERSONAL "Y___ Oi1!E - I ' rC^, � F, ;,�' "� Q� _ /� %� 11 M�.. *; l�IK1L/•�•lJhhl pQ,� ---J-E¢��1 T'^y' _ ^— I ,� PRODUCTS -COMPLETED OPERATIONS AGGREGATE $ PERSONAL &ADVERTISING INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MEDICAL EXPENSE (Any one person) @ `p AUTOMOBILE LIABILITY: ❑ ANY AUTO "'', N, ' --- COMBINED SINGLE LIMIT $ BODILY INJURY (Per Person) $ S OO B ❑ ALL OWNED AUTOS BODILYINJURY (Per $ 500 SCHEDULED AUTOS ABF 0989936 02-04-1999 02-04-2000 Accident) HIRED AUTOS ION -OWNED AUTOS PROPERTY DAMAGE $ lOO EXCESS LIABILITY:, .._......:-� EACH OCCURRENCE AGGREGATE A [�g[1MBRELLAFORM UMC 0700503 02-04-1999 02-04-2000' $ 11000 $ 11000 ❑OTHER THAN UMBRELLA FORM EMPLOYERS LIABILITY: ��. ..; .: '. $ FARM EMPLOYER'S ❑ LIABILITY ❑ FARM EMPLOYEE'S MEDICAL 3 (Each Occurrence) Each Employee) OTHER: $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: COUNTY OF MONROE — IS BY POLICY DEFINITION A DESIGNATED INSURED CANCELLATION: Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail 3_ days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: County Code 050 Date Issued 4-6-99 COUNTY OF MONROE Serviced y PALM BEACH County Farm Bureau RISK MANAGEMENT SECTION AUTHORIZED REPRES TATIVE 93-7-692 (Rev. 5/93) A3 0989936 CO 50-0 COMMERCIAL AUTO FFB CA 20 48 10 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the BUSINESS AUTO POLICY. With respect to coverage provided by this endorsement, the provisions of the policy apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured provision of the policy. This endorsement does not alter coverage provided in the policy. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 04-06-1999 Named Insured: John F. Peart & Universal Beach Services Corp. Name of Person(s) or Organization(s): COUNTY OF MONROE Countersigned By: Len W. Strong SCHEDULE (Authorized Representative) (If no entry appears above, information required to complete this endorsement will be shown in the Declarations.) Each person or organization indicated above is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II of the policy. FFB CA 20 48 10 96 ............................... ................................ Aanon PRODUCER (561)737-6464 FAX (561)737-7355 auseway Insurance, Inc. 3652 S. Seacrest Blvd. Boynton Beach, FL 33435-8662 Ext: INSURED Universal Beach Service Corp P.O. Box 2151 Delray Beach, FL 33444-2151 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 POLICY EFFECTIVE POLICY (EXPIRATION ! LIMITS LTR DATE GENERAL LIABILITY GENERAL AGGREGATE $ ............... __........................................................... COMMERCIAL GENERAL LIABILITY PRODUCTS - COMPlOP AGG $ CLAIMS MADE OCCUR : PERSONAL & ADV INJURY $ _...: ....................................................................................... OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ _....._.......................................... _...........................................:........................................ MED EXP (Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS URY SCHEDULED AUTOS Y (Per persILY on) HIRED AUTOS -_- f _ --� :BODILY INJURY $ NON -OWNED AUTOS _.. J _ (Per accident) _.............................. �t{✓JI PROPERTY DAMAGE S 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 WORKERS COMPENSATION AND - . TIT - X TORV - LIMITS : Fa E: ...:,...:,.::.. EMPLOYERS' LIABILITY .......:.:::.: .......:: - -- A THE 2700002472991 12 01 1999 12 01 2000 / / / / EL EACH ACCIDENT ............ $ - 100 0�0 ......... ' PROPRIETOR/ INCL PARTNERS/EXECUTIVE EL DISEASE - POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL. w EL DISEASE - EA EMPLOYEE $ 100,000, OTHER ach Cleaning Service DATE O� Monroe CounTIAL ty Risk Management Depa men 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 REPRESENTATIVES. CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: UNIVERSAL BEACH SERVICE CORP PO BOX 2151 DELRAY BEACH FL 33447 COMPANIES AFFORDING COVERAGES: Company Letter A: Florida Farm Bureau General Ins. Co. Company Letter B: Florida Farm Bureau Casualty Ins. Co. The policies of insurance listed below have been issued to the insured named above and are in Torce ai rnls ume. rvo[wlmszanumy an lcyuiivillulir, condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance a orded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. CO. POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS LTR TYPE OF INSURANCE POLICY NUMBER I DATE (MM/DD/YY( DATE (MM/DD/YY) DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: County of Monroe - is by policy definition a designated insured. CANCELLATION: 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 below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: ATTN MARIA DEL RIO COUNTY OF MONROE RISK MANAGEMENT SECTION 5100 COLLEGE RD DATE KEY WEST FL 33040 INITIAL County Code 05-0 Date issued 04-14-" Serviced by Palm Beach County Farm Bureau Len W. Strong AUTHORIZED REPRESENTATIVE 93-7-692 (Rev. 5/93) AB 0989936 CO 50-0 COMMERCIAL AUTO FFB CA 20 4810 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the BUSINESS AUTO POLICY. With respect to coverage provided by this endorsement, the provisions of the policy apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured provision of the policy. This endorsement does not alter coverage provided in the policy. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: I Countersigned By: 04-12-99 Named Insured: Len W. Strong (Authorized Representative) SCHEDULE Name of Person(s) or Organization(s): County of Monroe - Risk Management Section (If no entry appears above, information required to complete this endorsement will be shown in the Declarations.) Each person or organization indicated above is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II of the policy. FFB CA 20 4810 96 CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: UNIVERSAL BEACH SERVICE CORP AND/OR JOHN F PEART PO BOX 2151 DELRAY BEACH, FL 33447-2151 COMPANIES AFFORDING COVERAGES: Company Letter A: Florida Farm Bureau General Ins. Co. Company Letter B: Florida Farm Bureau Casualty Ins. Co. 1 CORRECTED I ne 9iicles of Insurance iistea below have been issued to the insured named above and are in force at this time. Notwithstanding any requirement, term or con 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. CO. POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) MCOMMERCIAL GENERAL LIABILITY (OCCURRENCE FORM) A OWNER'S & CONTRACTOR'S PROTECTIVE CPP 0509298 06 02/04/2000 02/04/200 ❑ ARBMETRI'S PERSONAL ALL LIMITS IN THOUSANDS CEldEPJ.L AGGREGATE 2 0 0 C @@A 2, 0 0 0 OPERATIONS AGGRGE `P PERSONAL JURY ERTISING 1 OR C EACH OCCURRENCE $ 1, 0 0 C =IRE DAMAGE (Any one fire) $ 5 C (Any one person) W J AUTOMOBILE LIABILITY: ANY AUTO COMBINED SINGLE LIMIT $ ❑ ALL OWNED AUTOS L BODILY INJURY (Per $ Person) ............... SCHEDULED AUTOS BODILY [ aTF INJURY Acctlenr, $ HIRED AUTOS ❑ NON -OWNED AUTOS ,,,� �: �: c PROPERTY $ DAMAGE EXCESS LIABILITY: EACH AGGREGATE ❑ UMBRELLA FORM OCCURRENCE OTHER THAN UMBRELLA FORM $ $ EMPLOYERS LIABILITY: @ •V FARM EMPLOYER'S n i ��A i . B L TY T n (Each Occurrence ( ) nFARM EMPLOYEE'S MEDICAL I r,�.::;:>.Mia;:.;:.;:.:t•11�:•;:• $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: c�'x SEE FORM CG 20 10 & CG 20 12 ADDITIONAL INSUREDS 4=— %0 p 0 .-SCE ?r` �7 �. r n Ca, C CANCELLATION: Should any of the above described policies be cancelled before the expiration date thereof, the issuing cc y AM endeavor to n ...a '.. uayo WIM011 Irvin:c iu ❑lu [JeIOW namea cerTlncate noiaer, but taiiure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: County Code 5 0 - 0 Date Issued 12 / 0 2 / 19 9 9 MONROE COUNTY RISK MANAGEMENT Serviced by PALM BEACH County Farm Bureau MONROE COUNTY BOCC AND TDC 5100 COLLEGE RD T.F.M W -qTPn'KTr- ODOTT A Trl KEY WEST FL 33040-4319 �� n/ �%�%� I AUTHORIZED REPRESENTATIVE - - — W4 9 93-7-692 (Rev. 5/93) I1VITIAL ._.`� POLICYNUMBER: CPP 0509298 06 COMMERCIAL GENERAL LIABILITY CG 20 10 10 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: MONROE COUNTY RISK MANAGEMENT MONROE CO'JidTY BOCC AND TDC (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that in- sured. CG 20 10 10 93 Copyright, Insurance Services Office, Inc., 1992 ❑ COMMERCIAL GENERAL LIABILITY POLICY.NUMBFR: CPP 0509298• �. THIS ENDORSEMENT. CHANGES THE POLICY. PLEAS .READ IT CAREW.LLY. ADDITIONAL INSURED -- STATE OR POLITICAL SUBDIVISIONSPERMITS This endorsement modifies insurance provided under (lie following: , COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE State or Political Subdivision: MONROE COUNTY ' TDC ' ATTN t SANDI1 A IiT,G(�S'f t;]�NCi 9i S1�C1;.7Zt (If no entry appears above, information required to complete this endorsement will be shown In the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) Is amended to include as an insured any state or political subdivision shown in the Schedule, subject to the following provisions: 1. This Insurance appliAs only -with respect to operations performed by you or on your behalf for which the state or political subdivi��,i'n has Issued a permit. 2. This Insurance does'no4 apply to: a. ,"Bodily injury,:!_"property. damage," ..personal.injury" or "advertising Injury" arising out of operations performed for Zhe state or municipality: or b.' "Bodily injury's of'.property damage" included within the "products-com ed operations hazard." 4 � CG 2? 12 11 85 : Copyright; Insurance Services Office, Inc., 1984 CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES COMPANIES AFFORDING COVERAGES: P.O. BOX 147030 Company Letter A: GAINESVILLE, FLORIDA 32614-7030 Florida Farm Bureau General Ins. Co. Company NAME AND ADDRESS OF INSURED: Letter B: UNIVERSAL BEACH SERVICE CORP ��'� Florida Farm Bureau Casualty Ins. Co. AND/OR JOHN F PEART PO BOX 2151 DELRAY BEACH, FL 33447-2151 1 "AMENDED" The policies of insurance listed below have been issued to the insured named above and are in force at this time. 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. Co. LTR TYPE OF INSURANCE X❑ COMMERCIAL GENERAL LIABILITY (OCCURRENCE FORM) A ❑OWNER'S & CONTRACTOR'S PROTECTIVE ❑FARMER'S PERSONAL LIABILITY POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER I DATE (MM/DD/YY) I DATE (MM/DD/YY) CPP 0509298 061 02/04/2000102/04/2001 ALL LIMITS IN THOUSANDS NERAL AGGREGATE $ 2 OR O $ 2, 000 OPERATIONS AGGREGATE PERSONALINJURY ADVERTISING 1,000 EACH OCCURRENCE $ 1,006 FIRE DAMAGE (Any one fire) $ 50 (Any one person) AUTOMOBILE LIABILITY: COMBINED ❑ ANY AUTO SINGLE LIMIT ❑ ALL OWNED AUTOS 1 l BODILY INJURY (Per $ Person) "Y _ 1S LLL ❑ SCHEDULED AUTOS BODILY .::::::::::::::: INJURY Per W ............... ::.:::::::::::::: ❑ HIRED AUTOS r 5T —." _-- —. __.__-- Accident »s:.;r:»ra.. NON -OWNED AUTOS ; "t ,,..� - -- PROPERTY DAMAGE $ :::..:::: ................ ................. ................ EXCESS LIABILITY: EACH AGGREGATE OCCURRENCE UMBRE LLA FORM $ $ OTHER THAN UMBRELLA ❑ % C FORM 1 EMPLOYERS LIABILITY: FARM EMPLOYEri'S :� Each Occurrence ( ) IA LIABILITY n FARM EMPLOYEE'S LOYEE S MEDICAL _._. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: SEE FORM CG 20 10 & CG 20 12 ADDITIONAL INSUREDS L;ANC;tLLAIIUN: 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 below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: ATTN: RISK MANAGEMENT SECTION MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 5100 COLLEGE RD KEY WEST, FL 33040-4319 County Code 5 0- 0 Date Issued O 1/ 0 4/ 2 0 0 0 Serviced by PALM BEACH County Farm Bureau L .N W ST ON t CPCU,ATC AUTHORIZED REPRESENTATIVE W 0 6 93-7-692 (Rev. 5/93) POLICYNUMBER: CPP 0509298 06 COMMERCIAL GENERAL LIABILITY CG20101093 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: ATTN: RISK MANAGEMENT SECTION MONROE COUNTY BOARD OF COUNTY COMMISSIONERS (if no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that in- sured. CG 20 10 10 93 Copyright, Insurance Services Office, Inc., 1992 ❑ Beach Cleaning Florida employees only Monroe County Risk Management Department 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 '40 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 REPRESENTATI, Warren Mack QAAZ CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES COMPANIES AFFORDING COVERAGES: Company P.O. BOX 147030 Letter A: GAINESVILLE, FLORIDA 32614-7030 Florida Farm Bureau General ins. Co. Company NAME AND ADDRESS OF INSURED: Letter. B: UNIVERSAL BEACH SERVICE CORP. Florida Farm Bureau Casualty Ins. Co. P.O. BOX 2151 DELRAY BEACH, FL 33447 The policies of insurance listed below have been issued to the insured named above and are in force at this time. 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. CO. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS AL LIABILITY: GENERAL AGGREGATE$ COMMERCIAL GENERAL LIABILITY (OCCURRENCE FORM) OWNER'S& CONTRACTORS ❑ PROTECTIVE ❑FARMER'S PERSONAL LIABILITY „` i ., R. � � ... . - -- � r n �j;. F I — _-------- s . OPERATIONS AGGREGATE $ PERSONAL & ADVERTISING INJURY $ EACH $ FIRE one lire) Is MEDICAL EXPENSE (Any one Person) is I B AUTOMOBILE 1 ANY AUTO ` ._. COMBINED SINGLE LIMIT Is ALL OWNED AUTOS BOLY INJURY (Per Peron) $ 500 USCHEDULED AUTOS ® HIRED AUTOS ABF 0989936 02-04-2000 02-04-2001 INJURY Accident $ 500 © NON -OWNED AUTOS PROPERTY DAMAGE $ ZOO EXCESS LIABILITY: EACH OCCURRENCE AGGREGATE A ®UMBRELLA FORM OTHER THAN UMBRELLA FORM UMC 0700503 02-04-2000 02-04-2001 1,000 $ 1,000 $ EMPLOYERS LIABILITY:.: ❑FARM EMPLOYERS LIABILITY (Each Occurrence) FARM EMPLOYEE'S MEDICAL (Each Empbyee) OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: COUNTY OF MONROE — IS BY POLICY DEFINITION A DESIGNATED INSURED I:ANI;t_LLA I IUN: bnouid 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 below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: County Code 050 Date Issued 02-15-2000 MONROE COUNTY RISK MANAGEMENT ^ / SeN• d by PALM BEACH County Farm Bureau 5100 COLLEGE ROAD KEY WEST, FL 33040 IDA11 AUTHORIZED REPRESENTATIVE ATTN: MARIA del RIO INITIAL __•_ r 93-7-692 (Rev. 5/93) y CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: UNIVERSAL BEACH SERVICE CORP AND/OR JOHN F PEART PO BOX 2151 DELRAY BEACH, FL 33447-2151 COMPANIES AFFORDING COVERAGES: Company Letter A: Florida Farm Bureau General Ins. Co. Company Letter B: Florida Farm Bureau Casualty Ins. Co. 1 rie oif _Ies or insurance iisiea Deiow nave been Issued to the insured named above and are in force at this time. Notwithstanding any requirement, term or con ition 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. CO. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS A GENERAL LIABILITY: COML LIABILITY (OCCURREERCIAL NCE FORM) ❑ OWNER'S &CONTRACTOR'S PROTECTIVE CP P 0509298 07 0 2/ 0 4/ 2 0 01 0 2/ 0 4/ 2 0 0 2 GENERAL AGGREGATE $ 2,000 PRODUCTS-coMPLETED OPERATIONS ONS AGGREGATE $ 2 , 000 PERSONAL & ADVERTISING INJURY $ 1, 0001 EACH OCCURRENCE $ 1, 000 FARMER'S PERSONAL ❑ LIABILITY FIRE DAMAGE (Any one fire) $ 5 0 MEDICAL EXPENSE (Any one person) $ 5 AUTOMOBILE LIABILITY: ❑ ANY AUTO COMBINED SINGLE LIMIT $ ❑ ALL OWNED AUTOS BODILY INJURY (Per Person) $ ❑ SCHEDULED AUTOS ❑ HIRED AUTOS Lly - r •' ,-'P. BODILY INJURY (Per Accident) $ t/,J`, J1 ❑ NON -OWNED AUTOSIQ PROPERTY DAMAGE $ EXCESS LIABILITY: ❑ UMBRELLA FORM ❑OTHER THAN UMBRELLA FORM I+'"'"'r4: / � =' • „ � VCR + 1 EACH OCCURRENCE $ AGGREGATE $ EMPLOYERS LIABILITY: FARM EMPLOYER'S LIABILITY _ C; :: .......-r Each Occurrence) $ (Each Employee) FARM EMPLOYEE'S MEDICAL THER: 3; ?? $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: SEE FORM CG 20 10 & CG 20 12 ADDITIONAL INSUREDS oi+vu,u any ur zne above oescrlDea policies De cancelled before the expiration date thereof, the issuing company will endeavor to mail 1— days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: ATTN: RISK MANAGEMENT SECTION MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 5100 COLLEGE RD KEY WEST, FL 33040-4319 County Code 5 0- 0 Date Issued _ 12 / 0 5/ 2 0 0 0 Serviced by PALM 'REACH County Farm Bureau PA TT, LAN .ASTER JR, C4TJJ, C'HFC' AUTHORIZED REPRESENTATIVE POLICYNUMBER: CPP 0509298 07 COMMERCIAL GENERAL LIABILITY CG20101093 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: MONROE COUNTY RISK MANAGEMENT MONROE COUNTY BOCC AND TDC (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that in- sured. CG 20 10 10 93 Copyright, Insurance Services Office, Inc., 1992 ❑ COMMERCIAL GENERAL LIABILITY, POLICY.NUMBER: CPP 0509298' �. THIS ENDORSEMENT.CHANGES THE POLICY. PLEASE -.READ IT CAREFULLY. ADDITIONAL INSURED-- ITS STATE OR POLITICAL SUBDIVISION S-PERMI This endorsement modifies insurance provid4d under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE State or Political Subdivision: MONA0Z COt1NTY ATTN I SANDXI\ IIT:GCS1Q.1NOI✓A TDC (If no entry appears above, information required to complete this endorsement will be shown In the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) Is amended to include as an insured any state or political subdivision shown in the Schedule, subject to the following provisions: 1 This Insurance applAs on4with respect to operations performed by you or on your behalf for which the state or political subdivljji,.fb,n has Issued a permit. 2. Phis Insurance doe5'rnlf apply to: arl`sing out of operations a. ."Bodily injury," -property damage."" personal. injury" amage,""personal.injury" or" adver tising Injury' performed for She state or municipality; or b. "Bodily Injury" of ''property damage" Included within the "prdducls com ed operations hazard." r . 1, Copyright; Insurance Services Office, Inc., 19E1�1 , t CG 2? 12 11 85 CERTIFICATE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TUIe rreQTIGIreTP nrnl=c Nr)T AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: JOHN F PEART & UNIVERSAL BEACH SERVICES CORP PO BOX 2151 DELRAY BEACH FL 33447-2151 COMPANIES AFFORDING COVERAGES: Company Letter A. Florida Farm Bureau General Ins. Co. Company Letter B: Florida Farm Bureau Casualty Ins. Co. The policies of insurance listed below have been issues to the insurea namea aoove miu ale III IVIiV a, _ condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance a orded by the policies i described herein s subject to all the terms, exclusions and conditions of such policies. POLICY EFFECTIVE I POLL EXPIRATION ALL LIMITS IN THOUSANDS LTR TYPE OF INSURANCE POLICY NUMBER GATE (MM/DD/Y1) DATE (MM/DD/Y1) Co' COMMERCIAL GENERAL ❑ UABILITY (OCCURRENCE FORM) PRODUCTS -COMPLETED OPERATIONS AGGREGATE PERSONAL & ADVERTISING INJURY $ ❑ POWNER'S & ROTECTIVE NTRACTOWS EACH OCCURRENCE$ FIRE DAMAGE iAny one fire) $ ❑FARMER'S PERSONAL LIABILITY _ MEDI (Any one Poison)E $ AUTOMOBILE UAB p ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS IINJUURY (Per Person) $ 5 0 0 ��1 Accidem) 500 B SCHEDUIEDAUTOS ABF0989936 02/04/2001 02/04/2002 -- ® HIRED AUTOS ® NON -OWNED AUTOS N�',';: a y'-; ., •• ,; ;h, PROPERTY $ 100 EXCESS LIABILITY: u' EACH OCCURRENCE AGGREGATE UMBRELLA FORM U D� /� v V ❑ OTHER THAN UMBRELLA FORM via --------------- EMPLOYERS LIABILITY: .d I.J T Occrt (Each Occurrence) ) LITYnvccr; F MEDICAL FARM EMPLOYEES.. n- - :<. ......... :... .. .. ...... Each Em ee P �Y 1 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: The Certificate Holder is by policy definition a Designated Insured. CANCELLATION: Should any of the above described policies be cancelled before the expiration date tnereot, the Issuing company wm enueavul IV mail 10 days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. County Code 50-0 Date Issued 0210419001_ Serviced by PALM BEACH County Farm Bureau PAUL LANCASTER JR, CLU, CHEC AUTHORIZED REPRESENTATIVE 33040 93-7-692 (Rev. 5/93) ABF0989936 COMMERCIAL AUTO FFB CA 20 4810 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the BUSINESS AUTO POLICY. With respect to coverage provided by this endorsement, the provisions of the policy apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured provision of the policy. This endorsement does not alter coverage provided in the policy. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 02/04/2001 Named Insured: JOHN F PEART & UNIVERSAL Name of Person(s) or Organization(s): See Declaration Countersigned By: SCHEDULE PAUL LANCASTER JR, CLU,CHFC (Authorized Representative) (If no entry appears above, information required to complete this endorsement will be shown in the Declarations.) Each person or organization indicated above is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II of the policy. FFB CA 20 4810 % PRODUCER:;:;;: (561)737-6464 FTM (561)737-7355 auseway Insurance, Inc. PO Box 243629 Boynton Beach, FL 33424-3629 Ext: INSURED Universal Beach Service Corp P.O. Box 2151 Delray Beach, FL 33444-2151 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 POLICY EFFECTIVE POLICY EXPIRATION:: LIMITS LTR DATE (MM/DD/YY) DATE (MM/DD/YY) GENERAL LIABILITY aGENERAL AGGREGATE $ .......,...................................................................................... COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ ... ...................................... .................................... ....._......... ..... OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ ....... ..................................................... :....................................................................................... MED EXP (Any one person) $ AUTOMOBILE LIABILITY ...I.... APPRO RI A zwrckkqT COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BY - BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS DATE NON -OWNED AUTOS WAIVER ES ' N/A—Yail_ BODILY INJURY (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 $ WORKERS COMPENSATION AND X TORY LIMITS : ER 7 EMPLOYERS' LIABILITY ......................__............ A THE PROPRIETOR/ WCV7018919 12/01/2001 EL EACH ACCIDENT $ ...............100. ' 12/01/2002 t. 000 PARTNERS/EXECUTIVE INCL EL DISEASE - POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL EL DISEASE - EA EMPLOYEE $ 100,000 Beach Cleaning Florida employees only Monroe County Risk Management Department 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 REPRESENTATIVES. AUTHORIZED REPRESENTZ�Aa-.-' Warren Mack /P M4'f '/ CERTIFICATE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. t THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: UNIVERSAL BEACH SERVICE CORP AND/OR JOHN F PEART PO BOX 2151 DELRAY BEACH, FL 33447-2151 COMPANIES AFFORDING COVERAGES: Company Letter A: Florida Farm Bureau General Ins. Co. Company Letter B: Florida Farm Bureau Casualty Ins. Co. I ne "cies or Insurance iistea below nave been issued to the insured named above and are in force at this time. Notwithstanding any requirement, term or con ition 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. CO. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS A GENERAL LIA ILITY: GENERAL COMX❑LIABILITY FORM) ❑OWNER'S&CONTRACTOR'S PROTECTIVE CPP 0509298 08 02/04/2002 02/04/2003 NERAL A ATE $ 2,000 PRODUCTS-COMPLETEDE OPERATIONS AGGREGATAL $ 2,000 PER-95N& ADVE TI INJURY $ 1,000 EACH URR N E $ 1,000 FARMER'S PERSONAL ❑ LIABILITY FIR AMA (Any one fire) 5 0 MEDICAL XP N (Any one person) $ 5 AUTOMOBILE LIABILI ❑ ANY AUTO COMBINED SINGLE LIMIT Q W ❑ ALL OWNED AUTOS APR p B R MET BO LY INJ ; (Per ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON -OWNED AUTOS BY DATE 1NAIVER , y� b I NIA /YES BODILY INJURY (Per Accident) $ DAMAGEPROPERTM $ EXCESS LIABILITY: EACH OCCURRENCE A RE AT..... UMBRELLA FORM ❑OTHER THAN UMBRELLA FORM '�'� $ $ EMPLOYERS LIABILITY: FARM F O Y _MPL ER' S LIABILITY 3. $ Each Occurrence) Occu a ce Each Employee) ( FARM EMPLOYEE'S MEDICAL C L THER: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES: SEE FORM CIS 2010 & CG 2012 VYIIVVGLLM I IIJIV. JIIVuIu any of me aoove aescrlDea policies De cancelled before the expiration date thereof, the issuing company will endeavor to mail 10 days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: ATTN: RISK MANAGEMENT SECTION MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 5100 COLLEGE RD KEY WEST, FL 33040-4319 County Code 5 0 - 0 Date Issued 12 / 0 4 / 2 0 01 Serviced by PA .M BEACH County Farm Bureau PATIL LANC'A TER T , (CLU, H C' AUTHORIZED REPRESENTATIVE POLICY NUMBER:CPP 0509298 08 COMMERCIAL GENERAL LIABILITY CG20101093 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: MONROE COUNTY RISK MANAGEMENT MONROE COUNTY BOCC AND TDC (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that in- sured. CG 20 10 10 93 Copyright, Insurance Services Office, Inc., 1992 171 POLICY NUMBER: CPP 0509298 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE State or Political Subdivision: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ATTN: RISK MANAGEMENT (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section 11) is amended to include as an insured any state or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. 2. This insurance does not apply to: a. 'Bodily injury," "property damage," "personal injury" or "advertising injury" arising out of operations per- formed for the state or municipality; or b. 'Bodily injury" or "property damage" included within the "products -completed operations hazard." CG 20 12 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 0 CERTIFICATE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. ruoc. t corimt,&rc nr►cc Nr1T• AU;:Nn. FXTFND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: JOHN F PEART & UNIVERSAL BEACH SERVICES CORP PO BOX 2151 DELRAY BEACH FL 33447-2151 COMPANIES AFFORDING COVERAGES: Company Letter A: Florida Farm Bureau General Ins. Co. Company Letter B: Florida Farm Bureau Casualty Ins. Co. fnrm nr The policies of insurance listed below have been ISSUea.to me insurea nameu auvve anu ary rn a...00 _.. __ _-. _-.._ e' condition of any contract or other document with respect to which this certificate may be Issued or may pertain, the Insurance a orded by the policies dPccrlee I he is subiect to all the terms, exclusions and conditions of such policies. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY: GENERAL AGGREGATE $$PRobucMCOMPLETED OPERATIONS AGGREGATE @ `p ❑COMMERCIAL GENERAL LIABILITY (OCCURRENCE FORM) OWNERS & CONTRACTOR'S ❑ PROTECTIVE APP . V D V BY DATE R MA"RGEVXY1r "" '" % ^� / irtsRSONAINJURY1/ ADVERTISING $ EACH OCCURRENC $ FIRE DAMAGE (Any me fire) $ ❑FARMER'S PERSONAL LIABILITY WAIVER ��-- MEDICAL ErsX NS (Any one peon) $ AUTOMOBILE LIABILITY: D ANY AUTOBODILY El ALL OWNED AUTOS � _ C Q /1 (J COMBINED SINGLE LIMIT INJURY INJURY (Per Person) 5 0 0 B SCHEDULED AUTOS ABF0989936 02/04/2002 02/04/2003 BODILY INJURY jeer Accident) 500 ® HIRED AUTOS ® NON -OWNED /1UTOS PROPERTY DAMAGEEACH $100 EXCESS LIABILITY: OCCURRENCE AGGREGATE D UMBRELLA FORM !' $ $ OTHER HE --l' '. FARM EMPLOYER'S ❑ LIABILITY ' MEDICAL FARM EMPLOYEESA 10 :•YAi: - :.. $ ach Em ee P �Y I T E. $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: The Certificate Holder is by policy definition a Designated Insured. CANCELLATION: Should any of the above described policies De canceiiea Derore me expirauun uatu u,nrrsvr, ane roaun"a — ... Foy —, `----.,. — mail 10 days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: COUNTY OF MONROE RISK MANAGEMENT 5100 COLLEGE RD KEY WEST FL County Code 50-1 Date Issued _ 02/04/2002 Serviced by PALM BEACH County Farm Bureau PAUL LANCASTER JR, C . . CHFC AUTHORIZED REPRESENTATIVE 33040 93-7-692 (Rev. 5/93) ABF0989936 COMMERCIAL AUTO FFB CA 20 4810 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the BUSINESS AUTO POLICY. With respect to coverage provided by this endorsement, the provisions of the policy apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured provision of the policy. This endorsement does not alter coverage provided in the policy. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 02/04/2002 Named Insured: JOHN F PEART & UNIVERSAL Name of Person(s) or Organization(s): See Declaration Countersigned By: SCHEDULE PAUL LANCASTER JR, CLU,CHFC (Authorized Representative) (If no entry appears above, information required to complete this endorsement will be shown in the Declarations.) Each person or organization indicated above is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II of the policy. FFB CA 20 4810 % CERTIFICATE OF INSURANCE a 3 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES COMPANIES AFFORDING COVERAGES: P.O. BOX 147030 Company Letter A: GAINESVILLE, FLORIDA 32614-7030 Florida Farm Bureau General Ins. Co. Company NAME AND ADDRESS OF INSURED: Letter B: UNIVERSAL BEACH SERVICE CORP Florida Farm Bureau Casualty Ins. Co. AND/OR JOHN F PEART PO BOX 2151 DELRAY BEACH, FL 33447-2151 The policies of insurance listed below have been issued to the insured named above and are in force at this time. 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. CO. LTR TYPE OF INSURANCE I POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/Yt) POLICY EXPIRATION DATE (MM/DD/YY) ALL LI"J ITS !"J THOUSANDS GENERAL LIABILITY: GENERAL AGGREGATE $ 2,000 COMMERCIAL GENERAL X❑ LIABILITY (OCCURRENCE OPERATIONS AGGREGATE $ 2,000 FORM) & ADVINJURYERTISING PERSONAL $ 1 , O O O A OWNER'S & ❑ PROTECTI ECONTRACTOR'S CPP 0 5 0 9 2 9 8 0 7 0 2/ 0 4/ 2 0 01 0 2/ 0 4/ 2 0 0 2 EACH OCCURRENCE $ 1,000 ❑MEPERSONAL LIABILITY FIRE DAMAGE (Any one fire) ......... $ 55 0 — (Any one person) w AUTOMOBILE LIABILITY: COMBINED $ ❑ ANY AUTO SINGLE LIMIT BODILY INJURY (Per $ 500 ElALL OWNED AUTOS Person) B FX SCHEDULED AUTOS ABF 0989936 19 02/04/2001 02/04/2002 BODILY INJURY $ 500 FE HIRED AUTOS �Per Accident Ixl NON -OWNED AUTOS PROPE DAMAGE Is 100 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: SEE FORM CG2010 BY DATE WAIVER NIA YES--- • OR CANCELLATION: Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail 1_ days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: County Code 5 0 - 0 Date Issued 0 8 / 2 7 / 2 0 01 MONROE COUNTY RISK MANAGEMENT Serviced by DELRAY BCH/PALM BCH County Farm Bureau 5100 COLLEGE RD KEY WEST FL 33040-4319 PAUL LANCASTER JR, CLU AUTHORIZED REPRESENTATIVE POLICYNUMBER: CPP 0509298 07 COMMERCIAL GENERAL LIABILITY CG 20 10 10 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: MONROE COUNTY RISK MANAGEMENT (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that in- sured. CG 20 10 10 93 Copyright, Insurance Services Office, Inc., 1992 ❑ CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: UNIVERSAL BEACH SERVICE CORP AND/OR JOHN F PEART PO BOX 2151 DELRAY BEACH, FL 33447-2151 COMPANIES AFFORDING COVERAGES: Company Letter A: Florida Farm Bureau General Ins. Co. Company Letter B: Florida Farm Bureau Casualty Ins. Co. The licies of insurance listed below have been issued to the insured named above and are in force at this time. Notwithstanding any requirement, term or con ition 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. CO. I M/POLICY EFFECTIVE I POLICY EXPIRATION I ALL LIMITS IN THOUSANDS LTR TYPE OF INSURANCE POLICY NUMBER DATE (MDDNY) DATE (MM/DDNY) 2.00 X❑ COMMERCIAL GENERAL LIABILITY (OCCURRENCE PRODUCTS -COMPLETED OPERATIONS AGGREGATE 2, FORM) PERSONAL & ADVERTISING INJURY $ 1 A ❑PRO ECTVEONTRACTOR'S CPP 0509298 08 02/04/2002 02/04/2003 EACH U N $ ,$ l� FIRE DAMAGE(Any one fire) FARMER'S PERSONAL ❑ LIABILITY KAMIrIal YPPM_ F A. ❑ ANY AUTO ❑ ALL OWNED AUTOS B X❑ SCHEDULED AUTOS X❑ HIRED AUTOS X❑ NON -OWNED AUTOS EXCESS LIABILITY: (Any one I COMBINED SINGLE LIMIT Is BODILY INJURY (Per $ 500 Person) BODILY ABF 0989936 20 02/04/2002 02/04/2003 INJURY(Per $ 500 Accident) PROPERTY $ 100 DAMAGE DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES: SEE FORM CG 2010 BY Uv DATE } r ' WAIVER N/A —,41—YES OCCURRENCE C CANCELLATION: 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 below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: MONROE COUNTY RISK MANAGEMENT 5100 COLLEGE RD KEY WEST, FL 33040-4319 County Code 5 0 - 0 Date Issued 12 / 0 4 / 2 0 01 Serviced by DELRAY BCH/ PALM BCH County Farm Bureau PAUL LANCASTER TR , CLU, CHFC AUTHORIZED REPRESENTATIVE 4 POLICY NUMBER:CPP 0509298 08 COMMERCIAL GENERAL LIABILITY CG20101093 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: MONROE CObTNTY RISK MANAGEMENT (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that in- sured. CG 20 10 10 93 Copyright, Insurance Services Office, Inc., 1992 CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: UNIVERSAL BEACH SERVICE CORP AND/OR JOHN F PEART PO BOX 2151 DELRAY BEACH, FL 33447-2151 COMPANIES AFFORDING COVERAGES: Company Letter A: Florida Farm Bureau General Ins. Co. Company Letter B: Florida Farm Bureau Casualty Ins. Co. I necles or Insurance IIStea Delow nave Deen Issued to the insured named above and are in force at this time. Notwithstanding any requirement, term or con itionIlof 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. CO. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS A GENERAL LIABILITY: GENERAL [XI$ LIABILITY AL (IOCCURR NCE FORM) ❑PROTECTIVE OWNER'S & CONTRACTOR'S CPP 0509298 09 02/04/2003 02/04/20041 GENERAL AGGREGATE 2,000 PRODUCTS7ffDIXTETED O ERATIONS AGGREGATE $ 2,000 N INJURY ADVERTISING $ 1, 0 0 0 EAOHu $ 1,000 ❑FARMER'S PERSONAL LIABILITY FIRE DAMAGE(Any one fire) $ 5 0 AUTOMOBILE IA TY: (Any one person) 4' -. ❑ ANY AUTO COMBINED SINGLE LIMIT $ ❑ ALL OWNED AUTOS BODILYINJURY (Per $ 500 Person) a SCHEDULED AUTOS B ABF 0989936 20 02/04/2003 02/04/2004 BODILY INJURY(Per $ 500 X❑ HIRED AUTOS , Accident) X❑ NON -OWNED AUTOS AP Ro �j ' Y rp M // - N C ME PERT $ 0 EXCESS LIABILITY: G EACH ❑ UMBRELLA FORM DATE " OCCURRENCE OTHER THAN UMBRELLA ❑ WAIVER NiA ' _ ;" $ FORM _ — EMPLOYERS LIABILITY: FARM EMPL r i 'Z OYER'S S LIABILITY TY V >: E ach Occurrence) FARM EMPLOYEE'S CAL � i �/% .............. _.. _ _ .,,,,,.,... $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: SEE FORM CG 2010 ^AAI/�CI I ATI^Kl. [Y-_.- Employee) i - -- —, Q aw o VGJl11VOU pvlluld, ua carlceieu oerore the expiration date tnereot, the issuing company will endeavor to mail 10 days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. County Code 5 0- 0 Date Issued 12 / 0 4/ 2 0 0 2 Serviced by DP.T IR AY H / PAT IM BC14 County Farm Bureau PA T L THAN ASTER JT , AUTHORIZED REPRESENTATIVE CG W6 0 93-7-692 (Rev. 5/93) POLICY NUMBER:CPP 0509298 09 COMMERCIAL GENERAL LIABILITY CG20101093 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: MONROE COUNTY RI SK MANAGEMENT (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that in- sured. CG 2010 10 93 Copyright, Insurance Services Office, Inc., 1992 0 CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES COMPANIES AFFORDING COVERAGES: Company P.O. BOX 147030 Letter A: GAINESVILLE, FLORIDA 32614-7030 Florida Farm Bureau General Ins. Co. Company NAME AND ADDRESS OF INSURED: Letter B: Florida Farm Bureau Casualty Ins. Co. UNIVERSAL BEACH SERVICE CORP AND/OR JOHN F PEART BOX 2151 �PO DELRAY BEACH, FL 33447-2151 The policies of insurance listed below have been issued to the insured named above and are in force at this time. Notwithstanding any requirement, term or certificate may be issued or may pertain, the insurance afforded by the policies of any xclusions and described nyis subject toralolthe the terms, Conto ditions of such CO. POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS LTn TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) N LIABILITY: NE AGGREGATE $$@ 2,000 `p 2 X❑ COMMERCIAL GENERAL LIABILITY (OCCURRENCE OPERATIONS AGGREGATE ,000 N V N INJURY $ 1,000 FORM) A ❑PROTECTIVEONTRACTOR's CPP 0509298 09 02/04/2003 02/04/2004 A " $ 1,000 - FIRE A y one tire) $ so FARMER'S PERSONAL LIABILITY MEDICALSE $ 5 (Any one person) AUTOMOBILE AB I C BINED $ GLE LIMIT ❑ ANY AUTO M -t `� ►VeG\ BODILY $ ❑ ALL OWNED AUTOS -:� 's^'�"' , ��� INJURY (Per Person) G APPR® ❑ SCHEDULED AUTOS v`. � BODILY INJURY (Per $ B l Accident) ❑ HIRED AUTOS / PROPERTY $ .::..........::::. ❑ NON -OWNED AUTOS \NPNelp, l DAMAGE EXCESS LIABILITY: Y EACH OCCURRENCE A RM LLA FORM UMBRELLA V - THAN UMBRELLA ❑OTHER FORM ITY: EMPLOYERS LIABILITY: (EachOccurrence) curve nce FARM LOlE R'S LIABILITY FARM EMPLOYEE'S MEDICAL e e (Each Employee) A. DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES: SEE FORM CG 2010 & CG 2012 CANCELLATION: Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to failure to such notice shall impose no obligation or liability of any kind mail 10 days written notice to the below named certificate holder, but mail upon the company. 2/04/2002 NAME AND ADDRESS OF CERTIFICATE HOLDER: ATTN: RISK MANAGEMENT SECTION MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 5100 COLLEGE RD KEY WEST, FL 33040-4319 County Code 5 0 - 0 Date Issued 1 Serviced by PALM BRA H County Farm Bureau PAUL TAN( -ASTER TR_ AUTHORIZED REPRESENTATIVE W 6 0 93-7-692 (Rev. 5/93) e t_ POLICY NUMBER:CPP 0509298 09 COMMERCIAL GENERAL L LIAB0ITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM 6) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: MONROE COUNTY RISK MANAGEMENT MONROE COUNTY BOCC AND TDC (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that in- sured. CG 20 10 10 93 Copyright, Insurance Services Office, Inc., 1992 ❑ POLICY NUMBER: CPP 0509298 09 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE State or Political SubdivisionATTN: RISK MANAGEMENT SECTION MONROE COUNTY BRD COUNTY COMMISSIONERS (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED(Section II) is amended to include as an insured any state or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. 2. This insurance does not apply to: a. "Bodily in1'ury," "property damage," "personal injury" or "advertising injury" arising out of operations performed for the state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard." CG 20 12 11 85 Copyright, Insurance Services Office, Inc., 1984 ACORQCERTIFICATE OF LIABILITY INSURANCE i2i0/2 03 PRODUCER (561) 737-6464 FAX (561) 737-7355 Causeway Insurance, Inc. PO Box 243629 Boynton Beach, FL 33424-3629 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 Universal Beach Service Corp P.O. BOX 2151 Delray Beach, FL 33444-2151 INSURER A: AmComp Preferred Ins. Co. 10346 INSURER B: 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. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (En amurence) $ CLAIMS MADE ❑ OCCUR MED EXP (Any one person) $ PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PROECT LOC J AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS AP i? Y By.,, _. K MA GEM Nl BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY 1,('if I„'-: f !»- }.-:'. 5.' j,/» .,. y M AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ � AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE ' AGGREGATE $ $ lfi $ DEDUCTIBLE $ RETENTION $ :YORKERS COMPENSATION ANC �( WC STATU- OTH- IMITS ER A EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 OFFICER/MEMBER EXCLUDED? WCV7018919 12/01 /2003 12/01 /2004 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Beach Cleaning Florida employees only Monroe County Risk Management Department 5100 College Road Key West, FL 33040 ACORD 25 (2001108) G C SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER 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 INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIV Warren Mack G w "<7 Iv-,f" ©ACORD CORPORATION 1981 0 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 (2001/08) CERTIFICATE OF INSURANCE UPON THE CERTIFICATE THISTSSUED IS CERTIF C TIRIGHTSAS A MATTER OF INFORMATION ONLY AND CONFERS NO E DOES NOT MEND, EXTEND OR A TER THE COVERAGE AFFORDED BYTHE POLICI S LISTED BELOW. ER FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. BOX 147030 GAINESVILLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: JOHN F PEART & UNIVERSAL BEACH SERVICES CORP PO BOX 2151 DELRAY BEACH FL 33447-2151 COMPANIES AFFORDING COVERAGES: Company Letter A: Florida Farm Bureau General Ins. Co. Company Letter B: Florida Farm Bureau Casualty Ins. Co. listed below have been issued to the insured named above and are in force at this time. Notwithstanding an requirement, term or The policies of insurance condition of any contract 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. POLICY EFFECTIVE I POLICY EXPIRATION CO. POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DDI" LTR TYPE OF INSURANCE ❑COMMERCIAL GENERAL LIABILITY (OCCURRENCE FORM) OWNER'S & CONTRACTOR'S ❑ PROTECTIVE ❑FARMER'S PERSONAL UABIUTY ALL LIMITS IN THOUSANDS GENERAL AGGREGATE $ P UCTs-COMP $ OPERATIONS AGGREGATE PERSONAL & ADVERTISING $ INJURY EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MEDICAL EX NSE $ (Any one person) COMBINED $ SINGLE LIMIT U ANY AUTO BODILY $ 500 - - ❑ ALL OWNED AUTOS INJURY (Per Person) $ ABF0989936 02/04/2004 02/04/2005 BODILY $500 ® SCHEDULED AUTOS INJURY (Per Acciden5) X❑ HIRED AUTOS PROPERTY $ 1 OO DAMAGE ® NON -OWNED AUTOS EACH AGGREGATE EXCESS LIABILITY: APPIR K MA OCCURRENCE MEN ❑UMBRELLA FORM BY -.� $ $ OTHER THAN UMBRELLA ❑ DATE E FORM $ EMPLOYERS LIABILITY: �1l,411/ER N/A (Each Occurrence) —YES— EMPLOYER'S ❑FARM LIABILITY - $ (Each Emplo yee) FARM EMPLOYEE'S MEDICAL DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: U" fV The Certificate Holder is by policy definition a Designated Insured. CANCELLATION: 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 below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. / 4 I A NAME AND ADDRESS OF CERTIFICATE HOLDER: COUNTY OF MONROE RISK MANAGEMENT SECTION ATTN: MARIA DEL RIO 5100 COLLEGE RD KEY WEST EL 33040 t- C County Code 50-0 Date issued 02 0 Serviced by PALM BEACH County Farm Bureau PAUL LANCASTER JR. CLU-CHEf— AUTHORIZED REPRESENTATIVE 93-7-692 (Rev. 5/93) ABF0989936 COMMERCIAL AUTO FFB CA 20 4810 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the BUSINESS AUTO POLICY. With respect to coverage provided by this endorsement, the provisions of the policy apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured provision of the policy. This endorsement does not alter coverage provided in the policy. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 02/04/2004 Named Insured: JOHN F PEART & UNIVERSAL Name of Person(s) or Organization(s): See Declaration Countersigned By: SCHEDULE PAUL LANCASTER JR, CLU,CHFC (Authorized Representative) (If no entry appears above, information required to complete this endorsement will be shown in the Declarations.) Each person or organization indicated above is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II of the policy. FFB CA 20 4810 96 ACORP. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 12/02/2003 PRODUCER (561) 737-6464 FAX (561) 737-7355 Causeway Insurance, Inc. PO Box 243629 Boynton Beach, FL 33424-3629 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 Universal Beach Service Corp P.O. Box 2151 Delray Beach, FL 33444-2151 INSURER A: AmComp Preferred Ins. Co. 10346 INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED 4THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT I CT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SW TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR 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 LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS i(Per BODILY INJURY person) $ BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS APf i'3 I:, V A( f_ �'M E N �', By_ + PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ ANY AUTO /C -N / WAIVER __,.._. _._... `• �.:.:;� OTHER THAN _ EA ACC $ $ I AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ /� 1. $ $ DEDUCTIBLE RETENTION $ 1 f $ WORKERS COMPENSATION AND X O Y I IMIT O T. ER A EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below WCV7018919 12/01 /2003 12/01 /2004 E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Beach Cleaning Florida employees only SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Monroe County Board of County Commissioners - Attn : Monroe County Risk Management BUT FAILURE TO MAIL SUCH NOTICE $HALL IMPOSE NO OBLIGATION OR LIABILITY 1100 Simonton St. OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Key West, FL 33040 AUTHORIZEDREPRESENTAT�IV Warren Mack . ACORD 25 (2001/08) 1-Ax: (JUb)ZUZ-4bb4 ©ACORD CORPORATION 1988 cc / P, CERTIFICATE OF INSURANCE 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 LISTED BELOW. FLORIDA FARM BUREAU INSURANCE COMPANIES P.O. Box 147030 GAI N ESVI LLE, FLORIDA 32614-7030 NAME AND ADDRESS OF INSURED: UNIVERSAL BEACH SERVICE CORP &/OR JOHN F PEART 107 NW 9TH ST DELRAY BEACH FL 33444-3927 COMPANIES AFFORDING COVERAGES: Company Letter A: Florida Farm Bureau General Ins. Co. Company Letter B: Florida Farm Bureau Casualty Ins. Co. I he goiicies of . insurance listed below have been issued to the insured named above and are in force at this time. Notwithstanding an requirement term or condition of any is or other document .with respect to which this certificate may be issued or may pertain, the insurance of orded b the policies described herein Is subject to all the terms, exclusions and conditions of such policies. y Co. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY: GENERAL AGGREGATE ❑COMMERCIAL GENERAL LIABILITY (OCCURRENCE PRODUCTS -COMP D OPERATIONS AGGREGATE FORM) PERSONAL & ADVERTISING OWNER'S &CONTRACTOR'S ❑ PROTECTIVE INJURY EACH OCCURRENCE EFARMER'S PERSONAL ]LIABILITY FIRE DAMAGE (Any one fire) MEDICAL EXPENSE (Any one Person) AUTOMOBILE LIABILITY: ANY AUTO COMBINED SINGLE LIMIT ❑ ALL OWNED AUTOS "''•' :;:::` =: ='=':::: BODILY INJURY (Per ,rj Q B SCHEDULED AUTOS ® ABF0989936 02/04/2010 02/04/2011 Person) BODILY INJURY (Per $ 500 HIRED AUTOS Accident) ® NON -OWNED AUTOS PROPERTY DAMAGE $ 10 0 EXCESS LIABILITY: EACH AGGREGATE OCCURRENCE ❑ UMBRELLA FORM OTHER THAN UMBRELLA -- ❑FORM _ EMPLOYERS LIABILITY: FARM EMPLOYER'S TY LIABILITY U (Each Occurrence) FARM EMPLOYEE'S P OY 'S L MEDICAL AL '1 (Each Employee) OTHER: do DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: �C/ The Certificate Holder is by policy definition a Designated Insured. I +Uiv: onoula any oT ine above aescrloea policies be cancelled betore the expiration date thereof, the issuing company will endeavor to mail 10 days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: COUNTY OF MONROE RISK MANAGEMENT 1100 SIMONTON ST RM 268 KEY WEST FL / w 33040 County Code 5 0- 0 Date Issued 0 2/ 0 4/ 2 010 Serviced by PALM BEACH PAUL R CONSTANT AUTHORIZED REPRESENTATIVE County Farm Bureau 00242 93-7-692 (Rev. 5/93) COMMERCIAL AUTO FFB CA 20 4810 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the BUSINESS AUTO POLICY. With respect to coverage provided by this endorsement, the provisions of the policy apply unless p Y PP Y modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured provision of the policy. This endorsement does not alter coverage provided in the policy. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 02/04/2010 Named Insured: UNIVERSAL BEACH SERVICE CORP Name of Person(s) or Organizxtion(s): See Declaration Countersigned By: SCHEDULE PAUL R CONSTANT (Authorized Representative) Of no entry appears above, information required to complete this endorsement will be shown in the Declarations.) Each person or organization indicated above is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II of the policy. FFB CA 20 4810 % 00240 ABF0989936