Certificates of Insurance
DU ER
Aon Risk Services, Inc of Florida
1001 Brickell Bay Drive
Suite 1100
Miami FL 33131
DATE(MMlDDIYY)
02/26/02
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
PHONE .(305) 372-9950
FAX - (305) 372-1455
COMPANY
A
St Paul Fire & Marine Insurance Co.
Toppino's Inc
P. O. Box 787
Key West FL 33041 0000 USA
COMPANY
B
Royal Surplus Lines Insurance Company
COMPANY
C
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PU.lCY 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 SHO'M'J MAY HAVE BEEN REDUCED BY PAID CLAIMS,
co POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR TYPE OF INSURANCE POLICYNUMBER DATE (MMlDDIYY) DATE (MMlDDIYY)
A GENERAL LIABILITY KK05800163 02/02/02 02/02/03 GENERAL AGGREGATE
COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE D OCCUR PERSONAL & ADV INJURY
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE
FIRE DAMAGE(Any one fire)
-. MED EXP (Anyone person)
KK05800 ~2/02/02 02/02/03 COMBINED SINGLE LIMIT
BUS SS AUTO COV~~ ,
~ :,) BODILY INJURY
~~~~ ( Per person)
BODILY INJURY
,Ji- \ ~ (Per accident)
NON-OWNED AUTOS ~~~ ~
PROPERTY DAMAGE
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
KHN171198 02/02/02 02/02/03 EACH OCCURRENCE
X COMMERCIAL UMBRELLA COVERAGE AGGREGATE
OTHER THAN UMBRELLA FORM Retained Limit Amoun
WORKER'S COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR/ INCL
PARTNERS/EXEC UTIVE
OFFICERS ARE: EXCL
EL DISEASE-EA EMPLOYE
$2,000,000
$2,000,000
$1,000,000
$1,000,000
$100,000
$5,000
$1,000,000
3,000,000
$3,000,000
$10,000
DESCRIPTION OF OPERA TlONSlLOCA TlONSlVEHICLESlSPECIAL ITEMS
Re: Palm Avenue Roadway Improvement Project, Key West, Monroe County, Fl.
Certificate Holder is named as Additional Insured
Monroe County Board
of Commissioners
1100 Simonton St.
Attn: Judy Lane
Key West FL 33040 USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
60 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE
ACORo'M CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYY)
2/26/2002
P~TImTANA & ASSOC INC 305-294-6261 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1704 N ROOSEVEL T BLVD HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
KEY WEST FL 33040
, INSURERS AFFORDING COVERAGE
INSURED INSURER A: FCCI MUTUAL INSURANCE COMPAN
TOPPINO'S INC. ~.
INSURER B'
PO BOX 787 INSURER c:
KEY WEST, FL 33040 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 IM-iICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~f: TYPE OF INSURANCE POLICY NUMBER PJl}+~~~~tg,R,~ Pg~lfl(~~~t;AAN
~G~NERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
=D CLAIMS MADE D OCCUR
LIMITS
EACH OCCURRENCE
$
FIRE DAMAGE (Anyone fire)
$
$
$
$
ANY AUTO
...-
ALL OWNED AUTOS
.-
SCHEDULED AUTOS
)
//
I
MED EXP (Anyone person)
-
PERSONAL & ADV INJURY
GENERAL AGGREGATE
-
GEN'L AGGREGATE LIMIT APPLIES PER
I POLICY n j:g: n LaC
PRODUCTS. COMP/OP AGG $
..-....-
AUTOMOBILE LIABILITY
-
COMBINED SINGLE LIMIT
(Ea accident)
,$
BODILY INJURY
(Per person)
-
-
-
-
HIRED AUTOS
NON-OWNED AUTOS
BODILY INJURY
(Per accident)
1$
-....
PROPERTY DAMAGE
(Per accident)
.......
AUTO ONLY. EA ACCIDENT $
GARAGE LIABILITY
I~ ANY AUTO
EXCESS LIABILITY
~ OCCUR D CLAIMS MADE
OTHER THAN
AUTO ONLY
EA ACC $
AGG $
EACH OCCURRENCE
AGGREGATE
$
$
$
$
$
I DEDUCTIBLE
I RETENTiON $
A WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
45287
3/01/2002
3/01/2003
IT~sl IO~~'
E.L. EACH ACCIDENT $
EL DISEASE. EA EMPLOYE $
EL DISEASE - POLICY LIMIT $
1,000,000
1,000,000
1,000,000
I OTHER
I
i
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
)ALM AVE, ROADWAY IMPROVEMENTS, KEY WEST, MONROE CO. FL
CERTIFICATE HOLDER 1 I ADDITIONAL INSURED; INSURER LETTER:
CANCELLATION
MONROE COUNTY BOARO OF COUNTY COMM,
GATO BUILDING, 1100 SIMONTON ST
KEY WEST, FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BEl CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAlVOR TO MAIL~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS O~
REPRESENTATIVES. ~
Ai!7)I{ozrLM~t^-- CY~1 ~
@ ACORD CORPORATION 1988
I
ACORD 25-S (7197)
Attachment to ACORD Certificate for Toppino's Inc
The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the
coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the
policy.
COMPANY
INSURED
Toppino's Inc
P. O. Box 787
Key West FL 330410000 USA
COMPANY
COMPANY
COMPANY
COMPANY
ADDITIONAL POLICIES
Ifa policy below does not include limit information, refer to the corresponding policy on the ACORD
certificate form for policy limits.
POLICY POLICY
CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION UMITS
L11I. POLlCYDESCRlmON DATE DATE
AUTOMOBILE LIABILITY
A KK05800163 02102/02 02/02103 Comprehensive $1,000
BUSINESS AUTO COVERAGE Deduct
Collision $1,000
Deductible
DESCRIPTION OF OPERATlONSlLOCATlONSNEHICLESlSPECIAL ITEMS
Certificate No:
570001980850