Certificates of Insurance
..
. QI.ertificaf.e of ~n5uranr.e
TO: Certificate Holder
MONROE COUNTY BOARD OF COUNTY
COMMISSIONS
5100 COLLEGE ROAD, STOCK ISLAND
KEY WEST, FL 33040
Insured:
SYNAGRO TECHNOLOGIES, INC., INCLUDING
ANY & ALL SUBSIDIARIES
1800 BERING DRNE, SUITE 1000
HOUSTON, TX 77057
Aon Risk Services
RE:
STORM SEWER CLEANING II KEY WEST TO KEY
LARGO APPROV~D BY RISK MANAGE~~~ ,
BYU .l~'a.:r ~~~~~""
DATE 2(.~/ c~ ( ..
(
WANER: N/_ V YES
This is to certify that the policies of insurance listed below have been effected for the Insured named
above for the policy period indicated, notwithstanding any requirement. term. or condition of any
contract or oiher 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
Policy Number
Co Type of Insurance
Policy
A General Liability
[gICommercial General Liability
DClaims Made [gIOccurrence
D
D
General Agg. Limit Applies Per:
DPolicy [gIProject DLocation
A Automobile Liability
[gIAny Auto
DAll Owned Autos
DScheduled Autos
[gIHired Autos
[gINon-Owned Autos
B Excess Liability
[gIOccurrence DClaims-Made
GEC000522501
AEC00052260 I OIS
AEC000522701 TX
BE7393230
Policy
Effective
Policy
Expiration
Policy LimitsNalues
11/01100
Each Occurrence
Fire Damage-Anyone Fire
Med. Exp.-Any one Person
Personal & Adv. Injury
General Aggregate
Products-Comp/Op Agg.
$1,000,000
$ 100,000
$ 5,000
$1,000,000
$2,000,000
$2,000,000
$1,000,000
$
$
$
$ 1,000
1,000
$5,000,000
$5,000,000
$
DDeductible $
[gIRetention $ 10,000
C Workers Compensation and WEC0007227 OIS 11101/00 11101101 [gIwc Statutory Limits DOther
A Employers Liability WEC0007234 NH E.L. Each Accident $1,000,000
E.L. Disease-Ea Employee $1,000,000
E.L. Disease-Policy Limit $1,000,000
o Pollution & Remediation Legal PEC000565201 11101100 11/01/01 Each Loss $1,000,000
Total All Losses $1,000,000
Retention - each loss $ 50,000
A Professional & Pollution Legal PEC000565101 11/01100 11/01101 Each Claim $5,000,000
General Contractor's Form Aggregate $5,000,000
Retention $ 50,000
E Commercial Property including MXI97800296 11/01100 11/01101 All Risk Building & Contents $10,000,000
Contractors Equipment And Contractors Equipment Loss Limit
including Rented & Leased
Insurance Company(ies): A) Greenwich Insurance Company B) National Union Fire Insurance Co. ofPA C) X.L. Specialty Insurance Co.
D) Indian Harbor Insurance Company E) Fireman's Fund Insurance Company
The subscribing insurers' Obligations under contracts of insurance to which they subscribe are several and not joint and are limited solely to the extent of their individual subscriptions, The
subscribing insurers are not responsible for the subscription of any co-subscribing insurer who for any reason does not satisfy all or part of its obligations.
Description of Operations: Certificate Holder is listed as Additional Insured where required by written contract under GUAUUMB/POLL. The insurance afforded to
the Additional Insured as described in this Certificate of Insurance for work performed by the Named Insured, is primary and non-contributory to any similar coverage
maintained by the Additional Insured. A Waiver of Subrogation is issued in favor of Certificate Holder where required by written contract under the GU AUUMB/WC.
Certificate Holder is included as a Loss Payee as their interest may appear for Property and Auto Physical Damage coverage.
Cancellation: 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 policy(ies) shown hereon. Should any of the above described policies be canceled before the expiration date thereof, this agency, on behalf of
the issuing company(ies), will endeavor to mail 30* days written notice to the above named certificate holder, but failure to mail such notice shall impose no obligation or
liability of any kind upon the company(ies) or this agency.
*except 10 days notice for non-payment of premium
Date:
February 1. 2001
By:
] 1101101
11101/00
11101/01
Combined Single Limit
Bodily Injury-per person
Bodily Injury-per accident
Property Damage-per acc.
Deductible: Collision &
Other than Collision
Each Occurrence
Aggregate
Prod/Comp Ops Agg.
1110]/00
11101101
Aon Risk Services of Texas, Inc.
~J_ t?z-'
Authorized Representative
AOIl Risk Services, of Texas, Inc.
2000 Bering Drive, Suite 900 Houston, Texas 77057-3790 tel (713)430-6000 fax:(713)430-6570
CERT'~ICATE OF INSURANCE Date: (MMIDDIYY)
10/31/2002
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Insurance Agency of Houston, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5847 San Felipe, Suite 320 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Houston, Texas 77057 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED: Insurer A: American International Specialty Lines
Synagro of Florida - Anti - Pollution, Inc. Insurer B: Zurich American Insurance
89111 Overseas Hwy. Insurer C:
Tavernier, FL 33070
Insurer D:
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 BE EXHAUSTED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POliCY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
X OCCURRENCE EG3779024 11/1/2002 02/01/2004 MED EXP (PER PERSON) $ 5,000
X XCU INCLUDED PERSONAL & ADV INJURY $ 1,000,000
X ISO FORM CG 00 01 1093 GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS/COMPo OP. AGG $ 2,000,000
X PROJECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B X ANY AUTO SAP 2347047-01 (O/S) (EACH ACCIDENT)
B ALL OWNED AUTOS TAP 2347048-01 (TX) 11/1/2002 02/01/2003
B SCHEDULED AUTOS MA 2347049-01 (MA)
B X HIRED AUTOS BAP 2347050-01 (VA) DEDUCTIBLE: COLLISION & $ 1,000
X NON-OWNED AUTOS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
LEGAL
A EG3779024 11/1/2002 02/01/2004 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE7410130 11/1/2002 02/01/2004 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
B and EMPLOYERS LIABILITY we 2347044-01 (O/S) 11/1/2002 02/01/2003 EL EACH ACCIDENT $ 1,000,000
B we 2347046-01 (MA, WI) EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLICY LIMIT $ 1,000,000
A PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
LEGAL. GENERAL eOPS6192166 11/1/2002 02/01/2004 AGGREGATE $ 1,000,000
CONTRACTOR'S FORM RETENTION $ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
CHECK ~ BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRmEN CONTRACT.
BOX
~ CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
Re: Project Description: Sealed Bid for Operation/Maintenance of Old Mariners Hospital Wastewater Treatment Plant; BID #120-24S-o-2002/LC; Project Location:
Key West, FL
Additional Insured in favor of The Monroe County Commissioners BOCC. Its Employees and Officials (on all policies except Workers' Compensation/ELl where
and to the extent reauired ~ n., , ..." ,,1'" ~ I'
CERTIFICATE HOLDER:.....r \'-"'\0r"i ,';.' }:;: CANCELLATION:
C o~.Y: ;::'""a.-rJ c.<..-.. tH ....... h n?p HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
'\ DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS WRITTEN NOTICE
:;:;..; THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE
It 1&>/0 a., DATE Nt A ..."..... YES --.,' SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS
OR REPRESENTATIVES. 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
WAIVER AU' IIATIVI:::
Monroe County ,\~
Purchasing Office ~--=r~
1100 Simonton Street, Room 2-213
Key West, FL 33040 U
i I
alYVn n7 ~ 'I t
F
CER1._ ICATE OF INSURANCE Date: (MMIDDIYY
10/31/2002
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Insurance Agency of Houston, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5847 San Felipe, Suite 320 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Houston, Texas 77057 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED: I nsurer A: American International Specialty Lines
Synagro Southwest, Inc. Insurer B: Zurich American Insurance
4512 Srittmoore
Houston, TX 77041 Insurer C:
Insurer 0:
COVERAGES
I;HE 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
ICERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS
,EXCLUS!ONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY BE EXHAUSTED BY PAID CLAIMS,
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
--
X OCCURRENCE EG3779024 11/1/2002 02/01/2004 MED EXP (PER PERSON) $ 5,000
X XCUINCLUDED PERSONAL & ADV INJURY $ 1,000,000
X ISO FORM CG 00 01 10 93 GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS/COMP, OP, AGG $ 2,000,000
X PROJECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B X ANY AUTO SAP 2347047-01 (O/S) (EACH ACCIDENT)
B ALL OWNED AUTOS TAP 2347048-01 (TX) 11/1/2002 02/01/2003
B SCHEDULED AUTOS MA 2347049-01 (MA)
---
B X HIRED AUTOS SAP 2347050-01 (VA) DEDUCTIBLE: COLLISION & $ 1,000
._-,--~
X NON.OWNED AUTOS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
LEGAL
A EG3779024 11/1/2002 02/01/2004 TOTAL ALL LOSSES $ 1,000,000
.~
RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE SE7410130 11/1/2002 02/01/2004 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
B and EMPLOYERS LIABILITY WC 2347044-01 (O/S) 11/1/2002 02/01/2003 EL EACH ACCIDENT $ 1,000,000
B WC 2347046-01 (MA, WI) EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLICY LIMIT $ 1,000,000
A PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
LEGAL. GENERAL COPS6192166 11/1/2002 02/01/2004 AGGREGATE $ 1,000,000
CONTRACTOR'S FORM RETENTION
$ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
CHECK [gJ
BOX BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT,
[gJ CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSUREO (EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
Re;...AKH Contract
Co<=. :~ - ^
CERTIFICATE HOLDEBPfV'l\~H~ \< MA, "-';"-J CANCELLATION:
'J3L~~"'" nUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
BY -..... ---1\ ,;.., DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS WRITTEN NOTICE
. O_.~_ TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE
DATi;; ... .. \ CQ \......... . SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS
OR REPRESENTATIVES, 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
County of Monroe WAlVER Y .."--erA .r AUTHORIZED REPRESENTATIVE:
. .-- .----,~..~"
Attn: Bevette Moore ~-~~
Airports Business Administration ~. ~
3491 S. Roosevelt Blvd. I. (
Key West, FL 33040 r r:", 1J v..o
'-"' f. JvJIl;t1 eA1k.
QUNr1 m~
CER" ~ ..=ICA TE OF INSURANCE Date: (MM/DDIYY)
11/1/2001
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Insurance Agency of Houston, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5847 San Felipe, Suite 320 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Houston, Texas 77057 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED: Insurer A: American International Specialty Lines
Synagro Southwest, Inc. Insurer B: Zurich American Insurance
4512 Brittmoore Insurer C: American Guarantee & Liability Insurance
Houston, TX 77041
Insurer 0:
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 BE EXHAUSTED BY PAID CLAIMS,
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANYONE FIRE) $ 1,000,000
X OCCURRENCE EA6192165 11/1/2001 11/1/2002 MED EXP (PER PERSON) $ 5,000
...... ~ MANAGEN ENT $
x XCU INCLUDED APPRrnD~ PERSONAL & ADV INJURY 1,000,000
X ISO FORM CG 00 0110 93 C'0 - GENERAL AGGREGATE $ 2,000,000
BY -df> 0 ~ $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS/COMP, OP. AGG
X PROJECT DATE
~ .-..
AUTOMOBILE LIABILITY WAIVER .,. -" COMBINED SINGLE liMIT $ 2,000,000
B X ANY AUTO BAP 2347047-00 (O/S) (EACH ACCIDENT)
C ALL OWNED AUTOS TAP 2347048-00 (TX) 11/1/2001 11/1/2002
B SCHEDULED AUTOS MA 2347049-00 (MA)
B x HIRED AUTOS BAP 2347050-00 (yA) DEDUCTIBLE: COLliSION & $ 5,000
X NON.OWNED AUTOS OTHER THAN COLLISION $ 5,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
LEGAL
A EA6192165 11/1/2001 11/1/2002 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE7413625 11/1/2001 11/1/2002 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
B and EMPLOYERS LIABILITY WC 2347044-00 (O/S) 11/1/2001 '1'1/1/2002 EL EACH ACCIDENT $ 1,000,000
B WC 2347046-00 (MA,WI) EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POliCY liMIT $ 1,000,000
A PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
LEGAL. GENERAL COPS6192166 11/1/2001 11/1/2002 AGGREGATE $ 1,000,000
CONTRACTOR'S FORM RETENTION $ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
CHECK [8J
BOX BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POUCIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
[8J CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
Additional insured In favor of certificate holder (on all policies except workers compensation) where and to the extent as required by written contract.
CERTIFICATE HOLDER: CANCELLATION:
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
irrr IO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE
i;" ""'i;T l'-' r ~t~L IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS
, 0, REPRESENTATIVES, "EXCEPT 10 DAYS NOTICE FOR NON.PAYMENT.
Monroe County B.O.C.C. NOV o 6 2001 PlUI ~~~ ,,~, TATIVE:
3583 S. Roosevelt Blvd. ! ~-~~
By:/lJ/I/!~,= I
Key West, FL 33040 ,
:J
I
CER. .FICA TE OF INSURANCE Date: (MM/DDIYY)
11/1/2001
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Insurance Agency of Houston, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5847 San Felipe, Suite 320 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Houston, Texas 77057 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
.- .- INSURERS AFFORDING COVERAGE
INSURED: APpmer 7U-;;)' nsurer A: American International Specialty Lines
Synagro Southwest, Inc. ~Y , . \' \\.1. /,)L Insurer B: Zurich American Insurance
4512 Srittmoore Insurer C: American ~uar~ntee & Liability Insurance
Houston, TX 77041 DATE ~Z'
WAIVER N/A YES Insurer 0: QL0\. lk ,. .:;;, ^ft
0:;;- ,." "^'" -
COVERAGES ("1<" ': ~1 //J IA.o '" Y If n ,I I l,CiYJl
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 BE EXHAUSTED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY FI RE DAMAGE (ANY ONE FIRE) $ 1,000,000
X OCCURRENCE EA6192165 11/1/2001 11/1/2002 MED EXP (PER PERSON) $ 5,000
X XCU INCLUDED PERSONAL & ADV INJURY $ 1,000,000
X ISO FORM CG 00 01 10 93 GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS/COMPo op, AGG $ 2,000,000
X PROJECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B X ANY AUTO SAP 2347047-00 (O/S) (EACH ACCIDENT)
C ALL OWNED AUTOS TAP 2347048-00 (TX) 11/1/2001 11/1/2002
B SCHEDULED AUTOS MA 2347049-00 (MA)
B X HIRED AUTOS SAP 2347050-00 (VA) DEDUCTIBLE: COLLISION & $ 5,000
X NON-OWNED AUTOS OTHER THAN COLLISION $ 5,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
LEGAL
A EA6192165 11/1/2001 11/1/2002 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE SE7413625 11/1/2001 11/1/2002 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
and EMPLOYERS LIABILITY we 2347044-00 (O/S) 11/1/2001 11/1/2002 ------
B EL EACH ACCIDENT $ 1,000,000
B we 2347046-00 (MA,WI) EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLICY LIMIT $ 1,000,000
A PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
LEGAL - GENERAL eOPS6192166 11/1/2001 11/1/2002 AGGREGATE $ 1,000,000
CONTRACTOR'S FORM RETENTION $ 100,000
REMARKS: DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
C~~~K ~ BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
~ CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
Re: AKH Contract
CERTIFICATE HOLDER: CANCELLATION:
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 COMPANY, ITS AGENTS
OR REPRESENTATIVES, 'EXCEPT 10 DAYS NOTICE FOR NON.f'AYMENT.
County of Monroe ~-~~
Attn: Bevette Moore AUTHORIZED REPRESENTATIVE
Airports Business Administration
3491 S. Roosevelt Blvd.
Key West, FL 33040
CERTIFICATE OF INSURANCE
Date: (MM/DDIYY)
4/26/2001
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
PRODUCER
Lockton Insurance A~ency of Houston, Inc.
5847 San Felipe, 1i Floor
Houston, Texas 77057
INSURED:
Synagro Southeast, Inc.
6220-A Hackers Bend Court
Winston-Salem, NC 27103
Insurer A:
Insurer B:
Insurer C:
Insurer D:
Greenwich Insurance Company
National Union Fire Insurance Co. of PA
X.L. Specialty Insurance Company
Indian Harbor Insurance Company
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 BE EXHAUSTED BY PAID CLAIMS.
EFFECTIVE DATE EXPIRATION
DATE
INSR
LTR
TYPE OF INSURANCE
GENERAL LIABILITY
POLICY NUMBER
LIMITS
OCCURRENCE
GEC000522501
EACH OCCURRENce $ 1,000,000
FIRE DAMAGE (ANY ONE FIRE) $ 100,000
11/1/2000 11/1/2001 MED EXP (PER PERSON) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
PRODUCTS/COMPo OP. AGG $ 2,000,000
COMBINED SINGLE LIMIT $ 1,000,000
(EACH ACCIDENT)
11/1/2000 11/1/2001
A
X COMMERCIAL GENERAL LIABILITY
X
X
X
XCU INCLUDED
ISO FORM CG 00 01 1093
GEN'L AGGREGATE LIMIT APPLIES PER:
X PROJECT
AUTOMOBILE LIABILITY
A X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
AEC000522601 (O/S)
AEC000522701 (TX)
X HIRED AUTOS
X NON-OWNED AUTOS
POLLUTION & REMEDIATION
LEGAL
D
PEC000565201
11/1/2000
DEDUCTIBLE: COLLISION & $ 1,000
OTHER THAN COLLISION $ 1,000
EACH LOSS $ 1,000,000
11/1/2001 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 50,000
EACH OCCURRENCE $ 5,000,000
11/1/2001 AGGREGATE $ 5,000,000
RETENTION $ 10,000
WORKERS' COMPENSATION STATUTORY
11/1/2001 EL EACH ACCIDENT $ 1,000,000
EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLICY LIMIT $ 1,000,000
11/1/2001 EACH CLAIM $ 5,000,000
AGGREGATE $ 5,000,000
RETENTION
$ 50,000
EXCESS LIABILITY/UMBRELLA
B X OCCURRENCE
CLAIMS MADE
BE7393230
11/1/2000
WORKERS' COMPENSATION
C and EMPLOYERS LIABILITY
A
WEC0007227 (O/S)
WEC0007234 (NH)
11/1/2000
A PROFESSIONAL & POLLUTION
LEGAL. GENERAL
CONTRACTOR'S FORM
PEC000565101
11/1/2000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
CHECK
BOX
[8J BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
[8J CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
Additional insured in favor of certificate holder (on al/ policies except workers compensation) where and to the extent as required
by written contract.
CERTIFICATE HOLDER:
CANCELLATION:
Monroe County Boct~fQ~\ 0\.'
3583 S. Roosevelt Blvd. . --- -- .- AUTHORIZED REPRESENTATIVE
Key West, FL 33040 .", ;\;,7- C C)
..(\ ~) 1(1
LVO-C (.', ~ . fl
Q"rV11 .. ~ .
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
: f.. ,,' 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 COMPANY, ITS AGENTS
OR REPRESENTATIVES, 'EXCEPT 10 DAYS NOTICE FOR NON.PAYMENT.
.-----
~-~~
CERTIFICATE OF INSURANCE Date: (MMlDDIYY)
4/10/2001
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Insurance A~ency of Houston, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5847 San Felipe, 17 Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Houston, Texas 77057 AI T~~ TI-I~ "Ai 1 HI-"'~ RI=I ow
~. , .
INSURED: \nl.l~\Jh~ _ Insurer A: Greenwich Insurance Company
Synagro Southwest, Inc. Insurer B: National Union Fire Insurance Co. of PA
4512 Brittmoore ~ \Q6lDI___ Insurer C: x.L. Specialty Insurance Company
Houston, TX 77041
., ,~-- :} ,~ Insurer 0: Indian Harbor Insurance Company
,', --
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 BE EXHAUSTED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANYONE FIRE) $ 100,000
X OCCURRENCE GECOO0522501 11/1/2000 11/1/2001 MED EXP (PER PERSON) $ 5,000
X XCU INCLUDED PERSONAL & ADV INJURY $ 1,000,000
X ISO FORM CG 00 01 1093 GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATIE LIMIT APPLIES PER: PRODUCTS/COMPo OP. AGG $ 2,000,000
X PROJECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
A X ANY AUTO AEC000522601 (O/S) (EACH ACCIDENT)
ALL OWNED AUTOS AEC000522701 (TX) 11/1/2000 11/1/2001
SCHEDULED AUTOS
X HIRED AUTOS DEDUCTIBLE: COLLISION & $ 1,000
X NON-OWNED AUTOS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
LEGAL
0 PECOO0565201 11/1/2000 11/1/2001 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 50,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
B X OCCURRENCE BE7393230 11/1/2000 1111/2001 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
C and EMPLOYERS LIABILITY WEC0007227 (O/S) 11/1/2000 11/1/2001 EL EACH ACCIDENT $ 1,000,000
A WEC0007234 (NH) EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLICY LIMIT $ 1,000,000
A PROFESSIONAL & POLLUTION PEC000565101 11/1/2000 11/1/2001 EACH CLAIM $ 5,000,000
LEGAL-GENERAL AGGREGATE $ 5,000,000
CONTRACTOR'S FORM RETENTION $ 50,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
C~~~K I:8J BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POUClES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
I:8J CERTlFICATIE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
Sealed Bid for storm sewer cleaning II Key West to Key Largo.
CERTIFICATE HOLDER: CANCELLATION:
" '0 SH~IJLD ANY OF THE ABOVE DESCRIBED POLICIES BE CA!l.CELLED BEFORE THE EXPIRATION
- DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS WRITTEN NOTICE
-~.- -,.-.--- ~l~ CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE
.- ----. , ' IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS
OR REPRESENTATNES, 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
---. - "
Monroe County ~
5100 College Road, Stock Island J,".l ~.UTHORIZED REPRESENTATIVE: ~-~.r::;~-<-r
Key West, FL 33040 .,. :.. '..! ,.. ~,
CERTIFICATE OF INSURANCE Date: (MM/DDIYY)
4/10/2001
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Insurance A~ency of Houston, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5847 San Felipe, 17 Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Houston, Texas 77057 \. k r'\"" ~^ "" . . :~: J- AI~-~TMI::5~BY RI:It"'lW
INSURED: L'V~\ \- )() JJlI\7A Insurer A: Greenwich Insurance Company
Synagro Southwest, Inc. · \ \lJ '.. Insurer B: National Union Fire Insurance Co. of PA
4512 Brittmoore D~TE___ ~Qj ,. Insurer C: X.L. Specialty Insurance Company
Houston, TX 77041 / v"s
\'i."\:["9: . Insurer 0: Indian Harbor Insurance Company
,.~ , . --' , --------
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 BE EXHAUSTED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANYONE FIRE) $ 100,000
X OCCURRENCE GECOO0522501 11/1/2000 11/1/2001 MED EXP (PER PERSON) $ 5,000
X XCU INCLUDED PERSONAL & ADV INJURY $ 1,000,000
X ISO FORM CG 00 01 1093 GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS/COMPo OP. AGG $ 2,000,000
X PROJECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
A x ANY AUTO AEC000522601 (0/5) (EACH ACCIDENT)
ALL OWNED AUTOS AEC000522701 (TX) 11/1/2000 11/1/2001
SCHEDULED AUTOS
X HIRED AUTOS DEDUCTIBLE: COLLISION & $ 1,000
X NON-QWNED AUTOS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
LEGAL
0 PECOO0565201 11/1/2000 11/1/2001 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 50,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
B X OCCURRENCE BE7393230 11/1/2000 11/1/2001 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
C and EMPLOYERS LIABILITY WEC0007227 (0/5) 11/1/2000 11/1/2001 EL EACH ACCIDENT $ 1,000,000
A WEC0007234 (NH) EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLlCY LIMIT $ 1,000,000
A PROFESSIONAL & POLLUTION PEC000565101 11/1/2000 11/1/2001 EACH CLAIM $ 5,000,000
LEGAL-GENERAL AGGREGATE $ 5,000,000
CONTRACTOR'S FORM RETENTION $ 50,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
CHECK ~
BOX BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POUClES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT .
~ CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/ELI WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
Storm sewer cleaning II Key West to Key Largo.
CERTIFICATE HOLDER: CANCELLATION:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CAJl~ELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR 1\0 MAIL 30' DAYS WRITTEN NOTICE
TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT ItAILURE TO MAIL SUCH NOTICE
SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE COMPANY, ITS AGENTS
OR REPRESENTATIVES. 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
Monroe County
Board of County Commissions AUTHORIZED REPRESENTATIVE: ~-":}.o~~
5100 College Road, Stock Island
Key West, FL 33040
AofL,
Clv~rlificafe of ~nsuranre
TO: Certificate Holder
MONROE COUNTY
5100 COLLEGE ROAD, STOCK ISLAND
KEY WEST, FL 33040
Insured:
SYNAGR') TECHNOLOGJES, INC., n,rCLUDING
ANY & ALL SUBSIDIARIES
1800 BERING DRIVE, SUITE 1000
HOUSTON, TX 77057
Aon Risk Servi~?f1,J1L _
~.11-
ora- Y
RE:
SEALED BID FOR STORM SRWE
WEST TO KEY LARGO" '(6).
[' ':'_.-L+l~ (~
/
This is to certify that the policies of insuri/"~e\iis?ed bel/J~' h'"ave berm-rjferfe~ jOr me 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
Policy Number
Co Type of Insurance
Policy
A General Liability
[8ICommercial General Liability
DClaims Made [8IOccurrence
D
D
General Agg. Limit Applies Per:
DPolicy [8IProject DLocation
A Automobile Liability
[8IAny Auto
DAU Owned Autos
DScheduled Autos
[81 Hired Autos
[8INon-Owned Autos
B Excess Liability
[8IOccurrence DClaims-Made
GEC000522501
AEC000522601 O/S
AEC000522701 TX
BE7393230
Policy
Effective
Policy
Expiration
Policy LimitsNalues
I 1/01/00
Each Occurrence
Fire Damage-Anyone Fire
Med. Exp.-Any one Person
Personal & Adv. Injury
General Aggregate
Products-Comp/Op Agg.
$1,000,000
$ 100,000
$ 5,000
$1,000,000
$2,000,000
$2,000,000
$1,000,000
$
$
$
$ 1,000
1,000
$5,000,000
$5,000,000
$
DDeductible $
DRetention $ 10,000
C Workers Compensation and WEC0007227 O/S 11/01/00 11/01/01 [8Iwc Statutory Limits DOther
A Employers Liability WEC0007234 NH E.L. Each Accident $1,000,000
E.L. Disease-Ea Employee $1,000,000
E.L. Disease-Policy Limit $1,000,000
o Pollution & Remediation Legal PEC000565201 11/01/00 11/01/01 Each Loss $1,000,000
Total AU Losses $1,000,000
Retention - each loss $ 50,000
A Professional & Pollution Legal PEC000565101 11/01/00 11/01/01 Each Claim $5,000,000
General Contractor's Form Aggregate $5,000,000
Retention $ 50,000
E Commercial Property including MXI97800296 11/01/00 11/01/01 AU Risk Building & Contents $10,000,000
Contractors Equipment And Contractors Equipment Loss Limit
including Rented & Leased
Insurance Company(ies): A) Greenwich Insurance Company B) National Union Fire Insurance Co. ofPA C) X.L. Specialty Insurance Co.
D) Indian Harbor Insurance Company E) Fireman's Fund Insurance Company
The subscnbing insurers' obligations under contracts of insurance to which they subscribe are several and not joint and are limited solely to the extent of their individual subscriptions. The
subscnbing insurers are not responsible for the subscription of any co-subscnbing insurer who for any reason does not satisfy all or part of its obligations.
Description of Operations: Certificate Holder is listed as Additional Insured where required by written contract under GUAUUMBIPOLL. The insurance afforded to
the Additional Insured as described in this Certificate of Insurance for work performed by the Named Insured, is primary and non-contributory to any similar coverage
maintained by the Additional Insured. A Waiver of Subrogation is issued in favor of Certificate Ho]der where required by written contract under the GU AUUMBIWC.
Certificate Holder is included as a Loss Payee as their interest may appear for Property and Auto Physical Damage coverage.
Cancellation: 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 policy(ies) shown hereon. Should any of the above described policies be canceled before the expiration date thereof, this agency, on behalf of
the issuing company(ies), wiU endeavor to mail 30* days written notice to the above named certificate holder, but failure to mail such notice shaU impose no obligation or
liability of any kind upon the company(ies) or this agency.
*except ]0 days notice for non-payment of premium
Date:
October 31. 2000
By:
11/01/01
I 1/01/00
11/01/01
Combined Single Limit
Bodily Injury-per person
Bodily Injury-per accident
Property Damage-per ace.
Deductible: CoUision &
Other than Collision
Each Occurrence
Aggregate
Prod/Comp Ops Agg.
] 1/01/00
11/01/01
Aan Risk Services, afTexas. Inc.
2000 Bering Drive, Suite 900 Houston, Texas 77057-3790 tel (713)430-6000 fax:(713)430-6570
AON
Synagro Technologies, Inc.
2000 - 2001
SYNAGRO TECHNOLOGIES, INC.
1800 Bering Drive, Suite 1000
Houston, TX 77057
Synagro Technologies, Inc.
ST Interco, Inc.
Organi-Gro, Inc.
Composting Corporation of America
Synagro Midwest, Inc.
A&J Cartage, Inc.
Synagro of Wisconsin, Inc.
National Resource Recovery, Inc.
Synagro of Michigan, Inc.
Michigan Organic Resources, Inc.
Rehbein, Inc.
Synagro of Minnesota - Rehbein, Inc.
Synagro Northeast, Inc.
COR Mid-Atlantic
COR Mid-Atlantic - OH
Residual Technologies, Limited Partnership
Fairhaven Residuals, Limited Partnership
NETCO-Waterbury, Limited Partnership
NETCO-Residuals Management, Limited Partnership
New Haven Residuals, Limited Partnership
New England Treatment Company, Inc.
Fairhaven Residuals Systems, Inc.
NETCO-Connecticut, Inc
NETCO-Residuals Management Systems, Inc.
NETCO-Waterbury, Inc.
NETCO-Waterbury Systems, Inc.
New Haven Residuals Systems, Inc.
Residual Technologies Systems, Inc.
Providence Soils, Limited Liability Company
EPIC, Inc.
Environmental Protection and Improvement Company, Inc.
Synagro Southeast, Inc.
Environmental Waste Recycling, Inc.
Synagro of North Carolina - EWR, Inc.
AMSCO, Inc.
Synagro of North Carolina - AMSCO, Inc.
Synagro of Florida - A&J, Inc.
A&J Cartage Southeast, Inc.
Anti-Pollution Associates, Inc.
0&0 Pumping, Inc.
Jewell's Sewage Service North, Inc.
Synagro of Florida - Anti-Pollution, Inc.
Synagro of Florida - Ecosystems, Inc.
Ecosystematics, Inc.
AON.
Synagro Technologies, Inc.
2000 - 2001
Synagro of Florida-Davis Water, Inc.
Davis Water Analysis, Inc.
AKH Water Management, Inc.
Synagro Mid-Atlantic, Inc.
Whiteford Construction Co., Inc.
Synagro Southwest, Inc.
COR Environmental, Inc.
Synagro of Texas - COR, Inc.
Vital-Cycle, Inc.
Synagro of Texas - Vital-Cycle, Inc.
Synagro West, Inc.
Pima Gro Systems, Inc.
Synagro of California, Inc.
Recyc, Inc.
Synagro Composting Company of California, Inc.
Residual Processing, Inc.
Future - Tech Environmental Services, Inc.
Wheelabrator Water Technologies, Inc.
Synagro WWT, Inc.
Enviroland, Incorporated
Soaring Vista Properties, Inc.
NYOFCO Holdings, Inc.
New York Organic Fertilizer Company
Wheelabrator Clean Water New Jersey, Inc.
Synagro - WCWNJ, Inc.
Wheelabrator Water Technologies Baltimore L.L.C.
Synagro - Baltimore L.L.C
JABB II, L.L.C.
~ AGENTSSTA'I'EMENT
, :
I have reviewed the above requirements with the bidde~ named. below. ~ faDowing deductibIes
apply to the corresponding policy.
POUCY
OroUCIlBlES
.
. :
I
:
.
. .
SEE THE ATl'ACHED CERTIFICATE
Liability policies are _Occurrence
-~
,
AON RISK SERVICES OF TEXAS
tnsurance Agency
Signature
I
. ,
BIDDERS Sf A TEMENir
I understand the insurance that will be mandatory if awarded the contract and will comply in fun
with all the requirements.
Signature
, ,
.
Bidder
INSCKLST
. i
I
. i
SUPPLEMENTARY INSURANCE DOCUMENTS
00900-7
M
CerLificate of InSUlance
TO: Certificate Holder
MONROE COUNTY RISK MANAGEMENT
5100 COLLEGE ROAD
KEY WEST, FL 33040
Aon Risk Services
RE:
Corporate Acquisition Effective February 4, 2000
Important: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) DUlSt 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 tenns 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.
Disclaimer: The Cert. of Ins. does not constitute a contract between the issuing insurer(s), authorized
representative or producer, and the Cer!. holder, nor does it affirmatively or negatively amend, extend or
alter the coverage afforded by the policies listed thereon.
The policies of insurance listed be/ow 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 subiect 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 Policy
Policy Effective Expiration
General Liability
I8IComrnercial General Liability
DClaims Made 18I0ccurrence
o
o
General Agg. Limit Applies Per:
DPolicy I8IProject DLocation
Automobile Liability
I8IAny Auto
DAll Owned Autos
DScheduled Autos
I8IHired Autos
I8INon-Owned Autos
Excess Liability
18I0ccurrence DClaims-Made
WC Statutory Limits
E.L Each Accident
E.L Disease-Ea Employee
E.L Disease-Policy Limit
Each Claim
Ag~gate
All Risk Building & Contents
Contractors Equipment
including Rented & Leased
Insurance Compan(les): A Reliance National Indemnitv Company B Firemen's Fund Insur:mce Comnany C Reliance Ins. Co. of lllinnls
Description of Operations/LocationsIV ehicleslExclusions Added by EndorsemenUSpecial Provisions: Certificate Holder is listed as Additional Insured
where required by written contract under GU AUUMB. The Insurance afforded to the A.I. as described In this Certificate of Insurance (COI) for work performed by
the Named Insured, Is nrlmsrv and non-contrlbutorv to any similar coverage maintained by the A.I. A Waiver of Subrogation is issued in favor of Certificate Holder
where required by written contract under the GUAUUMBIWC. Certificate Holder is included as a Loss Payee as their interest may appear for Property and Auto Physical
Damage coverage.
Cancellation: Cancellation: This certificate is issued as a matter of information only and confers no rights upon the certificate holdec. This certificate does not amend,
extend or alter the coverage afforded by the policy(ies) shown hereon. Should any of the above described policies be canceled before the expiration date thereof, this
agency, on behalf of the issuing company(ies), will endeavor to mail 30* days written notice to the above named certificate holder, but failure to mail such notice shall
impose no obligation or liability of any kind upon the company(ies) or this agency.
Insured:
Synagro Southeast, Inc.
AKH Water Management, Inc.
Box 205
Key Colony Beach, FL 33051
A
NGB 172100202
01-26-00
11-01-00
A
NKA 163049802
(Other States)
01-26-00
11-01-00
A
NUA 163352202
01-26-00
11-01-00
A
DDeductible $
Retention $ 10,000
Workers Compensation and
Employers Liability
11-01-00
NWAOl5073401
01-26-00
C
Professional & Pollution
NTU 251115601
01-26-00
11-01-00
B
Commercial Property Including
Contractors Equipment
COPAJI0554
01-26-00
11-01-00
Policy LimitsIValues
Each Occurrence
Fire Damage-Anyone Fire
Med. Exp.-Any one Person
Personal & Adv. Injury
General Aggregate
Products-Comp/Op Agg.
Combined Single Limit
Bodily Injury-per person
Bodily Injury-per accident
Property Damage-per acc.
Deductible: Collision &
Other than Collision
Each Occurrence
Aggregate
ProdlComp Ops Agg.
$
$
$
$
$
$
1,000,000
1,000,000
10,000
1,000,000
2,000,000
2,000,000
$
$
$
$
$
1,000,000
1,000
$
$
$
5,000,000
5,000,000
5,000,000
$
$
$
$
$
$
Other
1,000,000
1,000,000
1,000,000
10,000,000
10,000,000
5,000,000
Loss Limit
*except 10 days notice for non-payment of premium
Aon Risk Services of Texas, Inc.
~',
C~',
~-
fax:(713)430-6570
Date:
Febru
9 2000
\!
L' l _
Authorized Repres
"'lI!,!\'[R:
~..: / vr<'
f":.- .~,..)
,ton Risk Services, of Texas, Inc.
2000 Bering Drive, Suite 900 Houston, Texas 77057-3790 tel (713)430-6000
ADM
eel ..jficate of Insu... ance
Aon Risk Services
TO: Certificate Holder RE:
~ffi:~~;L: OF~~,c::,oriCr&l:Eff:I:=4':j~ J
[TF_'~-~-ty) __~~o
Insured:
v.Inmortant: If the certificate holder is an ADDmONAL INSURED, the policy(ies) must be endorsed.
i~t;' 't - - l~;j -;tatetncnt on this certificate does not confer rights to the certificate holder in lieu of such
endorsetrent(s). If SUBROGATION IS WAIVED, subject to the tenns and conditioos of the policy,
certain policies may require an endorsetrent. A statetrent on this certificate does not confer rights to the
certificate holder in lieu of such endorsetrent.
Disclaimer: The Cert. of Ins, does DOt coostitute a contract between the issuing insurer(s), authorized
representative or producer, and the cert. holder, nor does it affirmatively or negatively amend, extend or
alter the coverage afforded by the policies listed thereon.
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 cenificate may be issued or may penain. The insurance afforded by the
olicies described herein is sub 'ect to all the terms, exclusions and conditions 0 such olicies. limits shown ma hove been reduced b aid claims.
Co Type of Insurance Policy Number Policy Policy
Policy Effective Expiration
General Liability
I8IComrnercial General Liability
DClaims Made 18I0ccurrence
D
D
General Agg. Limit Applies Per:
DPolicy I8IProject DLocation
Automobile Liability
I8IAny Auto
DAIl Owned Autos
DScheduled Autos
I8lHired Autos
I8INon-Owned Autos
Excess Liability
I8IOccurrence DClaims-Made
I8Iwc Statutory Limits
E.L. Each Accident
E.L. Disease-Ea Employee
E.L. Disease-Policy Limit
Each Claim
Aggregate
All Risk Building & Contents
Contractors Equipment
includinl!; Rented & Leased
Insurance Com an les: A Reliance National Indemnit Com an B Firemen's Fund Insurance Com an C Reliance Ins. Co. of Illinois
Description of Operations/Locations/V ehicIeslExcIusions Added by Endorsement/Special Provisions: Certificate Holder is listed as Additional Insured
where required by written contract under GUAUUMB. Tbe Insurance afforded to tbe A.I. as described In this Certificate ofInsurance (COI) for work performed by
tbe Named Insured, Is Drlmarv and non-contrlbutorv to any similar coverage maintained by tbe A.I. A Waiver of Subrogation is issued in favor of Certificate Holder
where required by written contract under the GUAUUMBIWC. Certificate Holder is included as a Loss Payee as their interest may appear for Property and Auto Physical
Damage coverage.
Cancellation: Cancellation: 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 policy(ies) shown hereon. Should any of the above described policies be canceled before the expiration date thereof, this
agency, on behalf of the issuing company(ies), will endeavor to mail 30* days written notice to the above named certificate holder, but failure to mail such notice shall
impose no obligation or liability of any kind upon the company(ies) or this agency.
Aon Risk Services of Texas, Inc.
Authorized Represen~
Synagro Southeast, Inc.
Ecosystematics, Inc.
203 Apache St.
Tavernier, FL 33070
\""".TR:
A
NGB 172100202
01-26-00
11-01-00
A
NKA 163049802
(Other States)
01-26-00
11-01-00
A
NUA 163352202
01-26-00
11-01-00
A
DDeductible $
Retention $ 10,000
Workers Compensation and
Employers Liability
11-01-00
NWA 015073401
01-26-00
C
Professional & Pollution
NTU 251115601
01-26-00
11-01-00
B
Commercial Property including
Contractors Equipment
COPAJ10554
01-26-00
11-01-00
*except 10 days notice for non-payment of premium
Date:
February 9, 2000
By:
Aon Risk Services, of Texas, Inc. INITI1\l
2000 Bering Drive, Suite 900 Houston, Texas 770 -379
000 fax:(713)430-6570
Policy LimitslValues
Each Occurrence
Fire Damage-Anyone Fire
Med. Exp.-Any one Person
Personal & Adv. Injury
General Aggregate
Products-ComplOp Agg.
Combined Single Limit
Bodily Injury-per person
Bodily Injury-per accident
Property Damage-per acc.
Deductible: Collision &
Other than Collision
Each Occurrence
Aggregate
Prod/Comp Ops Agg.
$
$
$
$
$
$
1,000,000
1,000,000
10,000
1,000,000
2,000,000
2,000,000
$
$
$
$
$
1,000,000
1,000
$
$
$
5,000,000
5,000,000
5,000,000
$
$
$
$
$
$
Other
1,000,000
1,000,000
1,000,000
10,000,000
10,000,000
5,000,000
Loss Limit
~!~d
, ~
CERTIFICATE OF INSURANCE Date: (MM/DDIYY)
1/21/2003
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Insurance Agency of Houston, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5847 San Felipe, Suite 320 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Houston, Texas 77057 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED: Insurer A: American International Specialty Lines
Synagro of Florida - Anti - Pollution, Inc. Insurer B: Zurich American Insurance
89111 Overseas Hwy. Insurer C:
Tavernier, FL 33070
Insurer D:
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 BE EXHAUSTED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
X OCCURRENCE EG3779024 11/1/2002 02101/2004 MED EXP (PER PERSON) $ 5,000
X XCUINCLUDED PERSONAL & ADV INJURY $ 1.000,000
X ISO FORM CG 00 0110 93 GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS/COMPo OP. AGG $ 2,000,000
X PROJECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B X ANY AUTO BAP 2347047-02 (O/S) (EACH ACCIDENT)
B ALL OWNED AUTOS TAP 2347048-02 (TX) 02/01/2003 02101/2004
B SCHEDULED AUTOS MA 2347049-02 (MA)
B X HIRED AUTOS BAP 2347050-02 (VA) DEDUCTIBLE: COLLISION & $ 1.000
X NON.OWNED AUTOS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
LEGAL
A EG3779024 11/1/2002 02101/2004 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE619 26 61 11/1/2002 02/01/2004 AGGREGATE $ 5,000.,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
B and EMPLOYERS LIABILITY WC 2347044-02 (O/S) 02/01/2003 02/01/2004 EL EACH ACCIDENT $ 1,000,000
B we 2347046-02 (MA, WI) EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLICY LIMIT $ 1,000,000
A PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
LEGAL - GENERAL eOPS6192166 11/1/2002 02/01/2004 AGGREGATE $ 1,000,000
CONTRACTOR'S FORM RETENTION
$ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
C~~~K [8J BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
[8J CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
Re: Project Description: Sealed Bid for OperationlMaintenance of Old Mariners Hospital Wastewater Treatment Plant; BID #120-245-D-2DD2/LC; Project
Location: Key West, FL
Additional Insured in favor of The Monroe County Commissioners BOCC, Its Employees and Officials (on all policies except Workers'
Compensation/EL) where and to the extent reauired bv written contract.
CERTIFICATE HOLDER: CANCELLATION:
APP MI"" NY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
BY'~ 1 \ _q.J/J> po Jkd 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
DATE _/t-~=.Q3 POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS
OR REPRESENTATIVES, 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
Monroe County AUTHORIZED REPRESENT A TIVE:
Purchasing Office WAIVER N/A -L..- YES ~-~~
1100 Simonton Street, Room 2-213
Key West, FL 33040 6\c;,@Jb
J
Cc. :~{... Cr 'lU~ Ufi 11' :/11 J L
,. a;tt~ t. ~'"
i
CERTIFICATE OF INSURANCE IDate: (MM/DDNY)
1/21/2003
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Insurance Agency of Houston. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5847 San Felipe, Suite 320 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Houston, Texas 77057 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED: Insurer A: American International Specialty Lines
Synagro of Florida - Anti - Pollution, Inc. Insurer B: Zurich American Insurance
89111 Overseas Hwy. Insurer C:
Tavernier, FL 33070
Insurer 0:
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 BE EXHAUSTED BY PAID CLAIMS,
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
X OCCURRENCE EG3779024 11/1/2002 02/01/2004 MED EXP (PER PERSON) $ 5,000
X XCUINCLUDED PERSONAL & ADV INJURY $ 1,000.000
X ISO FORM CG 00 01 1093 GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS/COMPo OP. AGG $ 2,000,000
X PROJECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B X ANY AUTO BAP 2347047-02 (O/S) (EACH ACCIDENT)
B ALL OWNED AUTOS TAP 2347048-02 (TX) 02/01/2003 02101/2004
B SCHEDULED AUTOS MA 2347049-02 (MA)
B X HIRED AUTOS BAP 2347050-02 (VA) DEDUCTIBLE: COLLISION & $ 1,000
X NON-OWNED AUTOS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
LEGAL
A EG3779024 11/1/2002 02/01/2004 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250.000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE619 26 61 11/1/2002 02/01/2004 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
B and EMPLOYERS LIABILITY we 2347044-02 (O/S) 02101/2003 02/01/2004 EL EACH ACCIDENT $ 1,000,000
B WC 2347046-02 (MA, WI) EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLICY LIMIT $ 1,000,000
A PROFESSIONAL & POLLUTION EACH CLAIM $ 1.000,000
LEGAL - GENERAL eOPS6192166 11/1/2002 02/01/2004 AGGREGATE $ 1,000,000
RETENTION
CONTRACTOR'S FORM $ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
CHECK rgJ BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRmEN CONTRACT.
BOX
rgJ CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRmEN CONTRACT.
Re: Bid #86-279'{)-2002/LC _ Sealed bid for Operation and Maintenance of MGC Wastewater Treatment Plant; Project Location: Key West, FL
Additional Insured in favor of The Monroe County Board of County Commissioners (on all policies except Workers' Compensation/ELI where and to
the extent required by written contract.
CERTIFICATE HOLDER: CANCELLATION:
. " D ~~S K ~ OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
EOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS WRITTEN NOTICE
BV ..~~ ,..........: ' Lf: / I '1 TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE
... I . ""1 ., ,ucnSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS
~ In '5':; OR REPRESENTATIVES. 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
DATE
Monroe County r IZED REPRESENTATIVE:
Purchasing Office WAIVER N/A. ~-~~
1100 Simonton Street, Room 2-213 - YES "..
Key West, FL 33040 <r' . ( O~(
~ ())~ ' ~---'.f\
<!. e' ~ tJ CC:.'-I J ,t tJ, ,'. ,! <.""'\
~~~ ~e~ f/ll5~
CERTIFICATE OF INSURANCE Date: (MM/DD/YY)
1/21/2003
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Insurance Agency of Houston, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5847 San Felipe, Suite 320 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Houston, Texas 77057 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED: Insurer A: American International Specialtv Lines
Synagro Southwest, Inc. Insurer B: Zurich American Insurance
4512 Srittmoore Insurer C:
Houston, TX 77041
Insurer 0:
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 BE EXHAUSTED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
X OCCURRENCE EG3779024 11/1/2002 02/01/2004 MED EXP (PER PERSON) $ 5,000
X XCU INCLUDED PERSONAL & ADV INJURY $ 1,000,000
x ISO FORM CG 00 01 1093 GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS/COMPo OP. AGG $ 2,000,000
X PROJECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B X ANY AUTO SAP 2347047-02 (O/S) (EACH ACCIDENT)
B ALL OWNED AUTOS TAP 2347048-02 (TX) 02101/2003 02101/2004
B SCHEDULED AUTOS MA 2347049-02 (MA)
B X HIRED AUTOS SAP 2347050-02 (VA) DEDUCTIBLE: COLLISION & $ 1,000
X NON.OWNED AUTOS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
LEGAL
A EG3779024 11/1/2002 02101/2004 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE SE619 26 61 11/1/2002 02/01/2004 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
B and EMPLOYERS LIABILITY WC 2347044-02 (O/S) 02101/2003 02101/2004 EL EACH ACCIDENT $ 1,000,000
B WC 2347046-02 (MA, WI) EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLICY LIMIT $ 1,000,000
A PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
LEGAL. GENERAL COPS6192166 11/1/2002 02/01/2004 AGGREGATE $ 1,000,000
RETENTION
CONTRACTOR'S FORM $ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
C~~~K 181 BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
I8J c""O'''''O'''''. "'JI1ll'l'l · ~~~"'... CO.'~" WH"""'" '"' 'i ""'""" ,v WRm" COO<YRACY.
Re: AKH Contract 1: . T~ ~ 0~ . C8
BY \. ~ 7).i/..
'~ CA.f'" ,db, -. ('..Ll /" - A' It
CERTIFICATE HOLDER: UAI t: ./ :ANCELLATION: ('( rl V~IJ .t'tfti.uJYI ~ r
WAIVER NIA '-::'-.Y '-'; ULD 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 COMPANY. ITS AGENTS
OR REPRESENTATIVES, 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
County of Monroe AUTHORIZED REPR"ESENTATIVE:
Attention: Airports Business Administration ~-~~
3491 S. Roosevelt Boulevard
Key West, FL 33040
/
(!. Co : ~-' .
CERTIFICA TE OF INSURANCE Date: (MM/DDIYY)
3/15/2004
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Lockton Companies of Houston, Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
5847 San Felipe, Suite 320 AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Houston, Texas 77057 INSURERS AFFORDING COVERAGE
This Certificate Voids and Suoercedes any oreviouslv issued certificate,
INSURED: Insurer A: American International Specialty Lines Ins. Co.
Synagro of Florida - Anti - Pollution, Inc. Insurer B: American Home Assurance Company
89111 Overseas Hwy. Insurer C: Insurance Company of the State of PA
Tavernier, FL 33070 Insurer D: Commerce & Industry Insurance Company
Insurer E: Lexington Insurance Company
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 BE EXHAUSTED BY PAID CLAIMS,
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
A X OCCURRENCE EG1955513 02/01/2004 05/01/2005 MED EXP (PER PERSON) $ 10,000
X XCU NOT EXCLUDED PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X PROJECT PRODUCTS/COMPo OP. AGG $ 2,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B ANY AUTO CA9798519 (0/5) 02/01/2004 05/01/2005 (EACH ACCIDENT)
X
B ALL OWNED AUTOS CA9798520 (TX) 02/01/2004 05/01/2005
E X HIRED AUTOS 128-2274 (APD) 02/01/2004 05/01/2005 DEDUCTIBLE: COLLISION & $ 1,000
X NON.OWNED AUTOS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
A LEGAL
EG1955513 02/01/2004 05/01/2005 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250,000
EXCESS L1ABILlTY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE4892990 02/01/2004 05/01/2005 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
C WORKERS' COMPENSATION 3715501 (AOS) 02/01/2004 05/01/2004 WORKERS' COMPENSATION STATUTORY
B and EMPLOYERS LIABILITY 3715502 (CA) 02/01/2004 05/01/2004 EL EACH ACCIDENT $ 1,000,000
D 3715503 (WI) 02/01/2004 05/01/2004
EL DISEASE-EA EMPLOYEE $ 1,000,000
C 05/01/2004 05/01/2005 EL DISEASE-POLICY LIMIT $ 1,000,000
3715504 (AOS)
B 3715505 (CA) 05/01/2004 05/01/2005
D 05/01/2004 05/01/2005 ------ -------~.. - _.~-~----- ---.-- - -- --_._---_._~_._-
3715506 (WI)
PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
A LEGAL - GENERAL COPS1956593 02/01/2004 05/01/2005 AGGREGATE $ 1,000,000
CONTRACTOR'S FORM RETENTION $ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
CHECK [gI BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT.
BOX
[gI CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE REQUIRED BY WRITTEN CONTRACT.
Re: Bid #86-279-G-2002lLC - Sealed bid for Operations and Maintenance of MGC Wastewater Treatment Plant
Additional Insured In favor of The Monroe County Board of County Commissioners (on all policies except Workers' Compensation/ELl where required by written contract.
,~ ....-.-n-_ . .t:\.
CERTIFICATE HOLDER: ..,,, -n r ""u h ...( L .tANCELLATION:
- -v-..-r~ ..-- ~ ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATi: . Dc DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS WRITTEN NOTICE
3.... ,.-j__,. TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE
t'JiA~___YES. "':'''~~~IVlPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS
Nt. ;\1 f~: ~.f OR REPRESENTATIVES, 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
Monroe County AU ( h~IIAIIVt::
Board of County Commissioners ~
.~ "
1100 Simonton Street, Room 2-213 (0/1 1- -'
Key West, FL 33040 ~ " IJ I .J I /'\
/ . dJ ~~/) ~
c.c ~-!40
. lJ.. m dlQ,
CERTIFICATE OF INSURANCE Date: (MMJDDIYY)
4/30/2005
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Lockton Companies of Hou ston NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
5847 San Felipe, Suite 320 AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Houston, Texas 77057 INSURERS AFFORDING COVERAGE
INSURED: Insurer A: American International Specialty Lines Ins. Co.
Synagro of Florida - Anti - Pollution, Inc. Insurer B: Liberty Mutual Fire Insurance Co.
89111 Overseas Hwy. Insurer C: Liberty Insurance Corporation
Tavernier, FL 33070 Insurer 0:
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 BE EXHAUSTED BY PAID CLAIMS,
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
A X OCCURRENCE EG7546806 05/01/2005 08/01/2006 MED EXP (PER PERSON) $ 10,000
X xcu NOT EXCLUDED PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X PROJECT PRODUCTS/COMPo OP. AGG $ 2,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B ANY AUTO AS2-691-437721-015 05/01/2005 05/01/2007 (EACH ACCIDENT)
X
ALL OWNED AUTOS AP~.~d:~SK ~ T~GEMENT
x HIRED AUTOS BY .l." , 'All u, DEDUCTIBLE: COLLISION & $ 1,000
..~--
X NON-OWNED AUTOS DATE ..._.. ,.5Q ~(h OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION WAIVER \{ YES EACH LOSS $ 1,000,000
LEGAL N I A______
A EG7546806 05/01/2005 08/01/2006 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE 974-61-68 05/01/2005 08/01/2006 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
C and EMPLOYERS LIABILITY WA7-69D-437721-025 (AOS) 05/01/2005 05/01/2006 EL EACH ACC!DENT $ 1,000,000
C WC7-691-437721-035 (WI) 05/01/2005 05/01/2006
EL DISEASE.EA EMPLOYEE $ 1,000,000
lJ'IcO'. (a()A I. :J
El DISEASE.POLlCY LIMIT $ 1,000,000
C( '. i ~~
' ..IA /Y1 ~ , ~
PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
LEGAL-GENERAL COPS1956674 05/01/2005 05/01/2007 AGGREGATE $ 1,000,000
A CONTRACTOR'S FORM (l/", I ,,~ \IJ11f) 'i) 0 RETENTION $ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXClUSIONS ADDED BY ENDORSEMENT PROVISIONS:
C~6~K C8l BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT.
C8l CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE REQUIRED BY WRITTEN CONTRACT.
Re: Bid #86-279-0-2002/LC - Sealed bid for Operations and Maintenance of MGC Wastewater Treatment Plant
Additional Insured in favor of The Monroe County Board of County commiSSioniMon ~~~IiCies except Workers'
Compensation/ELl where required by written contract. r - Iou &
CERTIFICATE HOLDER: CANCELLA l1eN:
\;" ~ r...c.. V".. (. ~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
c..~v> '\ \L ~ " 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 COMPANY, ITS AGENTS
OR REPRESENTATIVES. "EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
Monroe County IAIIV!:: ~-~~
Board of County Commissioners
1100 Simonton Street, Room 2-213
Key West, FL 33040
07
CERTIFICATE OF INSURANCE Date: (MM/DDIYY)
4/30/2005
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Lockton Companies of Houston NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
5847 San Felipe, Suite 320 AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Houston, Texas 77057 INSURERS AFFORDING COVERAGE
INSURED: Insurer A: American International Specialty Lines Ins. Co.
Synagro of Florida - Anti - Pollution, Inc. Insurer B: Liberty Mutual Fire Insurance Co.
89111 Overseas Hwy. Insurer C: Liberty Insurance Corporation
Tavernier, FL 33070 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 BE EXHAUSTED BY PAID CLAIMS,
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
A X OCCURRENCE EG7546806 05/01/2005 08/01/2006 MED EXP (PER PERSON) $ 10,000
X XCU NOT EXCLUDED PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X PROJECT PRODUCTS/COMPo op, AGG $ 2,000,000
AUTOMOBILE LIABILITY .f\PF)~(J\./?=rl ;.~ . ,~~1J:~tfO~ II, ~~tr07 COMBINED SINGLE LIMIT $ 2,000,000
B ANY AUTO AS2-691-~l~.~.1-:0.~-~~q (EACH ACCIDENT)
x ,.... 4'. .
ALL OWNED AUTOS -~
X HIRED AUTOS ~..._~ "'-'-, --"\T~~' ~-Q:5.'. DEDUCTIBLE: COLLISION & $ 1,000
NON.OWNED AUTOS Vl//!,f .' $ 1,000
X '/ '~._.._~_ YEs OTHER THAN COLLISION
POLLUTION & REMEDIATION () %,'Jlb.l 11 " EACH LOSS $ 1,000,000
A LEGAL
EG7546806 05/01/2005 ~/2006 TOTAL ALL LOSSES $ 1,000,000
re'.. ~ RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE 974-61-68 05/01/2005 08/01/2006 AGGREGATE $ 5,000,000
CLAIMS MADE ~ ~c.I? 1="1 RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
C and EMPLOYERS LIABILITY WA7-69D-437721-025 (AOS) 05/01/2005 05/01/2006 EL EACH ACCIDENT $ 1,000,000
C WC7-691-437721-035 (WI) 05/01/2005 05/01/2006
(tv I ,fl 1ti (f)iP-'< EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLICY LIMIT $ 1,000,000
-
PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
A LEGAL-GENERAL COPS1956674 05/01/2005 05/01/2007 AGGREGATE $ 1,000,000
CONTRACTOR'S FORM RETENTION $ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
C~6~K [8] BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERllFICA TE HOLDER ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT.
[8] CERTIFICATE HOLDER IS NAMED AS AN ADDIllONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE REQUIRED BY WRITTEN CONTRACT.
Re: Project Description: Sealed Bid for Operation/Maintenance of Old Mariners Hospital Wastewater Treatment Plant; BID #120-245-
0-2002lLC; Project Location: Key West, FL
Additional Insured in favor of The Monroe County Commissioners BOCC, its Employees and Officials (on all policies except
Workers' Compensation/ELl where required bv written contract.
CERTIFICA TE HOLDER: CANCELLATION:
C <Dp i e.. s.', \:-~ ~o.. I"\..~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS VVRITTEN 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. 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
Monroe County AUI IIAIIVe:
Purchasing Office ~-~~
1100 Simonton Street, Room 2-213
Key West, FL 33040
CERTIFICATE OF INSURANCE Date: (MM/DDIYY)
7/6/2005
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Lockton Companies of Houston NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
5847 San Felipe, Suite 320 AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
Houston, Texas 77057 INSURERS AFFORDING COVERAGE
INSURED: Insurer A: American International Specialty Lines Ins. Co.
Synagro Southeast, Inc. Insurer B: Liberty Mutual Fire Insurance Co.
5198 Overseas Highway Insurer C: Liberty Insurance Corporation
Marathon, FL 33050 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 BE EXHAUSTED BY PAID CLAIMS,
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANYONE FIRE) $ 1,000,000
A X OCCURRENCE EG7546806 05/01/2005 08/01/2006 MED EXP (PER PERSON) $ 10,000
x xcu NOT EXCLUDED PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X PROJECT PRODUCTS/COMPo op, AGG $ 2,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B ANY AUTO A82-691-437721-015 05/01/2005 05/01/2007 (EACH ACCIDENT)
X
ALL OWNED AUTOS
X HIRED AUTOS DEDUCTIBLE: COLLISION & $ 1,000
X NON-OWNED AUTOS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
A LEGAL
EG7546806 05/01/2005 08/01/2006 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE 974-61-68 05/01/2005 08/01/2006 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION 8T A TUTORY
C and EMPLOYERS LIABILITY WA7-69D-437721-025 (AOS) 05/01/2005 05/01/2006 EL EACH ACCIDENT $ 1,000,000
C WC7-691-437721-035 (WI) 05/01/2005 05/01/2006
EL DISEASE-EA EMPLOYEE $ 1,000,000
- _._-._---,--
EL DISEASE-POLICY LIMIT $ 1,000,000
PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
A LEGAL-GENERAL COP81956674 05/01/2005 05/01/2007 AGGREGATE $ 1,000,000
CONTRACTOR'S FORM RETENTION $ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
C~~~K ~ BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT.
~ CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE REQUIRED BY WRITTEN CONTRACT.
Re: Operations & Maintenance Sewage Treatment Plant; Project Location: Marathon Government Center; 4796 Overseas
Highway; Marathon, FL 33050
Additional Insured in favor of Monroe County Board of Commissioners (on all policies except Workers' Compensation/EL)
where and to the extent reauired bv written contract.
CERTIFICATE HOLDER: APPP\~D~ISK ,...,,,....,,- r. .....'CELLA TION:
BY _ ~ II ~:~Jl tI () SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
.... -, "" "...-----. ~THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS WRITTEN NOTICE
DATE_._7...- /5.,:-0;5....--___ E 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
.aa..aEPRESENTATIVES, 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
Monroe County WAIVER G~','F~ AUI .--. ,,....IIVt:.:
Board of Commissioners ~-~~
Monroe County Risk Management .....
PO Box 1026
Key West, 5- 33041-1026
C C :;:::;,..~- ,. flMAII /LA4,A ~~
.- '.... !' v- 0 v
CERTIFICATE OF INSURANCE Date: (MM/DDIYY)
4/26/2006
PRODUCER ,.-- HjlS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
I
Lockton Companies of Houston ~ECE'VED NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
5847 San Felipe, Suite 320 AM ND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Houston, Texas 77057 INSURERS AFFORDING COVERAGE
;
INSURED: I i-\T L. LUUD 111 ~urer A: American International Specialty Lines Ins. Co.
Synagro South, LLC I Ir ~urer B: Liberty Mutual Fire Insurance Co.
I
89111 Overseas Highway 1__- "ONROE COUNTY Ir surer C: Liberty Insurance Corporation
Tavernier, FL 33070 .::;K MANAGEMENT III surer 0:
~..". "."
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 BE EXHAUSTED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
A X OCCURRENCE EG7546806 05/01/2005 08/01/2006 MED EXP (PER PERSON) $ 10,000
X xcu NOT EXCLUDED PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X PROJECT PRODUCTS/COMPo OP. AGG $ 2,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B ANY AUTO AS2-691-437721-015 05/01/2005 05/01/2007 (EACH ACCIDENT)
X
ALL OWNED AUTOS m(~ '114 '..
x HIRED AUTOS ~. DEDUCTIBLE: COLLISION & $ 1,000
X NON-OWNED AUTOS 5-... )-DJ;> OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION 'f EACH LOSS $ 1,000,000
LEGAL ,
A EG7546806 05/01/2005 08/01/2006 TOTAL ALL LOSSES $ 1,000,000
~ l,A . ((k.n RETENTION - EACH LOSS $ 250,000
~.
EXCESS LIABILITY/UMBRELLA '-t:. [ '. ~ EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE 974-61-68 05/01/2005 08/01/2006 AGGREGATE $ 5,000,000
CLAIMS MADE e:,i~L 0uD RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
C and EMPLOYERS LIABILITY WA7-69D-437721-026 (AOS) 05/01/2006 05/01/2007 EL EACH ACCIDENT $ 1,000,000
C WC7-691-437721-036 (WI) 05/01/2006 05/01/2007
- ~O 0/1 191 Iii A^ EL DISEASE-EA EMPLOYEE $ 1,000,000
/ EL DISEASE-POLICY LIMIT $ 1,000,000
PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
LEGAL-GENERAL COPS1956674 05/01/2005 05/01/2007 AGGREGATE $ 1,000,000
A CONTRACTOR'S FORM RETENTION
$ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
C~~~K [gI BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW.
[gI CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/ELl WHERE REQUIRED BY WRITTEN CONTRACT.
Re: Operations & Maintenance Sewage Treatment Plant; Project Location: Marathon Government Center; 4796 Overseas Highway; Marathon, FL
33050
Additional Insured in favor of Monroe County Board of Commissioners (on all policies except Workers' Compensation/ELl where and to the extent
reQuired bv written contract.
CERTIFICATE HOLDER: CANCELLATION:
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 COMPANY, ITS AGENTS
OR REPRESENTATIVES. 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
Monroe County AU' '''--. IATIVE: ~-~~
Board of Commissioners
Monroe County Risk Management
PO Box 1026
Key West, ~L 33041-1026
c..c. :~
CERTIFICATE OF INSURANCE Date: (MM/DDIYY)
4/26/2006
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Lockton Companies of Houston NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
5847 San Felipe, Suite 320 AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Houston, Texas 77057 INSURERS AFFORDING COVERAGE
INSURED: Insurer A: American International Specialty Lines Ins. Co.
Synagro South, LLC Insurer B: Liberty Mutual Fire Insurance Co.
4512 Brittmoore Insurer C: Liberty Insurance Corporation
Houston, TX 77041 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 BE EXHAUSTED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
A X OCCURRENCE EG7546806 05/01/2005 08/01/2006 MED EXP (PER PERSON) $ 10,000
X XCU NOT EXCLUDED PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X PROJECT PRODUCTS/COMPo OP. AGG $ 2,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B ANY AUTO AS2-691-437721-015 05/01/2005 05/01/2007 (EACH ACCIDENT)
X 'n ~ ~OnnH: h
ALL OWNED AUTOS J/~
HIRED AUTOS .' DEDUCTIBLE: COLLISION & $ 1,000
x 3'2 -Of
x NON-OWNED AUTOS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION .... r Ej\CH LOSS $ 1,000,000
A LEGAL
EG7546806 05/01/2005 08/01/2006 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE 974-61-68 05/01/2005 08/01/2006 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
C and EMPLOYERS LIABILITY WA7-69D-437721-026 (AOS) 05/01/2006 05/01/2007 EL EACH ACCIDENT $ 1,000,000
C WC7 -691-43 7721-036 (WI) 05/01/2006 05/01/2007
~' 100 ()~ , EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLICY LIMIT $ 1,000,000
-.- -...--..--.-.- .- ,____._ 'Un' --. , "~ 'Oa ------ -"-'-----'" ---- - - - --- -.------.. .
. ,
LEr'':'" ~ ~ },j}-t;. ^ /
PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
A LEGAL - GENERAL COPS1956674 05/01/2005 05/01/2007 AGGREGATE $ 1,000,000
CONTRACTOR'S FORM RETENTION
$ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
CHECK [gJ
BOX BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW.
[gJ CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/ELI WHERE REQUIRED BY WRITTEN CONTRACT.
CERTIFICATE HOLDER: CANCELLATION:
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 COMPANY, ITS AGENTS
OR REPRESENTATIVES. 'EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
Monroe County Florida AU IIAIIVl:.:
Marathon Airport ~-~~
9400 O/S Highway, Suite 200
Marathon, ~
Co C-: !RRl --F:IVED
MAY - 1 2006
il~Y:
CERTIFICATE OF INSURANCE Date: (MMIDDfYY)
5/31/2006
PRODUCER THI.C:: CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION QNL Y AND CONFERS
Lockton Companies of Houst~n W:CCW~D NO IGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
5847 San Felipe, Suite> 320 ! ,<1- L.l ,- AM" D, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Houston, Texas 77057' : ----..!
I ' , INSURERS AFFORDING COVERAGE
, ,
INSURED: , j JUL 24 L005 \ Inslirer A: American International Specialty Lines Ins, Co.
I
Synagro South, LLC I Instlrer B: Liberty Mutual Fire Insurance Co.
4512 Brittmoore Road I L_____________..._._.l InsLlrer C: Liberty Insurance Corporation
r."":"'-;:-"(;':":"''/
Houston, TX 77041 r:',,',,"", ",' n.s.Jrer D:
Insurer E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWITHSTANDING 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 BE EXHAUSTED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABiliTY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
A X OCCURRENCE EG7546806 05/01/2005 08/01/2006 MED EXP (PER PERSON) $ 10,000
X XCU NOT EXCLUDED PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X I PROJECT PRODUCTS/COMPo OP. AGG $ 2,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B ANY AUTO AS2-691-437721-015 05/01/2005 05/01/2006 (EACH ACCIDENT)
X
B ALL OWNED AUTOS AS2-691-437721-016 05/01/2008 05/01/2007
-- DEDUCTIBLE: COLLISION & $ 1,000
X HIRED AUTOS
---
X NON-OWNED AUTDS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
A LEGAL ....--
EG7546806 05/01/2005 08/01/2006 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE 974-61-68 05/01/2005 08/01/2006 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
C and EMPLOYERS LIABILITY WA7-69D-437721-026 (AOS) 05/01/2006 05/01/2007 EL EACH ACCIDENT $ 1,000,000
C WC7-691-437721-036 (WI) 05/01/2006 05/01/2007
, EL DISEASE-EA EMPLOYEE $ 1,000,000
1----- -- --- $
EL DISEASE-POLICY LIMIT 1,000,000
-
PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
LEGAL-GENERAL COPS1956674 05/01/2005 05/01/2007 AGGREGATE $ 1,000,000
A CONTRACTOR'S FORM RETENTlON
$ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
C~6~K ~ BLANKET WAIVER DF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW.
I:gJ CERTIFICATE HOI.DER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/ELI WHERE REQUIRED BY WRITTEN CONTRACT.
Project DescriptIon: wastewaterTrea~a:~rathon Airport, Roth BuildIng, Marathon Government Center, Plantation Key Government Center.
CERTIFICATE HOLDER: U .-1_ "\l. IjJ to CANCELLATION:
I 'f- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
~~TE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS WRITTEN NOTICE
o THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE
61t', ~HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS
'5 REPRESENTATIVES. *EXCEPT 10 DAYS NOTICE FOR NON.PAYMENT.
Monroe County Board of County Commissioners AUTHlJRlZED REt'KtoM,NTATIVE:
3583 South RDosevelt Boulevard a~~ ~-,,>-r;<~>-
Key West, FL 33040
/.
c.c.: "4. . O'''A/\ (. , ,", 7,
~
{6~ ,,-H ^ /%.l~
;r ()u)~.D
35
CERTIFICATE OF INSURANCE Date: (MM/DDIYY)
7/31/2006
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION QNL Y AND CONFERS
Lockton Companies of Houston ;'---"""'~" ~.,,_.._-.,"~._-- ~LRIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
I '.-... "'-f" r'" ,'-
5847 San Felipe, Suite 320 : h:-:'l-il"D AMI=NO, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
Houston, Texas 77057 l L''';,_i 'Ii L :
, ,.---------, ! INSURERS AFFORDING COVERAGE
INSURED: I AUG 4 :T-; Insurer A: American International Specialty Lines Ins. Co.
, ,
, In:surer B: Liberty Mutual Fire Insurance Co.
i :o..----______--.J
Synagro South, LLC In surer C: Liberty Insurance Corporation
4512 Brittmoore Road ,
I MrNRGE COUNTY
Houston, TX 77041 l P,1~~~,iMl!1,G~MENT In surer D:
nsurer 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 BE EXHAUSTED BY PAID CLAIMS
INSR TYPE OF INSURANCE r POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $ 1,000,000
A X OCCURRENCE EG 7040963 08/01/2006 11/01/2007 MED EXP (PER PERSON) $ 10,000
X XCU NOT EXCLUDED PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X IPROJECT PRODUCTS/COMPo OP. AGG $ 2,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
B ANY AUTO AS2-691-437721-015 05/01/2005 05/01/2006 (EACH ACCIDENT)
X
B ALL OWNED AUTOS AS2-691-437721-016 05/0112006 05/0112007
X HIRED AUTOS DEDUCTIBLE: COLLISION & $ 1,000
X NON-OWNED AUTOS OTHER THAN COLLISION $ 1,000
POLLUTION & REMEDIATION EACH LOSS $ 1,000,000
A LEGAL
EG 7040963 08/01/2006 11/01/2007 TOTAL ALL LOSSES $ 1,000,000
RETENTION - EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X OCCURRENCE BE 974-62-22 08/0112006 11/01/2007 AGGREGATE $ 5,000,000
CLAIMS MADE RETENTION $ 10,000
WORKERS' COMPENSATION WORKERS' COMPENSATION STATUTORY
C and EMPLOYERS LIABILITY WA7-69D-437721-026 (AOS) 05/01/2006 05/01/2007 EL EACH ACCIDENT $ 1,000,000
C WC7-691-437721-036 (WI) 05/01/2006 05/01/2007
EL DISEASE-EA EMPLOYEE $ 1,000,000
EL DISEASE-POLICY LIMIT $ 1,000,000
PROFESSIONAL & POLLUTION EACH CLAIM $ 1,000,000
A LEGAL - GENERAL COPS1956674 05/01/2005 05/01/2007 AGGREGATE $ 1,000,000
CONTRACTOR'S FORM RETENTION $ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHIClESfEXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS:
CHECK ~ "_..
BOX BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE eY LAW,
~ CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE REQUIRED BY WRITTEN CONTRACT.
Project Description: Wastewater Treatment Plants, Re: 4 Locations: Marathon Airport, Roth Building, Marathon Government Center, Plantation Key Government Center.
,,^ r
CERTIFICATE HOLDER: III, \/1.- . fL . CANCELLATION:
SJ- 1 -() r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITIEN NOTICE
- Te-::rtlE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE
'f SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS
q.~REPRESENTATIVES. .EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
Monroe County Board of County Commissioners % ._(Qy~ AU I REPI 'AlIV":
3583 South Roosevelt Boulevard c:5-.--=>-~
Key West, FL 33040 C C 'kJ;k
Cc. " ~I't')~"C~ "t-. /
CERTIFICATE OF INSURANCE
Date: (MM/DDIYY)
4/30/2007
PRODUCER
Lockton Companies. LLC
5847 San Felipe, Suite 320
Houston, Texas 77057
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.
INSURED:
Insurer A:
Insurer B:
Insurer C:
Insurer D:
Insurer E:
INSURERS AFFORDING COVERAGE
American International Specialty Lines Ins. Co.
Liberty Mutual Fire Insurance Co.
Liberty Insurance Corporation
Synagro South, LLC
1002 Village Square, Suite C
Tomball, TX 77375
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 BE EXHAUSTED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS
LTR DATE
GENERAL L1ABILl'rv EACH OCCURRENCE $ 1,000,000
X COMMERCiAL GEN ERAL LIABiliTY FIRE DAMAGE (ANYONE FIRE) $ 1,000,000
A X OCCURRENCE EG 7171054 08/01/2006 11/01/2007 MED EXP (PER PERSON) $ 10,000
X XCU NOT EXCLUDED PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X I PROJECT PRODUCTS/COMPo OP. AGG $ 2,000,000
B AUTOMOBILE L1AIlILITY AS2-691-437721-017 05/01/2007 05/01/2008 COMBINED SINGLE LIMIT $ 2,000,000
X ANY AUTO (EACH ACCIDENT)
ALL OWNED AUTOS Y'i -~-~k
X HIRED AUTOS "_.'. DEDUCTIBLE: COLLISION & $ 1,000
X NON-OWNED AUTOS S-n Q j OTHER THAN COLLISION $ 1,000
'-.-
POLLUTION & REMEDIATION T' EACH LOSS $ 1,000,000
A LEGAL -'__u
EG 7171054 08/01/2006 11/01/2007 TOTAL ALL lOSSES $ 1,000,000
RETENTION EACH LOSS $ 250,000
EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 5,000,000
A X 10CCURRENCE BE 974-62-22 08/01/2006 11/01/2007 AGGREGATE $ 5,000,000
ICLAIMS MADE RETENTION $ 10,000
WORKERS' COMPE,NSATION WORKERS' COMPENSATION STATUTORY
C and EMPLOYERS LIABILITY WA7-69D-437721-027 (AOS) 05/01/2007 05/01/2008 El EACH ACCIDENT $ 1,000,000
C WC7-691-437721-Q37 (WI & OR) 05/01/2007 05/01/2008
I EL DISEASE-EA EMPLOYEE $ 1,000.000
I I EL DISEASE-POLICY LIMIT $ i ,000,000
+
I
PROFESSIONAL & I'OLLUTION EACH CLAIM $ 1,000.000
A LEGAL - GENERAL COPS2334591 05/01/2007 05/01/2009 AGGREGATE $ 1,000,000
CONTRACTOR'S FORM RETENTION $ 100,000
REMARKS: DESCRIPTION OF OPERATIONS/lOCATIONSNEHICLES/EXClUSIONS ADDED BY ENDORSEMENT PROVISIONS:
CHECK K7l
BOX L::::::::.l BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW.
k8J CERTIFICATE HOLDIE:R IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE REQUIRED BY WRITTEN CONTRACT.
Project Description: Wastewater Treatment Plants. Re: 4 Locations: Marathon Airport, Roth Building, Marathon Govemment Center, Plantation Key Govemment
Center.
CERTIFICATE HOLDE'R:
CANCELLATION:
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 COMPANY, ITS AGENTS
OR REPRESENTATIVES. -EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT.
Monroe County Board of County Commissioners
3583 South Roosevelt Boulevard
Key West, FL 33040
IAU'
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<:5-,- ."..,r-; < <-
>--
CERTIFICATE OF INSURANCE llaI8:
(MMlDDIYY)
412912008
CER THIS CERTIFICATE IS ISSUED AS A MATTeR OF INFORMATlON ONLY AND CONfERS
L.ockIon Cornpenleo, LLC NO RIGHTS UPON THE CERTFICATE HOLDeR. 11-118 CERTtFlCATE DOES NOT
'47 s.n FeIpe, Sub 320 AMEND. !XT!ND OR o\LT!R THe: COV!RAGI! AP'I'()ftD!D BY THE POLICII!S 1!I!laN.
_. T_ 77OIl7
INSURERS AFFORDING COVERAGE
INIURED: Insurer A: Amerlc8n Internationel SpeclllltY Lines Ins. Co.
Insurer B: Uberty Mutual Fire Insurance Co.
s_ Sout1. LLC Insurer C: Uberty Insurance Corporatlon
1D02111bge~. _ C
Tombell, TX 77375 Insurer 0:
Insurer E:
11iE POLICIE8 OF I8.JftIlNCE LI8n!D IILOW HAY! BEEN I8IUID TO THe: If8IAID JMM!D AllOY! FOR THE POLICY PERIOD INDICATED. N01WITH8TNONG NI'(
REOUIN!MI!!Nr. TERM OR lXJNDmON OF Ntr CONTRACT OR OTH!A DCICUM!NT WITH N8P!CT TO WHICH THIS CIR11FICATe MAY IE 8ItA!D OR MAY PERTAIN. THE
I8.IWlICE AFFORDED BY 11E PCUCE8 DESC ~ HER9IIS 8IJBJECf TO AU.. THE TERMS. EXa.uIJICllI8 /IIID COMltlJNS OF SUCH POl.lCES. NJGRe~TE UMlTI
Y IV PAIOCU ..
i.TR TYPE Of _URANCE POUCY NUMBER IPPICTMI DATI DATE UMITB
GEN"...... UMlLITY EACH OCCURRENCE $ 1,000,000
X ~.1I11C1Al GENeRAL lIMLrIY FIREDAMAG-, $ 1,000,000
A x """""""" EG 6ol307118 1110112007 05I0112OOll M-=ua:XPl,._wJ. .01} $ 10,000
X xcu NOTIXCLUCEI> PERSOIW.&ADVtlJURY $ 1,000,000
GIN'L~TI LMT APPLID....: GENERAl AGGREGATE $ 2.000,000
X IPAOJECT PROOUCTSICOMP.ClPAGG $ 2.000,000
B r- ._Cl8ILE ~UTY __..am..()lI 0510'1200I 05I0112OOll COMBINED SINGLE L""IT $ 2,000,000
X ""AUTO L.bDl.\( 11/;> (EACIW:CIlI!Hf)
AU OWNI!DAUTOS )
X ....., AUTOS "" I' DEDUCTI_:_lONl $ 1.000
.. .
X _AUTOS . ( -I( - j II\' OTIER1HANCOLUlION $ 1,000
POLWTION & _EDlATION . i. EACH LOSS $ 1,000,000
A LEGAL (J'r;7 .
EG s.30758 .ll6Ioll:iDOO TOTAl AU. L088ES $ 1,000,000
[il):~:. RETENTION -EACH LOSS $ 250,000
I!XCI!8S UABILlTYIUIIBMLLA U CC , J.<.Xl EACH OCCURRENCE $ 5.000,000
A x 10CCUIUlENCE BE~ 1110112007 If:;~ AGGREGATE $ 5.000,000
ICUlIIIMADE :::Ii) t/lh t RETeNTION $ 10.000
-q'COM_..ON WORKERS' COMPENSATION STATUTORY
C .nd EIIPLOYI!Il8 UAIIILITY WA7_m1-<l2ll lAOS) llMl112OO1 05I0.12OOf/ $ 1,000,000
WC7.eG1-43ml.()3B (WI) 0I/0'/2OOB llM)11:iDOO EL EACH ACCIDENT
C EL OISEASE-a EMPLOYEE $ 1,000,000
EL DISEASE-POLICY lIMIT $ 1,000,000
PROFEIIlONAI. & POLLUTION EACH CLAIM $ 1.000,000
A LEGAL . GEIIEIIAL CClPS23_ OMJ112OO7 O5IOll:iDOO AGGREGATE $ 1,000,000
CONTRACTClR'S FOIUI RETENTION $ 100 000
..EMARKB: DESCRPTION OF OPERATIONSILOCATION&NEHICLESIEXCLUSlON8 ADDED 8Y ENDORSEMENT PROIII8I0N8:
-iDx...... ~ ~w__ Of IUlJlDClAllOfiI"lIIWITID. 'AVOIIOf'~n HDLDIII ON AlL POUCIDWHIM~... vwurretlCOIrfnW:T....,.........., IIY LAW.
~ CMTIPICATE HOI.DB'. N-.J AI AN ADDn1DIML~ IUCIPT FOIl....... CCJWa.)"'" UCIUIUD.Y WIIfT1UCOIiI'I'MCT.
lie: Project Du_ I-'a: 0pef6n .....6.. T' h. .. ,,............... LooIIfon: Mer Wee&, FL. ..........1Mt.tNd In fevorof...... Countr
...... oIc.u.tr ~ (.. II....... .......... C.l........ &).....,..... br.,............ ""......... ~ to....,......
-=--. --.....In....c..-...oI..............~,..,.....,.. bribe ......1..UNCI.."....,....non4...........,.1IO .,.,.I......COWNII,..".......
....-----
CERTIFICATE HOLDER: .lCANCELLATION:
:~ _11ON
01\1'2:,....". lH! IIIUING....,. WILL I!ND!AVOft TO MAL 3D"' D\YlWRfTTEN NOTICE
TO ntI!! CEllTPlCAn HOLDIA NMEDT01'JoE LEFT. BUTFALUAE TO AWL SUCH NOTICE
.w..LIW'08EN00BL.ItM11OMORLlAlNl..n'YOF AHV KJC)LI'ONTHE aJItiIINN,IT8AQENT8
OR RlPfEl&NTATIYD. ......, 'It DAYS IKmCE FOIl........v.NT.
- of County Cornm__ at Monroe County, FlorId. -- .. .~..._: ~-"""-:'<:r
PublIc F_.. .....,'"-,..._
31183 South "-t aou_rd
KoyWOOL FL 33040