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Certificates of Insurance PRODUCER .......... . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Johnson & Higgins of GA Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 191 Peachtree Street, NE, Suite 3400 ~~i.P~'iH~H~~.;:~:JC:l:o~g~~ :~~'1M~~Bb~~~oC: Atlanta, GA 30303 . Tel. No. (404) 586-0000 COMPANIES AFFORDING COVERAGE COMPANY A Federal Insurance Company INSURED The Salvation Army 1424 N.E. Expressway Atlanta, GA 30329 COMPANY B COMPANY C COMPANY D ::atI_II:IIII:~:t:::IIII~~:tttiII:ti:t::~II::::i:::::::::::::::I::::~:::::::::::::IIII::::::::::::::II~:ii:t:::i:~:I::::~t:::~~i:~::::::::Ii:::::::::::~:::~~::~I~::::::~:::i:~::I::Iiii::i::I::::::m::~i::::::i:::~::~~::~t:~:~~mtt~:::tt:I::::III:tttt:II::::::::::::::::::::::i:::I::~t:~:iI::i:tt:::Ii::tt:::i:I::i:~:::::::i:::i::::t::i:ttt:::::::::::::IIiII THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOlWITHSTAND1NG 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. AUTOMOBILE LIABILITY ANY AUTO AlL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-owNED AUTOS POLICY EFFECTIVE POLICY EXPIRAnON LIMITS DATE (MMIDD/VY) DATE (MMIDDIYY) GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ PERSONAL & ADV INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ MED EX? (Any one person) $ COMBINED SINGLE LIMIT $ BODILY INJURY $ (Per person) BODILY INJURY $ (per accident) PROPERTY DAMAGE $ AUTO ONLY. EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ $ STATUTORY LIMITS EACH ACCIDENT $ DISEASE, POLICY LIMIT $ DISEASE - EACH EMPLOYEE $ 10/01/95 CON- EMPLOYEE DISHONESIY TlNUOUS $500,000 CO LTR TYPE OF INSURANCE POLICY NUMBER GENERAL UASILlTY COMMERCIAL GENERAL UABILliY CLAIMS MADE 0 OCCUR OWNER'S & CONTRACTOR'S PROT hi, GARAGE UASILlTY ANY AUTO EXCESS UABILliY UMBRELlA FORM OTHER THAN UMBRELlA FORM WORKERS COMPENSAnON AND EMPLOYERS' UASILlTY THE PROPRIETOR/ PARTNERSlEXECUTlVE OFFICERS ARE: A OTHER COMMERCIAL CRIME INCL EXCL 8058-49-38H DESCRIPnON OF OPERAnONSILOCAnONSNEHICLESfSPECIAL ITEMS (LIMITS MAY HAVE BEEN REDUCED BY PAID CLAIMS AND MAY HAVE DEDUCnBLES OR RETENnONS) The Salvation Army Key West, FL Correctional Services Client Fees - Misdemeanant Probation ~tl.f'1.~1$)!q4P$~:: .. The "COUNTY" MONROE COUNTY Key West, FL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . ................................. .................. .................................................. ....... ............................... ....... .................... . .. ............... . --...... ..... ... ..................... ..................... ..................... ..................... ..................... ..................... ..................... ..................... ..................... ..... .............. b.ANcSlliAndN~~~ ........................................................................... .................. ....... . . . . . . . . . . . . . . . . . . . .................. .......... ............... .... ..,................,........ ........................ ....................... BOARD OF COUNTY COMMISSIONERS 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAnON DATE THEREOF, THE ISSUING COMPANY WI~-l::NDEAVOR TO MAIL ....2Q... DAYS ~RmeN NonCE TO THE CERnFICATE HOLDER NA-NED TO THE LEFT. BUT FAILURE io MAIL SUCH NonCE SHALL OSE NO OBLlGAnON OR UABILliY n . OF ANY KIND UPONl TH OR REPRESENTAnVES. AUTHORIZED REPRESENTA"lW ._"A-..--- Cerllltcate ot Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND. OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. This is to Certify that THE SALVATION ARMY 1424 NORTHEAST EXPRESSWAY ATLAl'i1'A, GA 30329 Name and address of Insured LIBERTI r. MUTUALt}I is. at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance aHorded by the listed policy(ies) is subject to all their terms, exclusions and conditions and is not altered by any requirement, term or condition of an contract or other document with reseect to which this certificate ma be issued. ERTlFICATE EXP. OATE TYPE OF POLICY . 0 CONTINUOUS POLICY NUMBER LIMIT OF LIABILITY o EXTENDED m POLICY TERM 10/01/98 WA 1-650-004052-278 Bodily Injury By Accident Eadl 1,000,000 Accid8rt Bodily Injury By Disease Policy 1,000,000 Limrt Bodily Injury By Disease Eadl 1.000,000 Per.;cn General Aggregate-Olt1er than Prod/Completed Operations $5,000,000 Products/Completed Operations Aggregate $500,000 Bodily Injury and Property Damage Uability $500,000 Personal and Advertising Injury $500.000 Other: Coverage AlIorded Under WC Law of the FoUowing Slales: AL.AR.DC.FL,GA.KY.LA. MD,MS,OK,NC.SC.TN.TX va EMPLOYERS LIABILITY WORKERS COMPENSATION GENERAL LIABILITY o CLAIMS MADE I RETRO DA TE IKJ OCCURRENCE 10/01/98 RG2-651-004052-287 Per Occurrence Per Person! Organization Olt1er: AUTOMOBILE UABILITY IKJ OWNED [[] NON-OWNED [[] HIRED 10/01/98 AS2-651-004052-297 $500,000 Each Accident - Single Umit - B. I. and P. D. Combined Each Person pv , , Each Accident or Occurrence '1\TE Each Acciclent or Occurrence OTHER Via "int NfA ~ VF.~ r ADDITIONAL COMMENTS: Insured is self insured for Physical Damage Coverage The Salvation Army Key West, Fl Correctional Services Client Fees - Misdemeanant Probation -IF THE CERTIFiCATE EXPIRATION DATE is CONTINUOUS OR EXTENDED TERM. YOU WILL BE NOTIFIED IF COVERAGE IS TERMINATED OR REDUCED BEFORE THE CERTIFICATE EXPIRATION DATE. HOWEVER. YOU WIU NOT BE NOTIFIED ANNUAU Y OF THE CONTINUATION OF COVERAGE. SPECIAL NOTICE. OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER. SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT,& CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL UNTUHEAST 30 DAYS NOTICE OF SUCH CANCELLAmN HAS BEEN MAUD TO . _'\ . Chief Judge ~ . ~ ~ CERTIFICATE Sixteeneth Judicial Circuit AUTHORIZED REPRESENTATIVE HOLDER 500 Whitehead Street Linda F. Childs Key West, Fl 33040 Liberty Mutual Insurance Group ThiS cer1!1,cate IS executed by LIBERTY MUTUAL !NSURANCE GROUP as reseedS such ,nSt;r INITIAL 10;01/97 ATE ISSUED NORCROSS OFFICE 85 7i"2R6 ,I Certificate of Insurance T~IS CERTIFICATE IS ISSUED AS A MATTER OF rNFORMATION ONLY AND CONFERS NO RIGHTS UPON YOLi CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND roES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. This Is to Certify that I THE SALVA nON AFMY 1424 NORTHEAST EXPRESSWAY ATLANTA, GEORGIA 30329 I ~ Liberty, ~ MutuaLM Name and ~- address of Insured. L _J Is, a~ t'le issue date of this certfficate, insurad by the Company under the policy(ies) listed below. The insurance afforded by the listed policy[les) is su:Jject to an their terms, exclusions a,1d conti;t;C:1S and is rot alteRd by any requirement, term or condition of any contract or other dorAlment with respect to which this certificate may be issue,:. EXP. DP.TE * D CONTI:~UOUS TYPE OF . Olley [l EXTENt.:!) POLlCY"lUMBER LIMIT OF L1ABlLlTY n' POLICY TERM WORKERS 10101/2001 WAI-C5D-OCut052-270 COVERAGE AFFORDED UNDER 'NC EMPLOYERS LIABILITY COMPENSATION LAW OF THE FOLLO,^11~G STATES: Bodily Injury By Accident AL AR DC FL GA KY LA MD $1,000,000 Each MS NC OK SC TN TX VA Accident Bodily Injury By Di;.;ease $1,000,000 perley Umit Bodily Injury By Disease $1,000,000 ~~~ GENEf~L LIABILITY 10/0112001 RG2-651-004052-280 General Aggregate - Other than Products/Completed Operations $5,000,000 ~ OCCURRENCE Products/Completed Operations Aggregate , ~ . ~500,000 D CLAIMS MADE ~'Ullo D(u . Bodily Injury and Property Damage Liability Per ';~~^,COO Occurrence J'\.L~--~-7 Personal Injury IRETRO DATE II Pel" Person! $500,000 Organization 1,#, :\lrp. ~,~ ' vrS lother '.." ,. G1iiiLJ;J , , W:V AUTOMOBILE L1ABILlT y , 10101/2001 AS2-651-004052-290 $500,000 Each Accident - Single Limit B.1. and P.O. Combined ~ OWNED Garage Coverage Form Each Person ~ L /,~ Each Accident or Occurrence NON-OWNED ~/. ~ HIRED Each Accident or Occurrence , OTHER Customer is self Insured for Physical Damage ADDITIONAL COMMENTS LISTED AS ADDITIONAL INSUREDS AS THEIR INTEREST MAY APPEAR: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, 5100 COLLEGE RD., KEY WEST, FL 33040 . If the certificate expiration date is continuous or extended term, you will be notified if covel"age is terminated or reduced before the certificate expiration date. SPECIAL NOTlCE.oHIO: A/f'( PERSON Vl.tiO, IMTH INTENT TO DEFRAUD OR KNOIMNG THAT HE IS FACIUTATING A FRAUO AGAINST AN INSURER, SUBMITS AN APPUCATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD. IMPORTANT NOTICE TO FLORIDA POUCYHOLDERS AND CERTIFICATE HOLDERS: IN THE EVENT YOU HAVE A/f'( QUESTIONS OR NEED INFORMATION ABOUT THIS CERTIFICATE FOR A/f'( REASON, PLEASE CONTACT YOUR LOCAL SALES PRODUCER, WHOSE NAME AHD TELEP NUMBER APPEARS IN THE Liberty Mutual Group LOWER RIGHT HAND CORNER OF THIS CERTIFICATE. THE APPROPRIATE LOCAL SALES OFFICE MAIUNG ADORESS MAY ALSO TAINED BY CALLING THIS NUMBER NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STA D TION DATE THE caMP CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POUCIES UNTIL AT LEAST 30 . I 5651 A~ Monroe County Board of County Comm. CERTIFICATE HOLDER 5100 College Road Room 203 L!..ey West, FL 33040 , LIn a F. Childs AUTHORIZED REPRESENTATIVE Norcross, GA (770) 564-0400 OFFICE PHONE NUMBER 8/1/2001 --.J DATE ISSUED BS 772L R2 This certificate is executed by LIBERTY MUTUAL GROUP as respects such insurance as is afforded by Those Companies ACORD,y CERTIFICATE OF LIABILITY INSURANCE 110 Mf)tYf'D1YY1 PRODUCER (330) 896-9777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CHESTERFIELD INSURANCE AGENCY. INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR .~y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. BOX 237 i GREEN, OH 44232-0237 i INSURERS AFFORDING COVERAGE . I , INSURED INSURER A: ZURICH AMERICAN INSURANCE CO. THE SALVATION ARMY, A GEORGIA CORP INSURER B: THE SALVATION ARMY LIABILITY RISK TRUST 1424 NORTHEAST EXPRESSWAY INSURER C: THE SALVATION ARMY, A GEORGIA CORP. A TLANT A, GA 30329-2088 I INSURER D: AMERICAN ZURICH INSURANCE COMPANY I I 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 OFSUCH , POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. !1~i:1 TYPE OF INSURANCE ! POLICY NUMBER I POLICY EFFECTIVE POLICY EXPIRATION I LIMITS i , , 500,000 ~ERAL LIABILITY EACH OCCURRENCE IS C : X 1 COMMERCIAL GENERAL LIABILITY SELF INSURED 10/01/01 10/01/02 ARE DAMAGE (Anyone fire) Is 500 000 r-~ [J RETENTION I s 5,000 ~ CLAIMS MADE : OCCUR MEO EXP (Anyone p.",on) PERSONAL & ADV INJURY I s 500.000 ~ I s 1 : GENERAL AGGREGATE 500,000 ~'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COM PlOP AGG I s 500,000 : I POLICY n ~:!?T Ii LOC I ! ~OMOBILE LIABILITY I COMBINED SINGLE LIMIT Is 100,000 A W ANY AUTO BAP 9300525-00 I 10/01/01 10/01/02 (Ea accident) ! U ALL OWNED AUTOS A ~UAN~GEMENT BODILY INJURY ! I 's ! ' i SCHEDULED AUTOS (Per person) I iXl HIRED AUTOS BY 1\111 A hd) BODILY INJURY Is !Xl NON-0WNED AUTOS '....\~r(J ~ (Per accident) il I DATE ~ PROPERTY DAMAGE I s ,- (Per aced.,,!) , I H'~~ I GARAGE LIABILITY I nrUy"" 1'1''''- I AUTO ONLY - EA ACCIDENT I $ 1,000,000 A ~ ANY AUTO GKL 9300883-00 10/01/01 10/01/01 OTHER THAN EAACC I $ X, AUTO DEALERS AUTO ONLY: AGG 1$ ~ESS LIABILITY EACH OCCURRENCE Is 2.000,000 I B ~I OCCUR 0 CLAIMS MADE TRUST #19578500 10/01/01 10/01/02 AGGREGATE I s Is ~ DEDUCTIBLE Is ! X RETENTION $ 500,000 1$ : A WORKERS COMPENSATION AND WC 9300799-00 10/01/01 10/01102 X I T~~I~J#s I IOJ~-1 EMPLOYERS' LIABILITY E.L EACH ACCIDENT 1$ 500,000 E.L DISEASE - EA EMPLOYES $ 500,000 E.L DISEASE - POLICY LIMIT ! s 500,000 I OTHER I I I I C AUTO LIABILITY EXCESS SELF INSURED 10/01/01 10/01/02 $400.000 XS OF $100,000 , RETENTION I I : i I I DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS THE SALVATION ARMY CORRECTIONAL SERVICES - MONROE COUNTY , FL MISDEMEANANT PROBATION : CLIENT FEES KEY WEST, FL also listed as additional insureds: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ; CERTIFICA TE HOLDER I ADDIT10NAL INSURED; INSURER LETTeR: CA NCELLA TION BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY 310 FLEMING KEY WEST, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEu.ED BEFORE THE EXPIRATION DATE TIlEREOF, TIlE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO TIlE CERTIFICATE HOLDER NAMED TO TIlE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTA 7<J 19 ACORD CORPORATION 1988 ACORD 25-5 (7/97) I ACORD'M CERTIFICATE OF LIABILITY INSURANCE 110 !tt f ftrfDDIYY) , PRODUCER (330) 896-9777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CHESTERFIELD INSURANCE AGENCY, INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. p, O. BOX 237 GREEN,OH 44232-0237 INSURERS AFFORDING COVERAGE INSURED INSURER A: ZURICH AMERICAN INSURANCE CO. THE SALVATION ARMY, A GEORGIA CORP INSURER B: THE SALVATION ARMY LIABILITY RISK TRUST 1424 NORTHEAST EXPRESSWAY INSURER c: THE SALVATION ARMY, A GEORGIA CORP. A TLANT A, GA 30329-2088 INSURER D: AMERICAN ZURICH INSURANCE COMPANY I INSURER E: COVERAGES I THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING I 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 I POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. !I~~ TYPE OF INSURANCE POLICY NUMBER I POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE S 500,000 C !Xl COMMERCIAL GENERAL LIABILITY SELF INSURED 10/01/01 10/01/02 FIRE DAMAGE (Anyone fire) S 500,000 I CLAIMS MADE 0 OCCUR RETENTION MED EXP (Anyone person) S 5,000 0 PERSONAL & ADV INJURY !s 500 000 GENERAL AGGREGATE S 500,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG I s 500,000 II POLICY n ~rg 'n LOC I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 100,000 - s A L ANY AUTO BAP 9300525-00 10/1 1/01 10/01/02 (Ea accident) - ALLpWNED AUTOS AP~{ YJjw ~caJ. BODILY INJURY $ SCHEDULED AUTOS (Per person) - BY t L HIRED AUTOS (JL___M 1 BODILY INJURY $ L NON-OWNED AUTOS DATE . (Per accident) - WAIVER '/ PROPERTY DAMAGE 1$ (Per accident) ~AGE LIABILITY AUTO ONLY - EA ACCIDENT $ 1,000,000 A ANY AUTO GKL 9300883-00 10/01/01 10/01/01 OTHER THAN EA ACC $ , I X AUTO DEALERS AUTO ONLY: AGG I S EXCESS LIABILITY EACH OCCURRENCE 1$ 2,000,000 B JSJ OCCUR 0 CLAIMS MADE TRUST #19578500 10/01/01 10/01/02 AGGREGATE $ $ ~ DEDUCTIBLE S X RETENTION $ 500,000 s i WORKERS COMPENSATION AND I X I WC STATU-; I IOTH- A WC 9300799-00 10/01/01 I 10/01/02 TORY LIMITS ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 500,000 , 500,000 E.L. DISEASE - EA EMPLOYEEI s , E.L. DISEASE - POLICY LIMIT I $ 500,000 ! OTH ER i C AUTO LIABILITY EXCESS SELF INSURED 10/01/01 10/01/02 $400,000 XS OF $100,000 I I RETENTION I DESCRIPTION OF OPERATIONS/LOCATlONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS THE SALVATION ARMY CORRECTIONAL SERVICES - MONROE COUNTY , FL MISDEMEANANT PROBATION CLIENT FEES KEY WEST, FL , also listed as additional insureds: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CERTIFICA TE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN 310 FLEMING NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL KEY WEST, FL 33040 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. .. AUTHORIZED REPRESENT~~ Jifft. '-Lh '/~, .. ~..~ '...~... I - . ACORD 25-S (7/97) @ACORD CORPORATION 1988 ACORQ. CERTIFICATE OF LIABILITY INSURANCE 1 0 /~Ali<52DDNY) PRODUCER (330) 896-9777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CHESTERFIELD INSURANCE AGENCY, INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. BOX 237 GREEN, OH 44232-0237 INSURERS AFFORDING COVERAGE INSURED INSURER A: ZURICH AMERICAN INSURANCE COMPANY THE SALVATION ARMY, A GEORGIA CORP. INSURER B: THE SALVATION ARMY LIABILITY RISK TRUST 1424 NORTHEAST EXPRESSWAY INSURER c: THE SALVATION ARMY, A GEORGIA CORP. A TLANT A, GA 30329-2088 INSURER D: AMERICAN ZURICH INSURANCE COMPANY I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I~~~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS ~NERAL LIABILITY EACH OCCURRENCE $ 500,000 C X COMMERCIAL GENERAL LIABILITY SELF INSURED 10/01/02 10/01/03 FIRE DAMAGE (Anyone fire) $ 500,000 l CLAIMS MADE D OCCUR RETENTION MED EXP (Anyone person) $ 5,000 - PERSONAL & ADV INJURY $ 500 000 -~._--_. - GENERAL AGGREGATE $ 500,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COM PlOP AGG $ 500,000 h POLICY n P,~,9T n LOC ~OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 100,000 A -.X ANY AUTO BAP 9300525-01 AG ~U~2 10/01/03 (Ea accidenf) ~p~~l'''^' - ALL OWNED AUTOS BODILY INJURY J1_.._~' $ SCHEDULED AUTOS (Per person) - .~~ -.X HIRED AUTOS BV 0"'\ \D\~ {j. ..-- J4," BODILY INJURY $ L NON-OWNED AUTOS (Per accident) OA:~.::-'-"~IA~: '~C E.S PROPERTY DAMAGE $ ~^; (Per accident) =rAGE LIABILITY ~ UV~7 , . '4J4? AUTO ONLY - EA ACCIDENT $ ANY AUTO C V ' EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ 2,000,000 B ~ OCCUR D CLAIMS MADE TRUST #1957850 10/01/02 10/01/03 AGGREGATE $ 2,000,000 $ ~ DEDUCTIBLE $ X RETENTION $ 500,000 $ WORKERS COMPENSATION AND X I WC STATU- I IOTH- A WC 9300799-01 10/01/02 10/01/03 TORY L1M ITS ER EMPLOYERS' LIABILITY E.L EACH ACCIDENT $ 500,000 EL DISEASE ~ EA EMPLOYEE $ 500,000 E,L, DISEASE. POLICY LIMIT $ 500,000 OTHER C AUTO LIABILITY EXCESS SELF INSURED 10/01/02 10/01/03 $400,000 XS OF $100,000 RETENTION DESCRIPTION OF OPERATIONSlLOCATIONSlVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS c:. 0 f..)~ : ~. ""' C4.1'1 Co (... The Salvation Army Key West,FL COURT PROBATIONERS SERVICES ALSO LISTED AS ADDITIONAL INSUREDS: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION MONROE COUNTY BOARD OF COUNTY COMMISSIONERS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Monroe County Risk Management DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West, FL 33040 REPRESENTATIVES. I AUTHORIZED REPRESENTATIVE ~~ ~ ACORD 25-S (7/97) LiUf-C~ @ ACORD CORPORATION 1988 PRODUCER (330) 896-9777 ACORD CERTIFICATE OF LIABILITY INSURANCE CHESTERFIELD INSURANCE AGENCY, INC. P. O. BOX 237 GREEN, OH 44232-0237 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE THE SALVATION ARMY, A GEORGIA CORP. 1424 NORTHEAST EXPRESSWAY A TLANT A, GA 30329-2088 INSURER A: INSURER B: INSURER C: INSURER D: INSURER E: INSURED . THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ~ TYPE OF INSURANCE POLICY NUMBER "~l'+~T/MM/DDIYY\ DATE (MM/DDlY'il LIMITS ~ERAL LIABILITY EACH OCCURRENCE $ 500,000 C X COMMERCIAL GENERAL LIABILITY SELF INSURED 10/01/03 10/01/04 FIRE DAMAGE (Anyone fire) $ 500,000 I CLAIMS MADE I X i OCCUR RETENTION MED EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $ 500,000 - - GENERAL AGGREGATE $ 500,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 500,000 I n PRO- nLOC POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 100,000 >-- BAP 9300525-02 10/01/03 10/01/04 $ A ~ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY f-- $ SCHEDULED AUTOS (Per person) - X HIRED AUTOS BODILY INJURY X $ NON-OWNED AUTOS (Per accident) - - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ==1 ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ 2,000,000 B o OCCUR D CLAIMS MADE TRUST #1957850 10/01/03 10/01/04 AGGREGATE $ 2,000,000 $ ~ DEDUCTIBLE $ RETENTION $ 500,000 $ A WORKERS COMPENSATION AND WC 9300799-02 10/01/03 10/01/04 X I TORY LIMITS I IUE~- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE. EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER C AUTO LIABILITY EXCESS SELF INSURED 10/01/03 10/01/04 $400,000 XS OF $100,000 RETENTION 1\ r" DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 0Ii({J:Jt The Salvation Army Key West, FL - COURT PROBATIONE:~~~::~MENi Cc DAre ------~~ '0f ,... '\'~'" ,,/\ Vi=C: CERTIFICA TE HOLDER I T ADDITIONAL INSURED; INSURER LETTER: CANCEL:L"'ATION also listed additional insureds: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION as 30 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN Monroe County Board of County - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Commissioners IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 Simonton Street REPRESENTATIVES. Key West, FL 33040 AUTHORIZED REPRESENTATIVE ~#il~ I 25-5 (7/97) (ji) ,I IV"" 1988 COVERAGES I . r:::C'~~"""/~~ cl b '-Y PRODUCER ACORDTII CERTIFICATE OF LIABILITY INSURANCE (330) 896-9777 o tt1f f!CfBfVY) THE SALVATION ARMY, A GEORGIA CORP. 1424 NORTHEAST EXPRESSWAY ATLANTA, GA 30329-2088 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. I INSURERS AFFORDING COVERAGE_ ____ --- -- ----"1-----.-----..------ _____..~_._______.__ "_______ _ : Jf'lSU~R_A_~1L8ICI_!~MERICAI\Jj/'J~,_c::_9_"_, __ __., '_,. t-'-N~URER~.IH E_ SAL.\.I. A TIQJ.! ~Fi.I\1.Y _~I~I<: TFi.LLST : INSURERC:.JH~_~,~~Y~TION .!'-_R f\IIY , A. GA..fQRf'.- ~-;~ER~M~RICA/'.J_?;l-LRIQf_l_'t'_JS. QQ. _ INSURER E: NAIC# 16535 CHESTERFIELD INSURANCE AGENCY, INC. P. O. BOX 237 GREEN, OH 44232-0237 INSURED COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN~-DD'-9- ------------,- POLICY NUMBER POLlCYEFFECTI~POLICYEXPIRA1..iON!---- ___ 40142 C GENERAL LIABILITY I){ COMMERCIAL GENERAL LIABILITY -_.-, CLAIMS MADE [~OCCUR LIMITS SELF INSURED RETENTION 10101/04 10101/05 EACH OCCURRENCE $ , 0A1.IfA\3E101~ENTEU- - r--- I_PR!OMISE~{E-" Q<:c~r8flC~_ _' !. i~E[) E_XPJAi1y..o.n,,_p-"r5"nl. _ L$___ 1 PERSONAL&ADVINJURY 1$ C8.~~~~~;~~~~i~~i-~l$~_ ~ I PRODUCTS, COMP/OP AGG I $ -- - -- -- -- - -- - .-----1 .. ~OQ,QQ.O_ 500,000 _ __5,QillJ_ __~OQ,QQ9n 500,000 - ---..--.___u__ 5QO,OQ9. - ---..------------ GARAGE LIABILITY , ANY AUTO i $ A' AUTOMOBILE LIABILITY ~----l i X: ANY AUTO J ALLOWNEDAUTOS I I SCHEDULED AUTOS I -, . )( : HIRED AUTOS ! X I NON,OWNED AUTOS I SAP 9300525-03 10101/04 I COMBINED SINGLE LIMIT 10101/05 IfEa accident)_ BODILY INJURY (Per person) 1$ 100,000 , $ , $ ....,-- . AUTO ONLY, EA ACCIDENT c - I OTHER THAN , AUTO ONLY: $ ~A!\CC it I EXCESS/UMBRELLA LIABILITY [X] OCCUR I=J CLAIMS MADE I I ,_ DEDUCTIBLE X RETENTION $ 500,000 A I WORKERS COMPENSATION AND , EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? , ~~~'i:;I~~~;i'<'5~,'S~6'NS below I OTHER C I AUTO LIABILITY EXCESS S AGG' $ TRUST #1957850 10/01104 10/01/05 l ~ACH OCCURRENCE_ : AGGREGATE I L mnL$ . __2..Q.OQ..D.QO_ I $ 2 000 000 ,l$:---- =___-1-== r- $ WC 9300799-03 10/01/04 10/01/05 I_~ n ~~intll,~: _ _: ol~~ ;___ ; E,L. EACH ACCIDENT : $ -'---'---.- --T'- ; E L. DI.1SEASE ,EAEMPLOYE.E! $ EL. DISEASE> POLICY LIMIT $ -- ---- 1,000,000 -- -- --- ----- .._--,--- _LQQ.O,O.QQ. 1 000 000 SELF INSURED RETENTION 10/01/04 10/01/05 $400,000 XS OF $100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS The Salvation Army Key West, FL also listed as additional insureds: THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS COURT PROBATIONERS SERVICES CERTIFICATE HOLDER CANCELLA TION Monroe County Board of County Commissioners 1100 Simonton Street Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE tJ . ~~y?Jt ~~bJu I ACORD 25 (2001/0}) c.e~ . ACORD CORPORATION 1988