Certificates of Insurance
- Af~f.lrl.~ CERTIFICATE OF LIABILITY
INSURANCE DATE (MM/ODIYY)
10lO4I99
PRODUCER THIS CERTIRCAlE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERnRCAlE
Commercial Ins. Consultants HOlDER. THIS CERTIRCAlE DOES NOT AMEND, EXTEND OR
P. O. Drawer 1398 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
402 S. Kentucky Ave., 4Ih R. COMPANIES AFFORDING COVERAGE
UkeIand Fl 33802.1398 COMPANY
A OhIo CasuaJty Ins Co
INSURED COMPANY
Tom Ryan, Inc. B FrontIer Pacific
and Rg: ConsbuctIon ServIces COMPANY
P.O. 555 C
BIg Pine Key Fl 33043
COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POlICY NUUBER POlICY EFFECTIVE POlICY EXPIRATION UUITS
LTR DATE (MMIODIYY) DATE (MM/ODIYY)
C GENERAL LlABIUTY G20002808700 01/22/99 01/22/00 GENERAL AGGREGATE S 1,000,000
i--
X COMMERCIAL GENERAL LIABILITY PRODUCTS. COMPIOP AGG S 1,000,000
I CLAIMS MADE [K] OCCUR PERSONAL & ADV INJURY S 1,000,000
- OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE S 1,000,000
FIRE DAMAGE (Asrf one fire) S 100,000
MED EXP (Asrf one p&1SOII) S 5,000
A ~OMOBJLE LIABILITY BAW52221956 01/22/99 01/22/00 1,000,000
COMBINED SINGLE UMIT S
ANY AUTO
f--
i-- All OWNED AUTOS BODILY INJURY
X SCHEDULED AUTOS (per p&1SOII) S
X HIRED AUTOS BODILY INJURY
X NON-QWNED AUTOS . /,rjl'l "'V~~.;W:'~' (Per accident) S
- )~-
,:~"L PROPERTY DAMAGE S
~RAGE LIABILITY '\c [Q'IQ4 AUTO ONLY. EA ACCIDENT S
-
~, ~ ...., '. I
ANY AUTO \\l*__--. - OTHER THAN AUTO ONLY:
f-- ~Yr:,
- l- EACH ACCIDENT S
~t,r#" .~o: ' ~. .
AGGREGATE S
EXCESS LIABIUTY MONROE COUNTY EACH OCCURRENCE S
~- UMBRELlA FORM CONSTRUCT!I)~J ~41l~.!rJ:!:~ ENT AGGREGATE s
OTHER THAN UMBRELlA FORM S
WORKERS COMPENSATION AND OCT U ts 1999 I -T N!f
EMPLOYERS' LIABILITY
TIME: <? ~ ~- .-1_/- -/-/- EL EACH ACCIDENT S
THE PROPRIETOR! R'NCL EL DISEASE - POLICY LIMIT S
PARTNERSlEXECUTIVE RECEIVED BY: I ^'W
OFFICERS ARE: EXCl EL DISEASE - EA EMPLOYEE S
OTHER '=
A I n I and Ma r i ne EfA052221956 01/22/99 01/22/00 Scheduled
A Auto Phys Damage BAW52221956 01/22/99 01/22/00 Scheduled
8ESCRIPTION OF O~ERAJIONSIlQCATIONSlVEHIClESlSPECIAL ITEMS
ert i f icate 01 er, I ts employees and di rectors are listed as additional
insured as resgects general liability and auto liability,
fax (305)872-4 47
CERTIFlCAlE HOLDER CANCEUATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCElleD BEFORE THE
Monroe County Board of County Commissioners EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAIL
-..!Q. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHAll IMPOSE NO OBlIGATION OR LIABIUTY
OF ANY KINO UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRES~TIVE " \ \-1 ~
.;==1=\ l II'
ACORD 25-S (1195) @ ACORD CORPORATION 1988
Certificate of Insurance
THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFlCA TE HOLDER. THIS CERTIFlCA TE 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
STAFF LEASING, L.P., BY STAFF ACQUIsmON, INC., THE GENERAL
PARTNER, AND THE AFFILIATED LIMITED PARTNERSHIPS OF WHICH
STAFF ACQUIsmON, INC. IS mE GENERAL PARTNER AND THEIR
SUCCESSOR CORPORATIONS
600 301 BOULEVARD WEST, SUITE 202
BRA DENTON, FLORIDA 34205
is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded 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
h h" 'f
Name and
address of
Insured
LIBERlYtJ
MUTUAL@ ,
any contract or other document wit resoect to W Ich thiS cert1 Icate may be issued.
CERTIFICATE EXP. DATE
TYPE OF POLICY * 0 CONTINUOUS POLICY NUMBER LIMIT OF LIABILITY
o EXTENDED
00 POLICY TERM
Coverage Afforded Under WC EMPLOYERS LIABILITY
Law of the Following States:
Bodily Injury By Accident Each
WORKERS WA1-65D-004110-299 $1,000,000. Accident
COMPENSATION 1-1-2000 WC1-651-004110-019 Bodily Injury By Disease
All States Endorsement Policy
$1,000,000. Um~
Bodily Injury By Disease Each
$1,000,000. Person
GENERAL LIABILITY General Aggregate-Other than Prod/Completed Operations
D CLAIMS MADE Products/Completed Operations Aggregate
I RETRO DATE I .1)}"' Q ?JJ:3'~ Bodily Injury and Property Damage Liability Per
Occurrence
" . Personal and Advertising Injury Per Person!
\" - .- [Q{g L~
D OCCURRENCE Organization
r ,~~r _- Other: I Other:
~
,. -" I'~. ' . Each Accident - Single Limit.
AUTOMOBILE
LIABILITY B.I, and P.D. Combined
D OWNED Each Person
D NON.OWNED Each Accident or Occurrence
MONROE CO UNTY
D CONSTRtlCT!m! ~4 ._.' 11.1'11 ' Each Accident or Occurrence
HIRED
nt'T n
OTHER __. v loJoJoJ
TIME: -f1 h:),
RECEIVED BY: (/1 J\
EMPLOYEES LEASED TO: EFFECTIVE DATE:
:L :I. 36(/J .. TOITI 1:~YAI'1 II'le 1 DBA 01 If?H 1'3'3
F~YAH COI'ISTFWCT I 0"1 !3ER....1 I CE
The above referenced Workers' Compensation policy provides statutory benefits only to employees of the Named Insured(s) on the policy, not to employees of any other employer.
-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.
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.
IMPORTANT NOTICE TO FLORIDA POUCY HOLDERS AND CERTIFICATE HOLDERS: IN THE EVENT YOU HAVE ANY QUESTIONS OR NEED INFORMATION ABOUT THIS CERTIFICATE FOR ANY REASON, PlEASE
CONTACT YOUR lOCAL SALES PRODUCER. WHOSE NAME AND TELEPHONE NUMBER APPEARS IN THE LOWER RIGHT HAND CORNER OF THIS CERTIFICATE. THE APPROPRIATE LOCAL SALES OFFICE
MAILING ADDRESS MAY ALSO BE OBTAINED BY CAWNG THIS NUMBER.
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 AT LEAST 30 DAYS NOTICE OF SUCH CANCELlATION HAS BEEN MAilED TO:
CERTIFICATE
HOLDER
1'10NI:;:OE COUHTY
ATTH:BOARD OF COMMISSIONERS
5100 COLLEGE ROAD
!3TClCK I!3l...nND
.:. ~:) r '! F L ,:~ J ~,) If .3 .... '} ::~ ::) :":)
_ Liberty Mutual Group
1~~~Ih.~
TERE~A M, SCHELL
AUTHORIZED REPRESENTATIVE
-......
Bradenton, FL
OFFICE
800-475-4430
PHONE
10/(1~:i/9':)
DATE ISSUED
This certificdte is executt'd Q\, IIRERTY rv1LTTlJAI CROUP ilr.:; f(-'SP('cts 5uch insurance ,1S i~ {lffnrdE:'d b~' T11i.l~e Compilnit's
BS 772L R2
ASSURANCE COMPANY OF AMERICA
NEW YORK, NEW YORK 10038
A Stock Company
COMMERCIAL INLAND MARINE COVERAGE PART QUICK REFERENCE
READ YOUR POLICY CAREFULLY
DECLARATIONS PAGE
Named Insured and Mailing Address
Policy Period
Description of Business and Location
Coverages and Limits of Insurance
COVERAGE FORM{S)
A. COVERAGE
1. Covered Property
2. Property Not Covered
3. Covered Causes of Loss
4. Additional Coverage-Collapse
5. Coverage Extensions (If Applicable)
B. EXCLUSIONS
· Earthquake (If Applicable)
· Governmental Action
· Nuclear Hazard
· War and Military Action.
· Water (If Applicable)
· Other Exclusions
C. LIMITS OF INSURANCE
D. DEDUCTIBLE (IF APPLICABLE)
E. ADDITIONAL CONDITIONS
F. DEFINITIONS
ENDORSEMENTS (IF APPLICABLE)
COMMERCIAL INLAND MARINE CONDITIONS
LOSS CONDITIONS
A. Abandonment
B. Appraisal
C. Duties in the Event of Loss
D. Insurance Under Two or More Coverages
E. Loss Payment
F. Other Insurance
GENERAL CONDITIONS
A. Concealment, Misrepresentation or Fraud
B. Legal Action Against Us
C. No Benefit to Bailee
G. Pair, Sets or Parts
H. Privilege to Adjust With Owner
l. Recoveries
J. Reinstatement of Limit After Loss
K. Transfer of Rights of Recovery Against Others to Us
D. Policy Period
E. Valuation
COMMON POLICY CONDITIONS
A. Cancellation
B. Changes
C. Examination of Your Books and Records
D. Inspections and Surveys
E. Premiums
F. Transfer of Your Rights and Duties Under This Policy
Copyright, Insurance Services Office. Inc., 1982, 1984
47681 Ed. 2-86 Printed in U.S.A.
COMMERCIAL INLAND MAl
CMOOOI069s
COMMERCIAL INLAND MARINE CONDITIONS
The following conditions apply in addition to the Common Policy Conditions and applicable Additional Conditions in Commercial !nIt
Marine Coverage Fonns:
LOSSCONDmONS
A. ABANDONMENT
There can be no abandonment of any property to us.
B. APPRAISAL
Ifwe and you disagree on the value of the property or the
amount of"loss." either may make written demand for an
appraisal of the "loss." In the event. each party will select a
competent and impartial appraiser. The two appraisers will
select an umpire. If they can not agree. either may request
that selection be made by a judge of a court having
jurisdiction. The appraisers will state separately the value
of the property and amount of "loss. " If they fail to agree.
they will submit their differences to the umpire. A decision
agreed to by any two will be binding. Each party will:
1. Pay its chosen appraiser; and '
2. Bear the other expenses of the appraisal and umpire
equally. .
If there is an appwsal. we will still retain our right to deny
the claim.
C. DUTIES IN THE EVENT OF LOSS
You must see that the following are done in the event of
"loss" to Covered Property:
1. NotifY the police if a law may have been broken.
2. Give us prompt notice of the "loss." Include a
description of the property involved.
. 3. As soon as possible. give us a description of how .
when and where the "loss" Occurred.
4. Take all reisonable steps to protect the Covered
Property from further damage and keep a record of
your expenses necessuy to proteCt the Covered
Property. for consideration in the settlement of the
claim. This will not increase the Limit of Insurance.
However. we will not pay for any subsequent "loss"
resulting from a cause of loss that is not'a Covered
Cause of Loss. Also iffeasible. set the damaged
property aside and in the best possible order for
examination.
5. Make no statement that will assume any obligation
or admit any liability. for any "loss" for which we
may be liable, without our consent
6. Permit us to inspect the property and records
proving "loss."
7. If requested. permit us to question you under 0,
at such times as may be reasonably required. at
any matter relating to this insurance or your cIa
including your books and records. In such evei
your answers must be signed.
8., Send us a signed, sworn statement of"loss"
containing the mfonnation we request to settle
claim. You must do this within 60 days after 0
request. We will supply you with the necessal)'
foons. ..
9. Promptly send.us any legal papers or notices
n:ceived concerning the "loss. "
10. Cooperate with us in the investigation or settle
of the claim.
D. INSURANCE UNDER TWO OR MORE
COVERAGES
If two or more of this policy's coverages apply to
the same "loss." we will not pay more than the
actual amount of the "loss."
Eo LOSS PAYMENT
We will pay or make good any "loss" covered under thi
Coverage Part within 30 days after:
. 1. We mdugrecment with you;
2. The entry offinaljudgement; or
3. The filing of an appraisal award.
We will not be liable for any part of a "loss" that has bt
paid or made good by others.
F. 011lER INSURANCE
If you have other insurance covering the same "loss" 8!
insurance under this Coverage Part. we will pay only tl
excess over what you should have x:eceivcd from the ot
insurance. We will pay the cxcsss whether you can col
on the other insurance or not .
CMOOOI0695
Copyright, Insurance Services Office, Inc., 1994
Page 1
COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are subject to the following conditions.
A. CANCELLATION D. INSPECTIONS AND SURVEYS
1. The first Named Insured shown in the Declara- We have the right but are not obligated to:
tions may cancel this policy by mailing or 1. Make inspections and surveys at any time;
delivering to us advance written notice of
cancellation. 2. Give you reports on the conditions we find; and
2. We may cancel this policy by mailing or deliver- 3. Recommend changes.
ing to the first Named Insured written notice of Any inspections, surveys, reports or recommenda-
cancellation at least: tions relate only to insurability and the premiums to
a. 10 days before the effective date of cancella- be charged. We do not make safety inspections. We
tion if we cancel for nonpayment of premium; do not undertake to perform the duty of any person
or or organization to provide for the health or safety of
b 30 days before the effective date of cancella- workers or the public. And we do not warrant that
. conditions:
tion if we cancel for any other reason.
1. Are safe or healthful; or
3. We will mail or deliver our notice to the first
Named Insured's last mailing address known to 2. Comply with laws, regulations, codes or stan-
us. dards.
4. Notice of cancellation will state the effective This condition applies not only to us. but also to any
date of cancellation. The policy period will end rating, advisory. rate service or similar organiza-
on that date. tion which makes insurance inspections. surveys,
reports or recommendations.
5. If this policy is cancelled. we will send the first
Named Insured any premium refund due. If we
cancel. the refund will be pro rata. If the first
Named Insured cancels, the refund may be less
than pro rata. The cancellation will be effective
even if we have not made or offered a refund.
6. If notice is mailed, proof of mailing will be suffi-
cient proof of notice.
B. CHANGES
This policy contains all the agreements between
you and us concerning the insurance afforded. The
first Named Insured shown in the Declarations is
authorized to make changes in the terms of this
policy with our consent. This policy's terms can be
amended or waived only by endorsement issued by
us and made a part of this policy.
C. EXAMINATION OF YOUR BOOKS AND
RECORDS
We may examine and audit your books and records
as they relate to this policy at any time during the
policy period and up to three years afterward.
IL 0017 11 85
E. PREMIUMS
The first Named Insured shown in the Declarations:
1. Is responsible for the payment of all premiums;
and
2. Will be the payee for any return premiums we
pay.
F. TRANSFER OF YOUR RIGHTS AND DU-
TIES UNDER THIS POLICY
Your rights and duties under this policy may not be
transferred without our written consent except in
the case of death of an individual named insured.
If you die. your rights and duties will be transferred
to your legal representative but only while acting
within the scope of duties as your legal represen-
tative. Until your legal representative is appointed.
anyone having proper temporary custody of your
property will have your rights and duties but only
with respect to that property.
Copyright, Insurance ~ervices Office. Inc., 1982. 1983
EXISTING BUILDING(S) OR STRUCTURE(S) COVERAGE
THIS ENDORSEMENT CHANGES THE HOME BUILDERS BUILDERS RISK
COVERAGE FORM. PLEASE READ IT CAREFULLY.
When this endorsement is added to your policy and a charge is made, the existing building or
structure is included as Covered Property. With respect to that existing building or structure,
SECTION E., ADDmONAL CONDmONS, Paragraph 5. Valuation is deleted and replaced
by the following:
The most we will pay for any loss to the existing building(s) or structure(s) will be the
least of:
1. The Limit ofInsurance which applies to the existing building(s) or structure(s); or
2. The amount you actually spend to repair the damaged or destroyed property with
property of comparable type or quality; or
3. Actual cash value of the existing building or structure as of the time of loss; or
4. The amount you paid for the existing building( s) or structure( s) plus the actual
cash value of the improvements made by or for you after you purchased the
building(s) or structure(s) up to the time of loss.
With respect to that existing building or structure, SECTION E., ADDITIONAL
CONDITIONS, Paragraph 6 d. is added:
d. The total completed value of the Covered Property shall include your acquisition
cost of the existing building or structure, plus the estimated completed value of the
improvements, alterations or repairs.
All other provisions in your policy will apply to this coverage unless they are specifically changed
by provisions of this endorsement.
HBIP-37 (5/95) May Be Reproduced
OCT-12-99 !0:49PM FRau-ZURICH INSURANCE
+904-346-3454
T-945 P,Ol!02 F-276
WINDSTORM OR HAIL exCLUSION
THIS ENDORSEMENT CHANGES THE BUILDER'S RISK COVERAGE FORM.
PLEASE READ IT CAREFULLY.
SECTION B. exCLUSIONS, paragraph 3 is amended to add the following:
e. Windstorm or Hail
SECTION A COVERAGE, paragraph 4, ADDITIONAL COVERAGE, a. (1) is deleted
and replaced by the following:
(1) Fire: lightning; explosion; smoke; aircraft; vehicles; riot; civil commotion;
vandalism; breakage of glass: falling objects; \IlIeight of snow. ice or sleet:
water damage; but only if the causes of loss are covered in this
Coverage Form;
HSIS 3S
Rev. 10.96