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Certificates of Insurance�AC�„ ORDr CERTIFICATE OF LIABILITY INSURANCE DATEEMYm PRODUCER 05/28/2008 HAROLD MORRISON 888-494-9844LTHILlYCERTIFICATE I8 ISSUED AS A MATTER OF INFORMATION DB/A C & C CONSULTANTS HOLDER THIS OCERTTIIFICATERDOES NOT AMEHTS UPON ND CEX EXTENDORP O BOX 701340 ALTER THE COVERAGE AFFORDED BY THE POLtC1E8 BELOW. ST CLOUD, FL 34770-1340 INSURERS AFFORDING COVERAGE _.. __.... NAIC0 ! INSURERA: ARCH INSURANCE COMPANY U.S WATER SERVICES CORPORATION INSURER NE _ -- - CROSS BAYOU BOULEVARD �aJC NEW PORT RICHEY, FL 34652 !INSURERC' �aVZIDINSURERD NVRCRgVC3 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACI MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES D POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCE .TR rARa Tv:... POMCYNUMM GMFJIALLIIIEIJTY A X: COMMERCIAL GENERAL LUBIIU Y GWPKGO077202 �CLMMS MADE X '.00CUR'; I OEN'LAGGREGATE LIMITAPPUES PER: �' r X LOC ! ADTOMDBEE LUM,, 11 A ! X ANY AUTO ALLOWNEDAUTOS SCHEWLEDAUTOS X HIREDAUTOS X NOY.OWNEDAUTOS GARAGE LIABILITY ANYAUTO TO ALL 11 /30/07 11 /30/08 G W P K G O077202 11 /30/07 E%CESEAIMBRBIA W BINTY A X'OCCUR 1 ICLAIMs MADE GWUFP0077202 11/30/07 EXCESS OF GENERAL, MDUCTISLE AUTO, AND EMPLOYER'S RETENTION i LIABILITY C �oDN AND ANY PROPRIETORYPARTNERIEA.EOUT OFFICERAR MSER EACLUDEOT 11/30/08 11 /30/08 Nj ; EACH OCCURRENCE -OAMAGETORENTED PIMIARMS (Es -cum) ) ! MEDE%P(Aft. mpa) �PERSONAL6 ADV INJURY GENERAL AGGREGATE PRODUCTS, COMPA]PAGO s I,. I i S (N M :i 1,000,000 100,000 10,000 1.000,000 3,000,000 3,000,000 ISV=INGLE OMIT i 1,000,000 (BODILYINJURY_.— YIffJYF1YN PRO Iaxe n10AMAGE E AUTO ONLY, EA ACCIDENT S OTHER THAN EA ACC i _ AGO i EACHOCCURRENCE ..: 2,000,000 AGGREGATE 2, 000,000.. i i ..` EL EACHACCIOWT EA. DISEASE, EA EMPLOYEE�i CERTIFICATE HOLDER LISTED AS ADDITIONAL INSURED FOR COMMERCIAL GENERAL LIABILITY AND AUTO LIABILITY AS THEIR INTEREST MAY APPEAR. MHOULDANY OF TIE ABOVE DVICRIRW POUCB RE CANCELLER) MVORE THE IDVMTMRY DATE THEREOF, TTE MBIINO INSURER MIRY ENDEAVOR TO MAN. 30 DAYS WETEN MONROE COUNTY BOCC NOTCE To TW RHOUDER MANED TO THE LLHALL FT BUT FALEEE TO DO EO E 3583 SOUTH ROOSEVELT BOULEVARD IMPOSE RLM OP ANY KIND UPON THIS BIMURM, NM AGENTS OR KEY WEST, FL 33040 REPR A w ACORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER THIS CERTIFICATE IS ISSUED AS Stahl 8 Associates Ins., Inc. ONLY AND CONFERS NO RIGHTS 8202 Washington St . , Ste. 4 MOLDER. THIS CERTIFICATE DOE Port Richey FL 34668 ALTER THE COVERAGE AFFORDE Phone:727-846-9969 Fax:727-848-4236 INSURED INSURERS AFFORDING COVERAGE INSURER B: U.S. Water services Corp INSURER C: New P39 ortsRichRyuFL134652-3434 NSURER D: 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 SU POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. BJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH nrammrr----- ERAL LIABILITY COMMERCIAL GENERAL LIABILITY ] CLAIMS MADE ❑ GCCUR GEN'L AGGREGATE LIIUIT APPLIES PER: POLICY PR'0. E^T OC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY 7 ANY AUTO EXCESSIUMBRELLA LIABILITY ] OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND A EMPLOYERS' LIABILITV ANY PROPRIETOR/PARTNER/EXECUTIVE 2008009126129 OFFICERMIEMSER EXCLUDED'! If yqq describe under SPECIAL PROVISIONS below OTHER E Professional PECO026481 LIMITS & ADV COMBINED SINGLE LIMIT (Ea accidenq $ BODILY INJURY (Per person) $ (Per ecddere)---- $ AUTO ONLY - OTHER THAN EA ACC $ AUTO ONLY: AGG $ EACH OCCURRENCE $ AGGREGATE e DATE (MM/DD/ /Y:� NAIC # 05/13/08 I 05/13,109 E.L. EACH ACCIDENT cn $ 1,000,000 E.L DISEASE - EA EMPLOYEE$1 000 000 E.L. DISEASE -POLICY LIMB I $T -ann nnA Ea Claim RE: Roth Building ------�.........�.,,v NVVBY BY ENDORSEMENT/ SPECIAL PROVISIONS - Certificate Holder is listed as additional insured with respect to Pollution Liability as required by written contract subject to the terms, conditions and exclusions of the policy. Monroe County BOCC Public Facilities Maintenance Attn: Jo Walters 3583 S Roosevelt Blvd Rey West FL 33040 2,000,000 2,000.Dan MOMROEI I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATKI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRnTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY IUND UPON THE INSURER, ITS AGENTS OR PRDACORD CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS, Stahl 6 Associates Ins., Inc. ONLY AND CONFERS NO RIGHTS 8202 Washington St., Ste . 4 HOLDER. THIS CERTIFICATE DOE Port Richey FL 34668 ALTER THE COVERAGE AFFORDE Phone:727-846-9969 Fax:727-848-4236 ENSURED INSURERS AFFORDING COVERAGE U.S. Water Services Corp tsscluLl34New Port Richly C: D: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO T,INDIN ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT W ITH RESPECT TO W HICH THIS CERTIFICATE MAY BE MAY PERTAIN, THE INSURANCE: AFFORDED By THE POLICIES DESCRIBED HEREIN IS SUBJECTS ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. a ¢Om r COMMERCIAL GEINERAL LIABILITY CLAIMS MADE ❑ OCCUR GEN'L AGGREGATE LIMIT APPLIES AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY 7 ANV AUTO EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE WORKERS COMPENSATION AMID A EMPLOYERS'LUIBILITY ANY PROPRIETOR/PARTNER/E)(ECUTIVE OFFICER/MEMBER EXCLUDED? 8 lProfessional Liters M encarson)JURY yTE $ 'UCTS- COMP/OP AGG S CO SINGLE LIMIT(Ea accident) $ BODILY INJURY (Per Parson) It BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ AUTO ONLY -EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGO $ EACH OCCURRENCE $ AGGREGATE $ It It 2008009126129 05/13/08 05/13/09 E.L. E.L. E.L. PECO026481 Ea Claim RE: Plantation Key Government Center Wastewater Treatment KKPlant Certificate holder is listed as additional insured with regards to Pollution liability with regards to written contract, subject conditions and exclusions of the policy. to the terms, DATE (MWDD/YYYY) OR NAIC # 7, 2,000,000 MONROEB ISHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT10 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe Country Board of NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL County Commissioners IMPOSE NO OBLIGATION OR LIABILITY OF ANY IOND UPON THE INSURER, ITS AGENTS OR 3583 South Roosevelt Blvd REPRESENTATIVES, Rey West FL 33040 Alm INSURERS AFFORDING COVERAGE NAIC # INSURER A: Zenith Insurance Co. i -- — 132169 INSURER B: Indian Harbo np INSURER C: i ---- INSURER D 71�' —_ COVERAGES INSURER E:- THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. JSl�iA�D' TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITY ICOMMERCIAL GENERAL LIABILITY CLAIMS MADE I� OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS I NON•OWNFD AUTOS � I I GARAGE LIABILITY—~��--� - ANY AUTO EXCESS/UMBRELLA LIABILITY J OCCUR rJ CLAIMS MADE t �I DEDUCTIBLE j I RETENTION $ WORKERS COMPENSATION AND A I EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER./EXECUTIVE If Yes, describe under SPECIAL PROVISIONS below OTHER ACORflTM CERTIFICATE OF LIABILITY INSURANCE RA N C E OP ID S DATE (MM/DD/YYYY) PRODUCER USWAT-1 05 13 09 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Stahl & Associates Ins., Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3939 Tampa Road HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Oldsmar FL 34 677 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ph one.813-818-5300 Fax:813-818-5396 INSURED — --- -- --- ---- --- U.S. Water Services Corp 4939 Cross Bayou Blvd New Port Richey FL 34652-3434 M10047 LIMITS r7-- URRENCE $ (��e ce) $ M� ED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) I $ PROPERIY TIAMAGF (Per accident) ! $ AUTO ONLY - EA ACCIDFNT $ OTHER THAN EA ACC 1 $ AUTO ONLY: - --� - AGG $ EACH OCCURRENCE $ AGGREGATE $ --------- _ $ E.L. EACH ACCIDENT I$ 1 r Coo 0! �0y 0 0 0 0 E.i... Llly C%1JG ' CH Gitq."LOYEF_ y 1 , V V V , ^ V o E.L. DISEASE - POLICY LIMIT $ 1 0 G 0 0 B 'VU Professional & PEC0026481 Pollution 05/26/08 05/26/09 �Are Claim DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ate RE: Roth Building Certificate Holder is listed as additional insured with respect to Pollution Liability as required by written contract subject to the terms, conditions Lion and exclusions of tije policy. ons CERTIFICATE HOLDER 05/13/091 05/13/10 2,000,000 21000,000 CANCELLATION MONROE 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Monroe County BOCC DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 Public Facilities Maintenance NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT DAYS WRITTEN FAILURE TO DSO SHALL Attn : Jo Walters IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 3583 S Roosevelt Blvd Key West FL 33040 REPRESENTATIVES. ACORD 25 (2001/08) © ACORD CORPORATION 1 888 Ac CERTIFICATE OF LIABILITY INSURANCE Fj ; ; ON r� 888-494-9844 HAROLD MORRISON D/8/A C & C COrlSULTANTS O BOX 701340 3T CLOUD, FL 34770-1340 TMI� COrTf7�J►Tt 1� lifll�D I►S A MATTER OF NIfOItMAT10N ONLY AND CONS NO Ig01tTi 11rON 7'ilE �T�C/11'� � C=lA�AF-FORM�� NOT A�� INSIJRER3 ARFOImMO COVERAGE w►� # U.S WATER SERVICES CORPORATION 4939 CROSS BAYOU BOULEVARD NEW PORT RICHEY, FL 34652 � w ARCH INSURANCE COMPANY w. — Nomm Q � a: THE POLE "OF NOSURANCE Uffm BELOW HAVE BEEN MUM TO THE M�IBURED NAMED ABOVE FOR THE POLICY PR� Tom• �Y �SSUED OR ANY ENT, OR OF ANY OR OTHER wn"IS SUBJECT THEO V*NCH TEIM, EXCLUSIONS AND OF SUCH MAY PE"AIN, THE AFFORDED SY THE POLICES DESCRIED HEREM! POLICIES. AGORt ATE LBM'T8 SHOM MAY HAVE BAN REDUCED BY PAID CLAMS. A POL�Y1A�t '! 1/30i09 11f30110 Lam T9NI�MML LIAMJTY1 X COMMERC" GOMAL LIAe uTY CLAW MACE ❑X 00" 1 GWPK00077204 EACH OCCtJIglENCE i I'm s 100 000 um ow an s 10 000 oNeALAsoRs+oATE i 3 000 040 OWLAQOREt#ATE taMrt APPL�E8 Poe: F-1 a rx-1 m PRO= I a - COMPIOP AGG i 390001000 A AaTot�tolMsuAttam ANY AUTO ALL OWAD AUTOS BCNEDtJLEQAUT06 HaeEaAUTos AUTOS GWPKGO077204 - 11 /30/09 11130110 � E UNIT __. : 1,000,000 X NO LY MURY ... i X � � : X � DAMAGE oddeM : J SARAN! UANLITY ANY AUTO AUTO ONLY - EA AOCIOENT i OTHER THAN EA ACC AUTO ONLY: AGO_ i A n :x:l oocut El cr.Al N MADE OEDt�CTIELE MIMTtON GMFP0077204 EXCESS OF GENERAL UAORM. AUTO 1AWJTY a EMPLOYERS LIASLITY 11 /30109 11 /30/10 EACH Ovcur4t&= s 5,000,000 51000,000 = i $ OIMilIIE ®O AIM AND mLoowLL*ALnv ANY pmfolio EaOC'LWEO� K dNe�lOa �NrMr Am LL EACH A0010SHT i E.L. DISEASE - EA E i E.L. OIeEASE • POLICY t.MT i a7M�R M�Qwl1tON Of I WOO" PIIOVINONE CERTIFICATE HOLDER LISTED AS ADDITIONAL INSURED FOR COMMERCIAL GENERAL LIABILITY AND AUTO LIABILITY AS THEIR i INTEREST MAY APPEAR. i i MONROE COUNTY BOCC 3583 SOUTH ROOSEVELT BOULEVARD KEY WEST, FL 33040 we "= OAlt TII�OR, no *sum MINI! vmL APon TO M>L 3_ my* ummm IIORIC! TO "a mw"" Nau= "A iro no L "o Wa M16y11M'ro 00.O ENAI.L No an LVUML Tr cP ANY MAID UN N US MlsUAW t1s ASEM CO A��111!!R� MlMwlTAtlYt ACORD 2512001MI W AccMv I rvw Is °A� �MM�°°mvr� OP ID S AC ORD CERTIFICATE OF LIABILITY INSURANCE U�,T-1 05 2, ,.o vRooucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION -ONHF��kNQtOMFER9 NO RIGHTS UPON THE CERTIFICATE Stahl &Associates Ias . , Inc. RE (� 92ATAI�_QQVERA THIS CERT�ICATE DOES NOT AMEND, EXTEND OR 4A40 Ts Qnnrl�� E AFFORDED BY THE POLICIE BELOW. s.nr� Oldsma r FL 34677 Phone: 813-818-5300 Fax: 813-818-5396 INSURE FF�RDIN COVERAGE NAICto SAL ev I # INSURED 10 U INSUF&R kWpj Ze ith Insurance Co. 132169 INSURER B: S t adf s t Insurance Co. U.S. Water Servicelvd�" 4939 Cross Bayou 8 New Port Richey FL 34652-3434 ` 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. MK LTR NS TYPE OF INSURANCE POLICY NUMBER POLICY EFFEC DATE M POLICY EXPIRATION DATE M LIMITS GENERAL LIABILITY EACH OCCURRENCE $ PREMISES Ea occumm $ COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COIMP/OP AGG S POLICY CTF-1 LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea acadent) $ BODILY INJURY (Per persm) S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accidwd) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per axident) $ .� AD - l GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ]CLAIMS MADE AGGREGATE $ s $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND X I TORY LIMITS ER A EMPLOYERS' LIABILITY ANY PRUPRIE'IOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? M10 0 4 7 0 2 0 5/ 13 / 10 0 5/ 13 / 11 E.L. EACH ACCIDENT $1, 0 0 0 0 0 0 E.L. DISEASE - EA EMPLOYEE $ 1, 0 0 0 , 0 0 0 yes' describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1 0 0 0 0 0 0 OTHER B Professional PEC6542361-01 05/26/10 05/26/11 Ea Claim 2, 000, 000 Pollution I I Aggregate 2 000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Roth Building Certificate Holder is listed as additional insured with respect to Pollution Liability as required by written contract subject to the terms, conditions and exclusions of the policy. CERTIFICATE HOLDER CANCELLATION Monroe County BOCC Public Facilities Maintenance Attn: Jo Walters 3583 S Roosevelt Blvd Key West FL 33040 A r►^nn 'e 10bn#%4 rnQ% momon I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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. n Af%f%Dn r%n00n0AT1nu 49100 �vv��v i.v �i.vv ■rvv, AC CERTIFICATE OF LIABILITY INSURANCE OP ID S USWAT-1 DATE (MM/DDlYYYY) 05 27 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Stahl & Associate;s Ins . , Inc . R EC 3939 Tampa Road NO RIGHTS UPON THE CERTIFICATE THIS CERT FICATE DOES NOT AMEND, EXTEND OR E C VERA E AFFORDED BY THE POLICIES BELOW. Oldsmar FL 34677 Phone: 813-818-5300 Fax: 813-818-5396 INSURE4 FFdRDIN COVERAGE NAIL # INSURED AJUWINSU R Ze ith Insurance Co. 132169 INSURER B: stiadfa st Insurance Co. U.S. Water Services Corp 4 939 Cross Bayou Blvd New Port Richey FL 34652-3434 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. 1N5K LTR L NS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIM POLICY EXPIRATION DATE M LIMITS GENERAL LIABILITY EACH OCCURRENCE $ PREMISES (Ea occurence) $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO - LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per pew) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 1-1 OCCUR ]CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ A WORKERS COMPENSATION AND ANY PRUPRIE'f OR/PARTNER/EKECUTNE EMPLOYERS' LIABILITY OFFICERIMEMBER EXCLUDED? ff yam, describe under SPECIAL PROVISIONS below � 0 0 4 7 ©? 0 5 / 1 3 ! 1 0 0.5 / 1 3 / 1 1 X ITORY LIMITTATUS ER E.L. EACH ACCIDENT $ 1i 0 0 0 0 0 0 E.L. DISEASE - EA EMPLOYEE $ 1 , 000,f 000 E. L. DISEASE - POLICY LIMIT $ 1 F 0 0 0 0 0 0 OTHER B Professional & PEC6542361-01 05/26/10 05/26/11 Ea Claim 2,000,000 Pollution I I I I Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Roth Building Certificate Holder is listed as additional insured with respect to Pollution Liability as required by written contract subject to the terms, conditions and exclusions of the policy. CERTIFICATE HOLDER ceNCFI I ATInN Monroe County BOCC Public Facilities Maintenance Attn: Jo Walters 3583 S Roosevelt Blvd Key West FIB 33040 MONROEI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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. ACORD 25 (20011091 n ern0n e+no12nnw81r1^L1 dnoo �oRo® DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 1 11/21/2010 PRODUCER 888-494-9844 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HAROLD MORRISON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR D/B/A C & C CONSULTANTS ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O BOX 701340 ST CLOUD, FL 34770-1340 INSURERS AFFORDING COVERAGE NAIC # INSURED INsuRERA: ARCH INSURANCE COMPANY_ -- -- — — U.S WATER SERVICES CORPORATION INSURERS:____—_____ 4939 CROSS BAYOU BOULEVARD INSURER C: NEW PORT RICHEY, FL 34652 INSURERD: _ -- INSURER E: a.vvcrv+uc� POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING THE ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INSR DO' ---- _- - _ T— — POLICY NUMBER POLICY EFFECTIVE POLICYEXPIRATK)N LIMITS A Y aENERALLIABILITY EACH OCCURRENCE S 1,000,000 AMA R Ea oxurrence) _ j—_-_ $ 100,000 X I COMMERCIAL GENERAL LIABILITY GWPKG0077205 11/30/10 % 11 /30/11 _PREMISES MED EXP (Any one person) - $_ __ 10,000 r_ _ _ _ i CLAIMS MADE r X OCCUR I 'PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE S _ 3,000,.000 PRODUCTS -COMP/OP AGG $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO LOC JECT A Y AUTOMOBILELIABILITY COMBINED SINGLE LIMIT 'Ea accident) $ 1,000,000 ANY AUTO G W PKGO077205 11 /30/ 10 11 /30/ 11 i ALL OWNED AUTOS j BODILY INJURY I $ (Per person) SCHEDULED AUTOS I _ _ _ X BODIaccident)LY INJURY $ HIRED AUTOS NON -OWNED AUTOS I (Per X PROPERTY DAMAGE $ _— (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT 1 $ _ EA ACLC$ OTHER THANAUTO 1 ANY AUTO I '� ONLY: AG A EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 1 1 1 GWUFP0077205 11l30/10 X� OCCUR CLAIMS MADE 1 11 aCTIBLE EXCESS OF GENERAL LIABILITY, AUTO fj LBILITY & EMPLOYERS LIABILITY DEDU — S RETENTION $ WORKERS COMPENSATION EMPLOYERS' LIABILITY r� WC STATU- OTH- T RY IMIT R -_ L. EACH ACCIDENT is AND YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE! $ OFFICER/MEMBER EXCLUDED' -� (1 u (Mandatory In NH) If describe under (2 5 es, SPECIAL PROVISIONS below ` E.L. DISEASE - POLICY LIMIT 1 $ OTHER I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED WITH REGARDS TO GENERAL LIABILITY, AND AUTOMOBILE LIABILITY AS THEIR INTERESTS MAY APPEAR. LOCATION: ROTH BUILDING MONROE COUNTY BOARD OF COUNTY COMMISSIONERS PUBLIC FACILITIES MAINTENANCE 3583 SOUTH ROOSEVELT BLVD KEY WEST, FL 33040 ATTN: JO WALTERS 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 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE / / A* AMmA ACORD 25 (2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and Joao are registered marks of ACORD OP ID: SG ACORO° CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDWYYYY) 07/05/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain poi ement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endoreement s . PRODUCER 813- 8-5300 Stahl & Associates Ins.,, Inc. 813- 3939 Tampa Road-MaL Oldsmar, FL 34677 Stahl & Associates Insurance 8.6396 JUL PHONE E • AX (IUC No): R C ER ID#:US AT-1 ER 8 AFFORDING COVERAGE NAIC# INSURED U.S. Water Services Corp 4939 Cross Bayou Blvd MONROE New Port Richey, FL 34662-3434 RISK MANA surance Co. 132169 a.Amerl Safe IndemnityCo INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. ILTR TYPE OFINSUPANCE POLICY NUMBER MWD MMID )LICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ Me occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-IIIADE [] OCCUR _PREMISES MED EXP (Any one person) $ PERSONAL & ADV INJURY S GENERAL AGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER_ PRODUCTS -COMPIOPAGG $ $ POLICY PRO- LOC AUTOMOBILE LIABILITY vr ( COMBINED SINGLE LIMB (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS {� 11 / � PROPERTYDAAIAGE (Per accident) $ $ $ VV UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE ( C ` EACH OCCURRENCE S AGGREGATE $ DEDUCTIBLE $ $ RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE YIN OFFICERIMEMBER EXCLUDED? ❑ (Mandatoryin NH) N 1 A X M1004703 05113111 05/13112 X WC STATU• OTH- I ER E.L. EACH ACCIDENT $ 1,000,00 — E.L. DISEASE - FA EMPLOYE • $ 1,000,00 IIyes desrribeunder DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00( g Professional & X X 01126111 01121/12 Claim 2,000,00 Pollution I I IPPLO20163110i 1Ea Aggregate 2,000,00 DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES (Attach ACORD 104, Additional Remarks Sehedute, If more space Is required) Workers Compensation Coveragge includes a Blanket Waiver of Subrogation when Required by Written Contract. ProfessionallPollution Policy Includes a Blanket Additional Insured and Blanket Waiver of Subrogation when required by written contract. MONROEB C C : �k.a � ce_ Monroe County Board of County Commissioners 3583 South Roosevelt Blvd Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009109) The ACORD name and logo are registered marks of ACORD OP ID: SG ACOR/DA �TY INSURANCE E (MM/DD/YYYY) DAT07/05/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER 813-818-5300 Stahl & Associates Ins., Inc. 813-818-5396 3939 Tampa Road Oldsmar, FL 34677 Stahl & Associates Insurance NAME: CONTACT PHONE FAX E't A/C, No E M,v� PPRRODUCER CUSTOMER ID#: USWAT-1 INSURER(S) AFFORDING COVERAGE NAIC # INSURED U.S. Water Services Corp 4939 Cross Bayou Blvd New Port Richey, FL 34652-3434 INSURER A: Zenith Insurance Co. 132169 INSURER B : American Safety Indemnity Co INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY qCOMMERCIAL GENERAL LIABILITY CLAIMS -MADE CJ OCCUR EACH OCCURRENCE $ I PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PROECT- F7 LOC POLICY F7 PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS _ / ! {r / 1 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/E)'ECUTIVE Y / N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A X M1004703 06/13/11 06/13/12 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 B Professional & Pollution X X PPL0291631101 05/26/11 05/26/12 Ea Claim 2,000,00 Aggregate 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required) Workers Compensation Coverage includes a Blanket Waiver of Subrogation when Required by Written Contract. Professional/Pollution Policy includes a Blanket Additional Insured and Blanket Waiver of Subrogation when required by written contract. � MONROEB CC .' (�, 'n a rt. Gc� Monroe County Board of County Commissioners 3583 South Roosevelt Blvd Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD OP ID: SG '4� RJR CERTIFICATE OF LIABILITY INSURANCE DAT0/YYYY) 7/05/05/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions Of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER 813-818-5300 Stahl & Associates Ins., Inc. 813-818-5396 3939 Tampa Road Oldsmar, FL 34677 Stahl & Associates Insurance CONTACT NAME: PHONE FAX A/c, No E MAIL PRODUCER CUSTOMER ID #: USWAT-1 INSURER(S) AFFORDING COVERAGE NAIC # INSURED U.S. Water Services Corp 4939 Cross Bayou Blvd New Port Richey, FL 34652-3434 INSURER A: Zenith Insurance Co. 132169 INSURER B: American Safety Indemnity Co INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR rypE OF INSURANCE POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE CJ OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS ( PROPERTY DAMAGE (Per accident) $ $ NON -OWNED AUTOS ( ' I 111 17 $ l ttfj UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/Er:ECUTIVE YIN OFFICER/MEMBER EXCLUDED? N / A M1004703 05/13/11 05/13/12 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 B Professional & X PPL0291531101 05/26/11 06/26/12 Claim 2,000,00 Pollution �Ea Aggregate 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: Plantation Key Government Center Wastewater Treatment Plant Certificate holder is listed as additional insured with regards to pollution liability with regards to written contract, subject to the terms, conditions and exclusions Of the policy. \,,CR 1 Irli.d\ 1 C r1 VLIJCK GANGtLLA I ION �C 6 K Q e7 U,— MONROEB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of ACCORDANCE WITH THE POLICY PROVISIONS. County Commissioners AUTHORIZED REPRESENTATIVE 3583 South Roosevelt Blvd Key West, FL 33040 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD OP ID: SG DATE (MM/DD/YYYY) A 0� CERTIFICATE OF LIABILITY INSURANCE 1 07/26/11 THIS CERTIFICATEISSUED AFFIRMATIVELYATTER NEGATIVELY AMENDYE TEND OR ALTER AND CONFERS NO RIGHTS CERTIFICATE OF HE COVERAGE AFFORDED BY THE POLICIES CERTIFICATE DOES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. t be IMPORTANT: If he o certificate of the policy, i an ADDITIONAL DDI policies may INSURED, the endorsement. mus A statement on this his certificaif te does not confer rights ,to the the terms and co certificate holder in lieu of such endorsement(s). co CT PRODUCER 813-818-5300 NAME: PHONE Fa ,No: Stahl & Associates Ins., Inc. 813-818-5396 A/C. No. Ext : 3939 Tampa Road ADDRESS: Oldsmar, FL 34677 PRODUCER USWAT-1 CUSTOMER ID #: Stahl & Associates Insurance INSURER(S) AFFORDING COVERAGE NAIL # INSURED U.S. Water Services Corp INSURER A: Zenith Insurance Co. 132169 4939 Cross Bayou Blvd INSURER B : American Safety Indemnity Co New Port Richey, FL 34652-3434 INSURER C : E: OVERAGES CERTIFICATE NUMBER: THIS GATED. CERTIFY NOTWIT STANDING ANY ISSUED POLICIESREQUIREMENT, TERM OR COND TION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE LW HIPERIOD THIS IN CERTIFICATE MAY IT 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. POLIc EXPLIMITS SR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MMIDD/YYYY fR EACH OCCURRENCE $ GENERAL LIABILITY $ COMMERCIAL GENERAL LIABILITY ICLAIMS -MADE D OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOG � JECT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS V PREMISES Ea occurrence MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) EACH OCCURRENCE $ UMBRELLA LIAB OCCUR AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE -� $ RETENTION $ X WC STATU- OTH- TORY LIMITS ER WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y703 M1004 05113/11 05/13/12 E.L. EACH ACCIDENT $ 1 A ANY OFFICER/MEMBER EXCLUDED? PROPRIETOR/PARTNER/EXECUTIVE ❑ N / A X L. DISEASE - EA EMPLOYEE $ 1 (Mandatory in NH)v (' E.L. DISEASE -POLICY LIMIT $ 1 If yes, describe under DESCRIPTION OF OPERATIONS below X PPL0291531101 05126111 05/26/12 Ea claim g Professional &X Aggregate Pollution DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space is required) RE: Roth Buildin6 Certificate Holder is listed as additional insured with respect to Pollution Liability as required by written contract subject to the terms, conditions and exclusions of the policy. CERTIFICATE HOLDER -- -" - - -- MONROE1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County BOCC Public Facilities Maintenance AUTHORIZED REPRESENTATIVE Attn: Jo Walters �-a 3583 S Roosevelt Blvd ,Key West FL 33040 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD DATE (MDD/YYYY) �® MICERTIFICATE OF LIABILITY INSURANCE 12/01 /2011 PRODUCER 888-494-9844 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HAROLD MORRISON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE D/B/A C & C CONSULTANTS HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O BOX 701340 ST CLOUD, FL 34770-1340 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: ARCH INSURANCE COMPANY U.S WATER SERVICES CORPORATION 4939 CROSS BAYOU BOULEVARD NEW PORT RICHEY, FL 34652 '4-NPl *:T_TcT _1 B: INSURER D: 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. NSR kDDL OF INSURANCE POLICYNUMBER POLICY EFFECTIVE POLICY EXPIRATIONTYPE LIMITS A Y GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FXI OCCUR GWPKGO077206 11/30/11 11/30/12 EACH OCCURRENCE E 1,000,000 A AGE "0 RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG E 3,000,000 POLICY PRO-JECT LOC A Y AUTOMOBILE LIABILITY ANY AUTO GWPKGO077206 11/30/11 11/30/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS AP Y RI$K HIRED AUTOS NON -OWNED AUTOS p 1 W % v �-:5 "W eCo 15 X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT E OTHER THAN EA ACC E ANY AUTO $ AUTO ONLY: AGG A EXCESSIUMBRELLALIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE GWFXS0077201 EXCESS OF GENERAL LIABILITY, AUTO LIABILITY & EMPLOYERS LIABILITY 11/30/11 11/30/12 EACH OCCURRENCE $ 5,000,000 AGGREGATE E 5,000,000 $ = $ RETENTION E WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE r--j OFFICERIMEMBER EXCLUDED? WC STA'U- OTR - E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT 1 E OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED WITH REGARDS TO GENERAL LIABILITY, AND AUTOMOBILE LIABILITY AS THEIR INTERESTS MAY APPEAR. LOCATION: ROTH BUILDING MONROE COUNTY BOARD OF COUNTY COMMISSIONERS PUBLIC FACILITIES MAINTENANCE 3583 SOUTH ROOSEVELT BLVD KEY WEST, FL 33040 ATTN: JO WALTERS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILLX` 0#)AKMO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT AUTHORIZED REPRESENTATIVE ACORD 25 (2009101) 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and loao are realstered marks of ACORD C. G USWAT-1 OP ID: SG ,�►`oRn� CERTIFICATE OF LIABILITY INSURANCE DAT05110D/YYYY) 05/10/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 813-818-5300 CNTACT NAME: Sue Goodman, CPCU Stahl & Associates Ins., Inc. 813-818-5396 3939 Tampa Road(,VC, Oldsmar, FL 34677 Stahl & Associates Insurance PHONE g13-818-5350 FAX A/c No Ell: A/c No): 813-818-5396 E-MAIL RE SS: sue.goodman@stahlinsurance.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Zenith Insurance Co. 13269 INSURED U.S. Water Services Corp INSURER B : Colony Insurance Co. 05719 4939 Cross Bayou Blvd New Port Richey, FL 34652-3434 INSURER C INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER. REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PREMDAMAGE T RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ . POLICY RO PLOC $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS APP $I( BY D W COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS �(� '^• PROPERTY DAMAGE Per accident $ $ fi UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F (Mandatory in NH) N / A X M1004704 05/13/12 05/13/13 X WC STATU- O R I ,T E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 tfy:s, describa under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POL_ ICY LIMIT I $ 1,000,00 B Professional & X X PKC300752 05/26/12 05/26/13 Per claim 2,000,00 Contracors Polluti Aggregate 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) RE: Roth Building D _1 l Certificate Holder is listed as additional insured with respect to Pollution Liability as required by written contract subject to the terms, conditions and exclusions of the policy. MAY 14 2012 v By ltlR[III2LOY-11R1:Lei 1111111U4V MONROE1 Monroe County BOCC Public Facilities Maintenance Attn: Alice Steryou 3583 S Roosevelt Blvd SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REREPRESENTATIVE 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) / The ACORD name and logo are registered marks of ACORD Gc-:4t4_-v ® DATE (MM/DD/YYYY) oRo. CERTIFICATE OF LIABILITY INSURANCE 11 /25/2012 PRODUCER 888-494-9844 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HAROLD MORRISON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE D/B/A C & C CONSULTANTS HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O BOX 701340 ST CLOUD, FL 34770-1340 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: ARCH INSURANCE COMPANY U.S WATER SERVICES CORPORATION INSURER B:_ - 4939 CROSS BAYOU BOULEVARD INSURER C: NEW PORT RICHEY, FL 34652 INSURER O: I INSURER E: CAVPRAnPR 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. - " POLICY EXPIRATION INSR DD' POLICY EFFECTIVE POLICY NUMBER DATE MM DDIYYYY 1 DATE IMM/DDfYYYY1 LIMITS A Y GENERAL LIABILITY EACH OCCURRENCE _$ 1,000,000 DAMAGE TO RENTED I L-PREMISES _(Ea occurrence)- I X COMMERCIAL GENERAL LIABILITY GWPKGO077207 I, 11/30/12 11/30/13 $ 100,000 " CLAIMS MADE l X7 OCCUR MED EXP (Any one person) - $ 10,000 $ 1,000,000 PERSONAL & ADV INJURY GENERAL AGGREGATE $ 3,000,000 �,. $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG F7 PRO- r--JECT, POLICY LOC A Y AUTOMOBILE - LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 - X ANY AUTO GWPKGO077207 11/30/12 11/30/13 (Ea accident) I ALL OWNED AUTOS BODILY INJURY _ SCHEDULED AUTOS N I_ (Per person) $ _ '� BODILY INJURY $ X HIRED AUTOS B X NON -OWNED AUTOS o / w __ C.c.�• yt (Per accident) PROPERTY DAMAGE, (Per accident) $ - I GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESS/ UMBRELLA LIABILITY EACH EACH OCCURRENCE $. _ 5,000,000 X OCCUR �I CLAIMS MADE G W FXS0077202 11/30/12 �. 11/30/13 $ 5,000,000 EXCESS OF GENERAL LIABILITY, AUTO LIABILITY -- - — - - - -` $ - - DEDUCTIBLE & EMPLOYERS LIABILITY ---- - - --- $ $ RETENTION $ WORKERS COMPENSATION.. WC STATU- IOTH- TORY LIMITS ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ f.-__-_-- ---------- - --- -- -- $ (Mandatory In NH) I, E.L. DISEASE - EA EMPLOYEE If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ARE LISTED AS ADDITIONAL INSURED WITH REGARDS TO GENERAL LIABILITY AND AUTOMOBILE LIABILITY AS THEIR INTERESTS MAY APPEAR. LOCATION: ROTH BUILDING %,.CKI IFIw AIt rlVLUtK 9,.A1YVCLLA I IVIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION MONROE COUNTY BOARD OF COUNTY DATE THEREOF, THE ISSUING INSURER WILL)W61)WXA0 MAIL 30 DAYS WRITTEN COMMISSIONERS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT>")(04X) XX XMXX 1100 SIMONTON STREET AO&W"M doom KEY WEST, FL 33040 XXXXXXXXXXXXXX)( AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and loco are reaistered marks of ACORD G G' USWAT-1 OP ID: GO '4�oRort CERTIFICATE OF LIABILITY INSURANCE DAT05/09//YYYY) 05/09/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions ofMm-ptiticy, certain poiictes'maT require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of s h' 06dorsement s . PRODUCER �'27-784-8554 Stahl& Associates Insurance � 3939Tampa Road MAY 1 4 2013 127-789-2823 Oldsmar, FL 34677 Michael Pagano, AAI 3! Imo, ��p_, CONTACT NAME: Sue Goodman PHONE FAX IC No Ext:813-818-5350 Xc No: 813-818-5396 ADDRESS: sue.goodman@stahlinsurance.com INSURERS AFFORDING COVERAGE NAIC # wsuRERA:Zenith Insurance Company INSURED U.S. Water Services Corp 4939 Cross Bayou Blvd New Port Richey, FL 34652-3434 INSURER B : Colony Insurance Co. 05719 INSURERC: INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR AP ISK AGEENT B BY V 0XV1 DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ POLICY 7 PRO LOC $ AUTOMOBILE LIABILITY COBINED SINGLE LIMIT Ea Maccident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY t DAMAGE Peracciden $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? 7 (Mandatory in NH) N / A X M1004705 05/13/13 05/13/14 X I WC STATU- I OTH- I TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000. E.L. DISEASE - EA EMPLOYEE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,00 B Profession) & X X PKC300752 05/26/12 05/26/13 Per Claim 2,000,00 Contrctr Pollution Aggregate 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Roth Building Certificate Holder is listed as additional insured with respect to Pollution Liability as required by written contract subject to the terms, conditions and exclusions of the policy. CERTIFICATE HOLDER CANCELLATION MONROEI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. Public Facilities Maintenance AUTHORIZEDREPRESENTATIVE Attn: Alice Steryou 3583 S Roosevelt Blvd —fp- , '( of iKey West FL 33040 cle- ' ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD / 1 ® DATE (MM/DD/YYYY) oizo CERTIFICATE OF LIABILITY INSURANCEF11 /29/2013 PRODUCER HAROLD MORRISONCEI D/B/A C & C CONSULTANTS P O BOX 701340 ST CLOUD, FL 34770-1340 IFICATE IS ISSUED AS A MATTER OF INFORMATION NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AMEND, EXTEND OR AFFORDED BY THE POLICIES BELOW. LILY ANCONFERS LDER.IS ALTER THCOVERAGE URERS ORDING COVERAGE NAIL # INSURED U.S WATER SERVICES CORPOR ION 4939 CROSS BAYOU BOULEVARD 14MMOECO NEW PORT RICHEY, FL 34652 RtSK MANAG _ INSURER A. AR INSURANCE COMPANY INSURER B: ERC: 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. NSR _TR DD' POLICY NUMBER POUCY EFFECTIVE POLICY EXPIRATION ATE (MMIDDfYYYYI LIMITS A Y GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE t ^ I OCCUR EPPERSONAL GWPKGO077208 11/30/13 11/30/14 DAMAGE TO RE—N—TED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 10,000 & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7 PRO--JECT LOC PRODUCTS - COMP/OP AGG $ 3,000,000 A Y AUTO MOBILELIABILITY ANY AUTO GWPKGO077208 11/30/13 11/30/14 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ A EXCESS / UMBRELLA LIABILITY 41 OCCUR CLAIMS MADE GWFXS0077203 EXCESS OF GENERAL 11/30/13 11/30/14 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DEDUCTIBLE LIABILITY, AUTO LIABILITY & EMPLOYERS LIABILITY $ $ $ RETENTION $ . WORKERS COMPENSATION AND EM?LCYERS' LIADIL'TY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) be under S yes, SPECIAL SPECIAL PROVISIONS below WC STATU- OTH- T RY IM T E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER -ESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS AONROE COUNTY BOARD OF COUNTY COMMISSIONERS ARE LISTED AS ADDITIONAL INSURED ITH REGARDS TO GENERAL ]ABILITY AND AUTOMOBILE LIABILITY AS THEIR INTERESTS MAY APPEAR. B iK GEMf>�1T D A OCATION: ROTH BUILDING W N,A CC aK I WIL;A I t_ HULUtK - N!NIIUJ LJNNnj,l CANCELLATION (I —rCA C/ LJ IJ�JSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION MONROE COUNTY BOARD OF COUNTY DATE THEREOF, THE ISSUING INSURER WILL)(MX XO MAIL 30 DAYS WRITTEN COMMISSIONERS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT)pj«UXMyEq" 1100 SIMONTON STREET Q 'Z Nn 01 030 U � X KEY WEST, FL 33040 AK*AUTHORIZED REPRESENTATIVE LCORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and loao are registered marks of ACORD USWAT-1 OP ID: GO DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1 05/08/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Stahl & Associates Insurance 3939 Tampa Road Oldsmar, FL 34677 Michael Pagano, AAI INSURED U.S. Water Services Corp 4939 Cross Bayou Blvd New Port Richey, FL 34652-3434 Phone• 727- Fax: 727- CONTACT Sue Goodman NAME rPHONE 813-818-5350 FAX N.: 813-818-5396 M� c„rr linsurance.com A: Zenith Insurance Corr B : Colony Insurance Co. D: E: 9 DVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. ADDLSUBR POLICY EFF POLICY EXP LIMITS IR R TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ �AW c�c0 RENTED nrp1 $ COMMERCIAL GENERAL LIABILITY ICLAIMS -MADE D OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: —1 POLICY n PRO n LOC JECT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS UMBRELLA LIAB EXCESS LIAB SCHEDULED AUTOS NON -OWNED AUTOS OCCUR CLAIMS -MADE MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OPAGG $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident EACH WORKERS COMPENSATION AND EMPLOYERS' LIABILITY M1004706 05/13/2014 05/13I2015 E.L. EACH ACCIDENT A ANY OFFICER/MEMBER ER EXCLUDED? ECUTIVE Y� N / A X E.L. DISEASE - EA EMI (Mandatory in NH) ff yes, describe under E.L. DISEASE - POLIC' DESCRIPTION OF OPERATIONS below g Profession) X X PKC300752 05/26/2014 05/26/2015 Per Claim B Pollution PKC300752 05/26/2014 05/26/2015 Per Claim DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Roth Building Certificate Holder is listed as additional insured with respect to pollution Liability as required by written contract subject to the terms, conditions and exclusions of the policy. 1.__,,,,,LA-,,,IL,�„ VIA $ 1,000 $ 1,000 a 1.000 MONROE1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATION ATE THEREOF, 9 � Nd (; " 1 XaAOWRDANCE WITH THE POLICY PROVISIONS.NOTICE WILL BE DELIVERED IN Monroe County BOCC u(��j U 1100 Simonton Street 080J38 80.E ED REPRESENTATIVE Mfg�04 Key West, FL 33040 C 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD R ® DATE (MWDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE I 11/28/2014 RTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER 888 494-9844 THIS CE HAROLD MORRISON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR D/B/A C & C CONSULTANTS ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O BOX 701340 ST CLOUD, FL 34770-1340 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: ARCH INSURANCE COMPANY U.S WATER SERVICES CORPORATION INSURER B: 4939 CROSS BAYOU BOULEVARD INSURER C: NEW PORT RICHEY, FL 34652 INSURER D: INSURER E: A+V V =r%AUr-0 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. NSR DD' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A Y GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR GWPKGO077209 11/30/14 11 /30/15 EACH OCCURRENCE $ 1,000,000 - 3E TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 3,000,000 POLICY PRO- LOC A Y AUTOMOBILE LIABILITY ANY AUTO GWPKGO077209 11/30/14 11/30/15 COMBINED SINGLE LIMIT (Ea accident) y 1,000,000 X ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ F I ANY AUTO S A EXCESS I UMBRELLA LIABILITY X OCCUR CLAIMS MADE GWFXS0077204 11/30/14 EXCESS OF GENERAL 11/30/15 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ DEDUCTIBLE HRETENTION S WORKERS COMPENSATION LIABILITY, AUTO LIABILITY & EMPLOYERS LIABILITY y WC STATU- O R II R $ E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L. DISEASE - EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below AGEMEM Rff E.L. DISEASE - POLICY LIMIT 1 $ OTHER DATE WAIVE N/ rESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS JIONROE COUNTY BOARD OF COUNTY COMMISSIONERS ARE LISTED AS ADDITIONAL INSURED WITH REGARDS TO GENERAL -IABILITY AND AUTOMOBILE LIABILITY AS THEIR INTERESTS MAY APPEAR. _OCATION: ROTH BUILDING MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON STREET 90 ;4 Na S 03Q �1Q� KEY WEST, FL 33040 ACORD 25 (2009101) 0, 80038 80.E 03313 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL)WU00 XO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT AUTHORIZED REPRESENTATIVE 01988-2009 ACI The ACORD name and loao are realstered marks of ACORD ,TION. All rights reserved. ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 11/21/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PHONE ,, Ext): ( 877) 234-4420 A/ (AC , No): ( 877) 234-4421 Applied Risk Services, Inc. 10825 Old Will Rd Omaha, NE 68154 E-MAIL ADDRESS: PRODUCER (877) 234-4420 CUSTOMER ID# INSURER(S) AFFORDING COVERAGE NAIC 0 INSURED INSURER A: Continental Indemnity Co. 28258 INSURERB: U.S. Water Services corporation dba U.S. Water Services Corporation 4939 Cross Bayou Blvd INSURER C: INSURERD: New Port Richey, FL 34652-3434 INSURER E: CTL 1273 946860 INSURER F: nn..eer.n�c reortetr ATe KI"RAMCD. RFVICInN NIIMRFR. 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. INSR LTR TtF INSURANCE ADDL INSR SUBS! WVD POLICY NUMBER POLICY EFF MM/DDNYY POLICY EXP MM/DDNYYY LIMITS GENERAILITY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occunence) $ COMAL GENERAL LIABILITY S �I a MED EXP (Anyone rson) $ MADE OCCUR PERSONAL & ADV INJURY $ - — GENERAL AGGREGATE $ LAGGREGATE LIMIT APPLIES PER: t PRODUCTS-COMP/OP AGG $ POLICY PROJECT i LOC AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS E-1 El Y NAGM COMBINED SINGLE LIMIT (Eaaccidenq $ BODILY INJURY Per erson $ BODILY INJURY Per accident $ SCHEDULED AUTOS W DAMAGE HIRED AUTOS NON -OWNED AUTOS `ti PReOPEdR t) $ $ I UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE ❑ DEDUCTIBLE $ $ RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y"N ANY PROPRIETOR/PARTNER/ N EXECUTIVE OFFICER/MEMBER IL-JI N / A El 7 3— 8 9 4 3 5 i_ 01 _ 0 2 10/31/2014 0/31/2015 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 EXCLUDED? (Mandatory in NH) It yes, describe under SPECIAL PROVISIONS below d1� h1ti1�0�30e1N0 I E.L. DISEASE -EA EMPLOYEE $ 1,000 000 E.L. DISEASE -POLICY LIMIT $ 1,000,00 R1sWs1PI]G Sf OPERATIONS / LOCATIONS / VEHICLES (Attach Acord 101, Additional Remarks Schedule, if more space is required) 70 :h Nd S 1 030 b101 ERTIFIC TE HOLDER t 1100 Sincntcn Street ULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH Key West, FL 33040 THE POLICY PROVISIONS. /� AUTHORIZED REPRESENTATIVE C <.� _. L039971 Attn: Project Mazer ACORD 25 (2009M9) The ACORD name and logo are registered marks of ACORD ©1988-2009 ACORD CORPORATION. All rights reserved. ; USWAT-1 OP ID: GO ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/05/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Phone: 813-818-5300 CONTACT NAME: Sue Goodman Stahl & Associates Insurance Fax: 813-818-5396 3939 Tampa Road Oldsmar, FL 34677 PHONE 813-818-5350 FAX No): 813-818-5396 ac No Ext ADDRESS: sue.goodman@stahlinsurance.com Michael Pagano, AAI INSURERS) AFFORDING COVERAGE NAIC # INSURER A: Colony Insurance Co. 05719 INSURED U.S. Water Services Corp 4939 Cross Bayou Blvd New Port Richey, FL 34652-3434 INSURER B : INSURER C : INSURER D INSURER E : INSURER F : rnV9PAr-ES CERTIFICATE NUMBER- REVISION NUMBER: vTHIS 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE D COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ MED EXP (Any one person) $ CLAIMS -MADE OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ POLICY PRO LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY A Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED PROPERTY DAMAGE Per accident $ HIREDAUTOS L AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- T RY LIMITS ER AND EMPLOYERS' LIABILITY Y /N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below A Profession) PKC300762 05/26/2015 05/26/2016 Per Claim 2,000,000 A Pollution PKC300752 05/26/2015 05/26/2016 Per Claim 5,000,000 DESCRIPTION OFJDERATIONS I LqfATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mo pace's quit ) C - - 'AP R A 1� O W �� DATE k %,�p_4/ � WAIVER N/A YES_ _ (J ' �4vYW �i l� W� : © o — C_�, W v;Lu [« Monroe County, Florida 1100 Simonton St Key West, FL 33040 MONROEC I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �a<:N U 19tSS-ZU1U AL.VKU I:VKMVKA I IVN. All rignxs reserveu. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD