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Certificates of Insurance_ SCHEALI OP ID JS DATE (MMlDD1YYYY) CERTIFICATE OF LIABILITY INSURANCE 05/08/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND END CONFERS NO OR ALTER R COVERAGE CERTI THE POLIO E CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, 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). cAWcT Emilie Madore PRODUCER NAME: Darr Schackow Insurane Agency PHONE 352 - 338 -0552 A No :3S2- 376 -5741 Holly Hill A!C No Ext 5200 -B West Newberry Road E _ DDRLEss: EMadore @dsins.biz Gainesville, FL 32607 INSURER(S) AFFORDING COVERAGE NAIC # Emilie Madore {27998 INSURER A Travelers Auto INSURED Alesha & Eugene Scheuerman INSURER B: 135 Bid A Wee Lane INSURER C: Panama City, FL 32413 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: T IS TO ANY NT AB PO REQUIREME, TERM OR COND TION OF ANY CONTRACTT OR OTHER DOCUMENT WITH RESPECT TOWHICH PE INDICATED. HIS 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. IN DDL, UBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMlDD MM /DD GENERAL LIABILITY EACH OCCURRENCE $ _DA__ TO EN ED COMMERCIAL GENE L IABILITY j PREMISES ( Ea occurrence $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ J j PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS - COMP/OP AGG $ 71 PRO - POLICY LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident A ANY AUTO X 9780673641012 04/09/2014 10/09/2014 BODILY INJURY (Per person) $ 250,00 ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ 500,00 X AUTOS AUTOS PROPERTY DAMAGE NON -OWNED PER ACCIDENT) $ 100,00 — HIRED AUTOS AUTOS $500 COI! $ $100 com I UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED 4 RETENTION l WC STATU- OTH- WORKERS COMPENSATION T RY /MIT R AND EMPLOYERS' LIABILITY Y ! N E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE � NIA. A OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below i DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is listed as Additional Insured on 2013 GMC Terrain De; VIN #2GKFLYE31D6330704 APPR I <MANAS' IT WAIVER N/ _ L c c � _ V I AIM03 30SNOW CERTIFICATE HOLDER CANCELLATION ((SSH�HOULD.ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE SE oc 6_ AV '• u k'�f[CCORDANCE ON ATE THEREOF, THTHE POLICY PROVISIONS ONSE WILL BE DELIVERED IN Monroe County Board of �j ^ �j �j County Commission 080338 80J 03 ' K4 7 HoRIZED REPRESENTATIVE 1100 Simonton Street Emilie Madore Keywest, FL 33040 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD DATE (MNUDDIYYYY) PRODUCER CERTIFICATE OF LIABILITY INSURANCE 9i1Zoo9 (305) 294-4494 FAX: (305) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION -ANrl r-0N IR�_RK NO RIGHTS UPON THE CERTIFICATE Keys Insurance Services, Inc. CERTIFI ATE DOES NOT AMEND, EXTEND OR _ VERAGE FFORDED BY THE POLICIES BELOW. 805 Peacock Plaza Key West FL 33040 INSURED E Hunt Scheuerman, DBA: Keys Forensic PO Box 523207 Marathon Shores FL 33052 TURE S AFFORDING C ERAGE NAIC # LLURERAD334VOto In urance INSURER B: M INSURER E: BELOW HAVE BEEN ISVFRAGFR SUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY THE POLICIES OF INSURANCE LISTED OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, REQUIREMENT, TERM OR CONDITION THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. CLAIMS. F. LIMITS SHOWN MAY HAVE BE REDUCED BY PAID INSR ADD'LLTRINSRD POLICY EFFECTIVE POLICY EXPIRATION LIMITS TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY GENERAL LIABILITY EACH OCCURRENCE $ 500,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ X COMMERCIAL GENERAL LIABILITY MED EXP (Any oneperson) $ A X I CLAIMS MADEF__] OCCUR MM815 6 9 5 9/ 1/ 2 0 0 9 9/ 1/ 2 010 PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 11000,100 0 PRODUCTS - COMP/OP A $ GEN'L AGGREGATE LIMIT APPLIES PER: CTI:] LOC X POLICY E JE O- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA A $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR FICLAIMS MADE � $ $ DEDUCTIBLE $ RETENTION LC WC STATU- OTH- WORKERS COMPENSATION AND EMPLOYERS' LIABILITY t r� f� ANY PROPRIETOR/PARTNER/EXECUTIVE C�"�G E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ If yes, describe under PE IAL PROVISIONbelow OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate holder is also added as an additional insured. I - \ Y\,CL/V\ (2 CQ�� *4 - I CERTIFICATE HOLDER Monroe County Board of County Commissione 1100 Simonton Street, Ste 268 Key West, FL 33040 (;ANC:tLLA I IU14 SHOULD ANY OF THE ABOVE DESCRIBED EXPIRATION DATE THEREOF, THE ISSUI 10 DAYS WRITTEN NOTICE CE FAILURE TO DO SO SHALL IMP NO IC. INSURER ITS AGENTS OR VE AUTHORIZED REPRESENT F Hager BE CANCELLED BEFORE THE R WILL ENDEAVOR TO MAIL OLDER NAMED TO THE LEFT, BUT LIABILITY OF ANY KIND UPON THE ACORD 25 (2001108) INS025 (0108).08a V HVVRu �.vRrvrtM Ivglq 117vv Page 1 of 2 THE POLICIES OF INSURAN(�E 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. VSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 110 0 0, 0 0 0 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100 000 PREMISES Ea occurrence $ A CLAIMS MADE 7 OCCUR LA80251405-09 8/21/2009 8/21/201Q GEN'L AGGREGATE LIMIT APPLIES PER: X POLICYF71 E n LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY l� ANY AUTO EXCESS/UMBRELLA LIABILITY OCCUR EICLAIMS MADE MED EXP An one erson $ cJ , 0 0 0 PERSONAL & ADV INJURY $ excld GENERAL AGGREGATE $ 2, 0 0 0, 0 0 0 PRODUCTS - COMP/OP AGG $ excld COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: G _t $ DEDUCTIBLE RETENTIONf� 61.1 F f� $ W C STAT TORY LIMITS ER U- OTH- B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a E.L. EACH ACCIDENT $ 10 0 , 0 0 0 E.L. DISEASE - EA EMPLOYE $ 10 0 , 0 0 0 If yes, describe under WC10000138812009A 8/21/2009 8/21/2010 SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ rJ 0 0 , 0 0 0 C OTHER MM817453 9/1/2009 9/1/2010 $500,000 ea occ i $1,000,000 agg DESCRIPTION OF OPERATIO NS/LOCATIONS/VEH ICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVI Certificate holder is also added as an additional insured as reclpects Genteral Liability and Professional Liability policies only. CERTIFICATE HOLDER (JUG) Z9Z-4487 - Monroe County Board of County Commssioner 1100 Simonton Street Key West, FL 33040 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 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 F. Hager/DAK ACORD 25 (2001 /08) IAICf17r. in�noN no„ © ACORD CORPORATION 1988 Donn 1 "f 7 � CERTIFICATE OF INSURANCE WPM SUCH INSURANCE AS RESPECTS THE INTEREST of THE CERTIFICATE HOLDER NAMED BELOW WILL NOT BE CANCELED OR OTHERWISE TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER, BUT IN NO EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DINE WRITTEN. THIS CERTIFICATE OF INSURANCE DOES NOT CHANGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW. This certifies that: STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois ❑ STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois ❑ STATE FARM COUNTY MUTUAL INSURANCE COMPANY OF TEXAS of Dallas, Texas ❑ STATE FARM INDEMNITY COMPANY of Bloomington, Illinois, or ❑ STATE FARM GUARANTY INSURANCE COMPANY of Bloomington, Illinois has coverage in force for the following Named Insured as shown below: NAMED INSURED: GARY MCCULLOUGH ADDRESS OF NAMED INSURED- PO BOX 5371j, KEY WEST FL 3 3 0 4 5 - 5 3 71 POLICY NUMBER 794 92 64-005--59 EFFECTIVE DATE OF POLICY 03/05/10-09/05/10 DESCRIPTION OF 20Q3 TOYOTA VEHICLE (including VIN) 5TDZT34A33S1.94298 LIABILITY COVERAGI� N YES ❑ NO ❑ YES [] NO ❑ YES ❑ No ElYES ❑ NO LIMITS OF LIABILITY a. Bodily Injury Each Person 10 0 r o o o Each Accident 3 0 0r 0 U 0 t r b. Property Damage y� c. Each Accident 500,000 c. Bodily Injury & � '77 7 PPropertyDamage Single Limit Each Accident PHYSICAL DAMAGE COVERAGES YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ Na a. Comprehensive $ 500 Deductible $ Deductible $ Deductible Deductible YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO b_ Collision S i n Deductible $ Dedur_ ble DpAuc tihle EMPLOYERS NON -OWNED 1 ❑YES No ❑ YES Q NO Q YES ❑ NO ❑ YES ❑ NO CAR LIABILITY COVERAGE -- HIRED CAR LIABILITY ® YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO COVERAGE FLEET - Ca RAGE FOR ALLa�N A ICENS�ED MOTOR I-�Ic s .. res - IVC3 - ❑ �r'�s -- 1 a ❑ rE ❑Iva ❑ �r�s ❑ Iwv -�____� Agent Rep 2586 03/09/2010 Signatur of Mt en ti Title Agent's Code Number Date Narne an d ss -of' ficai older Name and Address of Agent Additional InsuAd BOB DEGRAAF INSURANCE AGENCY, INC. MCBOCC 3499 4TH STREET NORTH 418 Simonton Street ST PETERSBURG, FL 33704 Rey Wert, FL 33040 727-821-9575 PHONE 727-8 22--312 6 FAX INTERNAL STATE FARM USE ONLY: LJ Request permanent Certifyate of Insurance for liability coverage. 122429.3 Rev. 07-- -2005 ❑ Request Certificate Holder to be added as an Additional Insured. �� r A� d CERTIFICATE OF LIABILITY INSURANCE °"M'""'°°""""' 8/24/2010 (305) 294-4d94 FAX: (305) 743-0582 4THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rays Insurance Services, Inc. ONLY AND CON NO RIGHTS UPON THE CERTIFICATE 805 Peacock Plaza �� T AMEND, EXTEND OR COVERA�i AFFORDED BY THE POUCIE8 BELOW. Key West _ _ FL 33040 INSURERS IN3 OVERAGE NAIC � - ---— - ---- -- ------------..-- - -- - __ _ _----__ --- -$-- - -----ram _Group - --- ty E Hunt Schauerma�z, DBA: Keys Forensic Aj iNsu� B; ' q Ci cisl Ins 1099e -- PO Hoc 523207 -IRc:Evans raaee Company - - -- -- ---- - UNTY Marathop Shores FL 33052 -.------------- �E�v�FNi 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 CST OR OTHER DOCUMENT VHTH RESPECT TO VMICH THIS CERTIFICATE MAY MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND BE ISSUED OR POUCIES. .HO S LIMI AGGREGATE TSHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS CONDITIONS OF SUCH . __..._.. � Po1scY N � j _ POLICY «PIAATiON. ` us= GENEaALUABUM _EACH OCCURRENCE . - 1,000.000 X COIF MIAL GENERAL LK&LITY A - CLAIMS MouDE X� OCCUR CCPS63230 8/21/2010 104MO GE TO RENTED ES (Ea 000um�nos�_ Is 9/21/2011 200 MED EXP one s _ 5�000 -- - - - - - - ' PERSONAL 8 ADV INJURY S scold - GOO AGGREGATE LIMIT APPLIES PER:; ; GENERAL_ AGGREGATE -- . S 2, 000 j 000 X j pRp. POLICY i LOC PRODUCTS • COIr�tPIiOP AGO _ _ . . $ wield AUTOM ME LIABILITYCOMBINED 1 - - ANY AUTO } SINGLE LIMIT �_ ALL OWNED AUTOS SCHEDULED AUTOS 8001LY WJURY (Per Pam) , � HIRED AUTOS _._ --- .. - - -- -- -. ------------------_- --- -- - - - NON-0V�fNEO AUTOS BODILY (Per Lam' Y --- -- - {Pat P d u DAMAGE _ OARAOE LMLffY AUTO ONLY - EA ACCIDENT J i � ---: ANY AUTO i OTHER THAN f ' AUTO ONLY: � AGO i = 1 EXCESS I UMBRELLA_IWIaIUTY ` 1 OCCUR -� CLAIMS MADE I EACH OCCURRENCE i - _ AGGREGATE 1 17 DEDUCTIBLE _ _.. - -------- --�- - -- - - - - - - I RETENTION OOYPEIfSAt1QN 8 AKD EWWVW4r L,IAN UTY YINc.�___�_A__�_______ = aOTN- Ao`Rfla oIR� EXCLUDED? 1:1. EL EACH ACCIDENT : - ---- 100 004 I iOry CIOO-OO13681-2010�A ; 8/21/2010 ; i . - - ---- --- 8/21/2011 i E.L. DISEASE . EA EMPLoYEE S � 100 000 -� j C 0TKE"Professional Liab, bB18i9162 19/1/2010 i EL. DISEASE • POLrCY LIMIT ! S 9/1/2011 $5006000 ea ooc 500,000 Cl a� Made fozs Retro date 9/1/08 1 ; ; 88160001000 aqq D PTIOII OF OPERA 110101 trO CATIONS 1 VEKICL,E'S 1 ADDED BY 1 SPECIAL Certificate holder is also addedlm as a:A additioaal insus�d as respects CeaOra' Liability and Professional L.iabili Policies only. ty CERTIFICATE HOLDER (305) 292-4487 Monroe County Hoard of County Commission 1100 34m nton Street F-SY West, FL 33040 CANCELLATION SHOULD ANY OF THE ABOVB DEsc:IBBED DATE THEREOF, THE ISSUNG INSURER NOTICE TO THE CERTIFICATE HQ N IMPOSE NO OBLIGATION / .. REPRESENT AUTHORIZED F Hager ACORD 25 (20MI ) 0119-08-W89' ACORD 'UCIZS WCANCBLLED BEFORE nM munRAT;ON �L. ENDEAVOR TO MAIL 1 DAYS YOUTTEN QED TO THE LEFT, BUT FAILURE To Do 80 SHALL ANY KIND UPON THE INSURER. ITS ApEM M pR ►TION. All rights reserved. --� �'� � CERTIFICATE OF LIABILITYDATE(MM/DDNYYY) INSURANCE $,5,2010 PRODUCER (305) 294-4494 FAX: (305) 743-0582 IFICATE IS ISSUED AS A MATTER OF INFORMATION .Keys Iasurance Services, Inc. ONLY AN CONFERS NO RIGHTS UPON THE CERTIFICATE RECEIVE DHOLDER. 805 Peacock Plaza HIS CERTIFICATE DOES NOT AMEND, EXTEND OR �---------- R TH COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 � 1MUR RS FORDING COVERAGE --� 1(z-I-- — -- NAIC # INSURED — INSURE A: Ce tury Surety Ins Group E Hunt Scheuerman,, DBA: Keys Fo ens C INSURE B: Mi higan Commercial Ins 10998 PO BOX 523207 MC?NRpE COUI&IsuRERc: _ Marathor} Shores FL 33052 - — --- INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAN DING SU ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE IS MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITION ED OR POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. S OF SUCH NSR DD' - TYPE OF INSURAN E POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION _GENERAL LIABILITY -DATEDATE (MM/ppNyyn LIMITS X► EACH OCCURRENCE $ 11000,000 � COMMERCIAL GENERAL LIABILITY DkEM .-PREMISES Ea occurrence) � $ 100,000 -MAGE -TO RENTED A _ � CLAIMS MADE X OCCUR CCP � - - -� ❑ 663230 8/21 2010 18/21/2 / 011 ll MED EXP (Any one person) $ 5 , 0 0 0 I� --- — - PERSONAL & ADV INJURY $ excld -- ---- � GEN L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 !1 [PRODUCTS - COMP/OP AGG L $ exc 1 d JECT X POLICY PRO- LOC AUTOMOBILE LIABILITY ANY AUTO _ ALL OWNED AUTOS J SCHEDULED AUTOS, HIRED AUTOS NON -OWNED AUTOS i j-GARAGE LIABILITY " r ANY AUTO EXCESS / UMBRELLA LIA131LITY I OCCUR CLAIMS MADE f r DEDUCTIBLE j RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) C100-0013881-2010A If yes, describe under SPECIAL PROVISIONS below OTHER COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY $ (Per person) i — BODILY INJURY $ f (Per accident) PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG I $ EACH OCCURRENCE $ AGGREGATE $ WC STATU- OTH- E.L. EACH ACCIDENT $ 100,000 8/21/2010 8/21/2011 E.L. DISEASE - EA EMPLOYE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 5001000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate holder is also added as an additional insured for General Liabilit only. CERTIFICATE HOLDER Monroe County Board of County Commissione 1100 Simonton Street, Ste 268 Key West, FL 33040 r ACORD 25 (2009/011 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POL IES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WIL NDEAVOR TO MAIL 1— DAYS WRITTEN NOTICE TO THE CERTIFICA4HOLDEM TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OF Y KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESE F Hager © '(988-2009 ACORDtCORAORATION. All rights reserved. INS025 (200901) The ACORD name and logo are registered g g stered marks of ACORD A ` 40R�� ;�•w.+' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIY 8,30,2011 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 ADDIT the tenns and conditions of the policy, certain pol certificate holder in lieu of such endomement(s). ies may r� "Y% endorsed. If SUBROGATION IS WAIVED, subject to nt on this certificate does not confer rights to the PRODUCER Keys Insurance Services, Inc.FAX 805 Peacock Plaza Ke West FL 33040 SEP 2 MONROE F. er EAE )294-4494 �: (305)743-0582 @keysinsurance.com 23696 SURE S AFFORDING COVERAGE NAIC# INSURED RISK MANASure E Hunt Scheuerman, DBA: Keys Forensic PO BOX 523207 Marathon Shores FL 33052 Ins Group INSURER Michi an Commercial Ins Mutual 10998 INSURER C: INSURER D : INSURER E : INSURER F: f�AVCMA f--CC ftFRTIFICOTE NIIMRFR-CL1183002777 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 IDD YYYY POLICYEXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 5,000 A CLAIMS -MADE CJ OCCUR CCP721027 /21/2011 /21/2012 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ excl $ X POLICY PRO El LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ SCHEDULED AUTOS HIRED AUTOS v �-( �[/, 1 i NON -OWNED AUTOS UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE{ { EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN ``jf t q WC STATU- OTH- BY_. ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYE $ 100,000 OFFICEMMEMBER EXCLUDED? (Mandatory in NH) N I A 100-0013881-2011A /21/20 1 /21/2012 E.L. DISEASE - POLICY LIMIT 1 $ 500,000 H yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required) Certificate holder is also added as an Additional Insured for General Liability only. CERTIFICATE HOLDER GAIVGCLLAI1UN (305)295-3178 Monroe County Board of County Commissione c/o Monroe County Risk Management 1100 Simonton Street, Ste 268 Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES ME C ELLED BEFORE THE EXPIRATION DATE THEREOF, NOTI DELIVERED IN ACCORDANCE WITH THE POLICY PROVIS AUTHORIZED REPRESENTATIVE ACORD 25 f2009/091 v - . Hager/LH - n - ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 poosos) The ACORD name and logo are registered marks of ACORD A� br CERTIFICATE OF LIABILITY INSURANCEF8/30/2011 DATE ) THIS CERTIFICATE IS ISSUED AS A MATTER OF IN pitlC ERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS tqL.y � CERTIFICATE DOES NOT AFFIRMATIVELFECERTIFICATE TEND ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURAESJTp�TITLTfEXA CONT CT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND T HOLDER. IMPORTANT: If the certificate holder is IDDITIONAL INSURED, the ocy(ies) the terms and conditions of the policy, cn policiesrola� requ5D aV dorsemen certificate holder in lieu of such endorse(s). 11//ll++�� ust be endorsed. If SUBROGATION IS WAIVED, subject to A statement on this certificate does not confer rights to the PRODUCER NAME: F. Hager ONE 305)294-4494 FAX Keys Keys Insurance Services, Inc. MOMOE 805 Peacock Plaza RISK MANAGEM AIL qer@keysinsurance.com PRODUCER 00023696 INSURER(S) AFFORDING COVERAGE NAIC# Key West FL 33040 INSURED INSURER A:Century Surety Ins Group INSURERB'Michigan Commercial Ins Mutual 10998 E Hunt Scheuerman, DBA: Keys Forensic INSURERC: PO BOX 523207 INSURERD: INSURER E : Marathon Shores FL 33052 INSURER F COVERAGES CERTIFICATE NUMBER-CL1183002777 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 INSR UBR WVD POLICY NUMBER POLICY EFF MWDD POLICY EXP MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX_1 OCCUR CCP721027 8/21/2011 8/21/2012 DAMA RENT ED PREMISES Ea oxurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ excl PROX POLICY JEC 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 �J/� PROPERTY DAMAGE (Per accident) $ $ NON -OWNED AUTOS ( _ UMBRELLA LIAB OCCURDF6 EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE _ DEDUCTIBLE $ $ RETENTION $ .% B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) ('1 / A C100-0013881-2011A 8/21/2011 8/21/2012 WC STATU- OTH- E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYE $ 100,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 C Professional Liability IN105629-01 09/01/201109/01/2012 Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate holder is also added as an Additional Insured for General Liability only. IiCR I iriLA i c 11VLUCK I,.ANI+tLLA 1 IUN (305)295-3178 Monroe County Board of County Commissione c/o Monroe County Risk Management 1100 Simonton Street, Ste 268 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 Hager/LH AGUKU 25 (Z009109) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909)The ACORD name and logo are registered marks of ACORD Cc, I AC40RV CERTIFICATE OF LIABILITY INSURANCE 8/15/2012 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. B the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. B SUBROGATION IS WAIVED, subject to the terns 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 =ACT Doan Marlene loss E. Kays Insurance Services PIWNE (305)294-4494 (�os)Taa-osu 805 Peacock Plaza ADDRESsaw Key West FL 33040 I AFFORDING COVERAGE NAIL s MURFRA.CGntUZY ety Ins Groulp INSURED INS REne:C&otlePoint Florida Ins. Cc E Hunt Scheuerman, DBAs Keys Forensic RER :First Professional Insurance PO Box 323207 INSURER0: NISU E: Marathon Shores FL 33052 GOVEHAUPM1 CERTIFICATE NUMRFR-CL1381503786 eeulalnu ul rumae. 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. LTR TYPE OF INSURANCE UDL sum POLICY NUMBER POLICY S GENERALLIABILITY EACH OCjj$ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLANS -MADE F OCCUR 7e4029 /21/2012 /21/ 0013 $ 100, 000 MED EXPs 51000 PERSONAs 1,000,000 GENERAL AGGREGATE S 2,000,000 AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMROP AGG S excl rNL POLICY LOC S AUTOMOBILE LIABILITY I y ? ISK BODILY INJURY (Per person) S ANY AUTO C3 ALL OWNED SCHEDULED AUTOS AUTO HIRED AUTOS AUTOS BODILY INJURY(Per acddern) S P r S S c: Ito., UMBRELLA UAB BUR EACH OCCURRENCE S AGGREGATE S EXCESS UAO CL/UMS•MADE DED I I RETENnON 2 S $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERM(ECUTWE OFFICEWMEAISER EXCLUDED? (MnMMM In NNp MIN OF NIA WCP761160000 /21/2012 /21/2013 WC STATU6 I JOTH- E.L. E.L.EACH ACCIDENT S lOO OOO E.L. DISEASE • EA EMPLOYEE S 100,000 E.L. DISEASE - POLICY LIMIT S 500,000 OPERATION below C U105629 /1/2012 /1/2013 OEECRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Algch ACORD 101. Additional Renurlu Schedule. N more spoil Is required) Certificate Bolder Is Also Listed As An Additional Insured With Rasyects To General Liability Only. diaz-moniqueftonroecounty- Monroe County Board Of County Ccl=issione 1100 Simonton Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Ste 268 AUTHORIZED REPRESENTATIVE Key Wes, FL 33040 G ACORD 25 (20101W 01 M2010 ACI INS025 (2ows).o1 The ACORD name and logo are registered marl& of ACORD reserved. ACbR CERTIFICATE OF LIABILITY INSURANCE 93i20` 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 polky(les) 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 ea,tlRewto holder In lieu of such endorsemsnt(p)�- PRODUCER Keys Insurance Services 805 Peacock Plaza Key West INSURED 8 Runt Schsuerman, PO Box 523207 FL 33040 DBAr Keys Forensic 052 �.. Donna Marlene Ross vfwN� e.. (305)294-4494 I=.No (303)743-QSS2 .cam nr1nLNAU unrelOCQ. COVERAGES GERnrIaAlanualaan.-+�»��-� ••-- LISTED BELOW HAVE BEEN ISSUED TO THE INSURED -- NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. KRIS EXP urns TYPE OP INSURANCE POLICY NUMBER 1, 000, 000 GENERAL UASIL1T11 EACH OCCURRENCE S 7/2-1/2013 = 100, 000 X COMMERCIAL GENERAL LIABILITY X S1S6800 /21/2014 MEO EXP one S 5,000 A CLAIMS -MADE OCCl1R PERSONAL& ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS . COMPIOP AGG S IiXCL X POLICY IT LOC MWj1ffNE%5MLF- S LIMIT AUTOMOBILE LIABILITY BODILY INJURY (Per Penn+) S ANY AUTO ALL OWNED SCHEDULED BODILY KMY (Per ecddem) S AUTOS AUTO TYDAMAGE s HIRED AUTOS AUTOS S UMBRELLA uAB OAR EACH OCCURRENCE S HCLADA&MADE AGGREGATE S EXCESS LIAR S OED TI+ YVC STATU DFA B WOERS COMPENSATION RK E.L. EACH ACCIDENT S 100 000 AND EMPLOYERS' UABILRY YIN ANY PROPRIETORIPARTNEROEXECUi1VE EL DISEASE - EA EMPLOYEE S 100.0001 EXCIUDEDT NIA 61160001 /21/2013 /21/2014 OkoddocyI In E.L. DISEASE • POLICY LIMIT S 500,000 voc SCRIN F ow C Professional Liability 930936 /1/2013 11/2014 Ead,000A„enp 500,000 i I Gomml Agpeom 1,500,000 DESCRIPTION OP OPEItATK)NS I LOCATIONS I VEHICLES (Atlseh ACORD 101, AddIdWd Rsmerb Sdwdute, If mom epees Is NW16 ) Certificate Holder in Also Listed As An Additional Insured With Respects To General Liability Only. APPRO D IC fiAA BY -71 o -n DA �-iL- WAI �; t ri ram? I'Q- tT1 1 � 1(305)292-4487 Diaz-MoniQue@monroecounty- Monroe County Board of County Commissions 1100 Simonton Street Ste 268 Key West, PL 33040 - a � SHOULD ANY OF THE ABOVE DESCRIBED POLL BE CAIMLLEPWORE THE EXPIRATION DATE THEREOF, NOTICE ILL BEO IN ACCORDANCE WITH THE POLICY PROVISIONS « C:) — r .•W AUTHORIZED REPRESENTATIVE Marlene Ross dS 11MIL2nIn ACORD CORPORATION. All dahis reserved. MHVnY"%-V.W/ j INS= (2woom The ACORD name and logo are registered marks of ACORD SCHEAL1 OP ID: LR ,44coRl7" CERTIFICATE OF LIABILITY INSURANCE A11/2 v) r1121/2012013 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 Darr Schackowlnsurane Agency Holly Hill CONTACT NAMEEmilie Madore PHONEFAX A1C No Ext 352-338-0552 A/C No; 352-376-5741 5200-B West Newberry Road Gainesville, FL 32607 E-MAIL ADDRESS, EMadOre d51nS.bIZ INSURERIS) AFFORDING COVERAGE NAIC p Emilie Madore INSURERA : Travelers Auto 27998 INSURED Alesha $ Eugene Scheuerman 135 Bid A Wee Lane INSURERS: Panama City, FL 32413 INSURERC: INSURER D : INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE -ISTED 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 I LTR I TYPE OF INSURANCE INSIR WVD POLICY NUMBER JMMIDDNYYY1LIMITS GENERAL LIABILITY _IMMUDDIYYYY1 EACH OCCURRENCE $ PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F—IOCCUR MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE UMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 17 PROT- LOC POLICY F7 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acadenf $ BODILY INJURY (Per person) $ 250,000 A ANY AUTO 9780673641012 10/09/2013 04/09/2014 X ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ 500,000 NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE PER ACCIDENT $ 100,000 $500 Coll $ $100 Com UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ WO RKERS COMPENSATIO N AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORfPARTNER/EXECUTIVE WC STATU- OTH- AU LIMITS ER E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ❑ NIA E.L.01SEAS E-EAEMPLO YEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POUCY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is listed as Additional Insured —. on 2013 GMC Terrain De; VIN #2GKFLYE31D6330704 A PftGEMENTB`_'DAf�li5(( O d N O 14 TAll N/A � cc .a CERTIFICATE HOLDER CANCELLATION LZ :6 bid ZZ AOIN [16Z Monroe County Board of County Commissi@�"10A 03 111 1100 Simonton Street Keywest, 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 Emilie Madore C 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD