Insurance Certificates
Certificate of Insurance
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT
AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW.
This is to Certify that
I Ocean Reef Community Association
100 Anchor Drive, #505
Key Largo, FL. 33037 - 5273
I
~-
Name and
address of
Insured.
liBERTI'
MUTUAL" '
L
~
Is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is sub
all their terms, exclusions and conditions and is not altered by any requirement, term or condition of any contract or other document with respect to whi
certificate ma be issued.
TYPE OF POLICY
WORKERS
COMPENSATION
EXP.DATE
o CONTINUOUS
o EXTENDED
~ POLICY TERM
06/21/2000
POLICY NUMBER
LIMIT OF LIABILITY
WC2-151-404302-079
COVERAGE AFFORDED UNDER
WC LAW OF THE FOLLOWING
STATES:
GENERAL LIABILITY
10/01/98
YV7 -151-404302 -04 7
EMPLOYERS LIABILITY
Bodily Injury By Accident
$500,000
Bodily Injury By Disease
$500,000
Bodily Injury By Disease
$500,000 ~~~on
General Aggregate - Other than Products/Completed Ope ratio
$2,000,000
FL
Each
Accident
Policy
Limit
I RETRO DATE
I
Products/Completed Operations Aggregat
$2,000,000
Bodily Injury and Property Damage Liability
$1,000,000
Personal Injury
$1,000,000
Other Fire Legal $50,000
Per
Occurrence
~OCCURRENCE
DCLAIMS MADE
Per Personl
Organization
Other Med Pay $5,000
UTOMOBILE L1ABILI
10/01/98
AS1-151-404302-027
$1,000,000
Each Accident - Single Limit
B.1. and P.D. Combined
~ OWNED
~ NON-OWNED
~ HIRED
THER
Each Person
,Y
Each Accident or Occurrence
Each Accident or Occurrence
T.
,It. IlleR:
I'~. ~ -
,Lns.
DDITIONAL COMMENTS
The Certificate Holder is named as Additional Insured with respects to General and Auto Liability Coverage.
. If the certificate expiration date is continuous or extended term, you will be notified if;overage is terminated or reduced before the certificate expiration date.
SPECIAL NOTlCE-oHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS
AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.
IMPORTANT NOTICE TO FLORIDA POLICYHOLDERS AND CERTIFICATE HOLDERS: IN THE EVENT YOU HAVE ANY QUESTIONS OR NEED INFORMATION
ABOUT THIS CERTIFICATE FOR ANY REASON, PLEASE CONTACT YOUR LOCAL SALES PRDDUCER, WHOSE NAME AND TELEPHONE NUMBER APPEARS IN THE LOWER RIGHT HAND
CORNER OF THIS CERTIFICATE. THE APPROPRIATE LOCAL SALES OFFICE MAILING ADDRESS MAY ALSO BE OBTAINED BY CALLING THIS NUMBER.
NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER DF DAYS IS ENTERED BELOW.) BEFORE
THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED
UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS
NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO:
AUTHORIZED REPRESENTATIVE
D^TE
I Monroe County Board of COU~lTIAL
Monroe County Risk Management
CERTIFICATE 5100 College Road
HOLDER
Key West, FL. 33037
LfaX#(305) 295 - 4364 -.J
This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by Those Compan
(800) 542-0055
05/12/99
PHONE NUMBER
DATE ISSUED
BS1501
.'PRODUCER'...."'..,. w...' ,,','.w.. '..,......"'m. ....,.... ....... .... ...... ..... .... ........... ............ ......... THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
AL TI=~ T~I= CO AFFORDED BY T~I= POI ICII=!:: RI=I nw
COMPANIES AFFORDING COVERAGE
DAVIS-GARVIN AGENCY, INC.
182 RILEY AVE SUITE C
MACON, GA. 31204
1-800-462-7807
COMPANY
A
THE HANOVER INSURANCE COMPANY
INSURED
COMPANY
B
OCEAN REEF COMMUNITY ASSOCIATION, INC.
OCEAN REEF VOLUNTEER FIRE DEPARTMENT,INC
OCEAN REEF PUBLIC SAFETY DEPARTMENT
31 OCEAN REEF DR. SUITE A-301
KEY LARGO, FLA. 33037
I
COMPANY
o
COMPANY
C
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDIVY) DATE (MM/DD1YY)
TYPE OF INSURANCE
POLICY NUMBER
LIMITS
REN OF ESP201634
MEDICAL MALPRACTICE
POLLUTION
ERRORS & OMMISSIONS
CLAIMS MADE
GENERAL AGGREGATE $
PRODUCTS. COMP/OP AGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED EXP (Anyone person) $
1 0/1/99
10/1/00
~TOMOBILE LIABILITY
A ~ ANY AUTO
_ ALL OWNED AUTOS
_ SCHEDULED AUTOS
_ HIRED AUTOS
_ NON-OWNED AUTOS
~ UM: $100,000
X PIP: $100,000
GARAGE LIABILITY
-
_ ANY AUTO
-
REN OF ESP201634
10/1/99
1 0/1/00
COMBINED SINGLE LIMIT $
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
MED PAY: $5,000
AUTO ONLY. EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
EXCESS LIABILITY
A -xi' UMBRELLA FORM
I OTHER THAN UMBRELLA FORM
AGGREGATE $
$
REN OF UMB 420294
1 0/1/00
EACH OCCURRENCE
1 0/1/99
AGGREGATE
$
_.J!9~~I!'~!;. L~o~ _
EL EACH ACCIDENT $
WORKER'S COMPENSATION AND
EMPLOYERS' LiABILITY
,'I1~:f.f1~' ,\:'
1./.
._ J 21 \ G 41 .-
EL DISEASE. EA EMPLOYEE $
lHE PROPRIETOR!
PARlNERSlEXECUTIVE
OFFICERS ARE:
RINCL
EXCL
EL DISEASE. POLICY LIMIT
OTHER
UNLIMITED
UNLIMITED
1,000000
1,000000
50 000
5,000
1,000,000
$
20 000 000
20 000 000
$
.~
/.. 'T') -- - 6V7\ ' (~(' q& ., /' 0 D..-
'OPERATIONS/LOCATIONSIV HiCLES/SPECIAL ITEMS L<\,~ ~ \I '--'
MONROE COUNTY BOCC IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY, AUTO LIABILITY, AND
PROFESSIONAL LIABILITY COVERAGES ABOVE
MONROE COUNTY BOCC DATE -'--7 " EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
ATTENTION: MARIA DEL RtQITIAL A J 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
5100 COLLEGE RD -;;2" BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
KEY WEST, FLA. 33040 OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
I
CHRIS DAVES
~-,. . I
,4CORDT~ CERTIFICA'I E OF LIABILITY INSU~~NCE DATE (MMID D/YY)
12/12/00
PRODUCER -' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Davis-Garvin Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
PO Box 21627 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Columbia, SC 29221-1627
803 732-0060 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Mas sachuset t s Bay Insurance Co.
Ocean Reef Community Association, Inc. INSURER B:The Hanover Ins. Co.
31 Ocean Reef Drive #505 INSURER c:
Key Largo, FL 33037 \ 'e '!J ---
INSURER D:
I INSURER E:
Client#
6002
nCEANREE
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWrrHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT wrrH 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 L1MrrS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSFlI 1 I POLICY EFFECTIVE IPOLlCY EXPI~ n
LTR' TYPE OF INSURANCE ! POLICY NUMBER LIMITS
DATE IMMIDD/YV\ DATE IMM~DD/Y
A I GENERAL LIABILITY ZDZ5630469 110/01/00 10/01/01 EACH OCCURRENCE $1 000,000
r .xi rol""C'~ ""~ '''''UTI FIRE DAMAGE (Any one fire~ $100 000
. . . CLAIMS MADE[K] OCCUR ME D EXP (Anyone person) I $ 5 , 0 0 0
PERSONAL & ADV INJURY $1,000 000
GENERAL AGGREGATE $N/A
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $N/A
I POLICy-I~- j~gT n LOC
A AUTOMOBILE LIABILITY ZDZ5630469 t\~ e-W01/OO 10/01/01' COMBINED SINGLE LIMIT $1,000,000
.iC~ ANY AUTO RtC (Ea accident) I
--_.~ I --.
--.J ALL OWNED AUTOS \)t~ , ) .~~\\ BODIL Y INJURY $
! SCHEDULED AUTOS (Per .person)
;\~G I
HIRED AUTOS \l\}\l.C"~ i BODIL Y INJURY
(Per accident) $
NON-OWNED AUTOS
. .--
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY- EAACCIDENT $
--1 ANY AUTO I OTHER THAN EA ACC $
AUTO ONL Y: AGG $
B EXCESS LIABILITY =IUHZ 5 6 30876 10/01/00 10/01/01 EACH OCCURRENCE $20,000,00C
OCCUR D CLAIMS MADE AGGREGATE $20 , 000 , 00 C
,
i $
I Jnl'~~'~
, DEDUCTIBLE I 'ti(wrr- Q'f IX' --- $
I "'\. .
I RETENTION $ .. \ ' ! " $
i WORKERS COMPENSATION AND v , J I . (\ _L......j f I..(..L) , (U .1I LWC smJx.s! !OJ~-
,.' O?~' -----~
EMPLOYERS' LIABILITY ~___ 1:
3- () i E.L. EACH ACCIDENT $
- - E.,L.DISEASE-EA EMPLOYEE $
cc' ~~ ()
. /' ",..,.. E.L. DISEASE-POLICY LIMI $
OTHER ! \ I-_f ' , -
I iw 1
I
I }).. '1A -
I , , .,
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS AD DE D BY ENDORSEMENT/SPECIAL PROVISIONS
Name Printed on DEC Page: Ocean Reef Community Association, Inc.
Ocean Reef Public Safety Department
Ocean Reef Volunteer Fire Department, Inc.
Ocean Reef Community Foundation, Inc.
(See Attached Descriptions)
CERTIFICATE HOLDER I X I ADDmONALlNSURED'lNSURER LETTER: CANCELLATION
SHOULD ANYOFTHE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION
Monroe County BOCC DATETHEREOF,THE ISSUING INSURER WILLENDEAVORTO MAl LlL DAYS WRITTEN
5100 College Road NOTICETOTHE CERTIFICATE HOLDER NAMED TO THE LEFT, BLlTFAILURE TO DO SO SHALL
Key West, FL 3304q IMPOSE NO OBLIGATION OR LIABILITY OF ANYKIND UPON THE INSURER,ITSAGENTSOR
REPRESENTATIVES.
A'tt::J.IZED REPRESENTATIVE
I It. W~
ACORD 25- S (7/97)1 0 f 3
#S49699/M49697
DSM @ ACORD CORPORATION 1988
DESl,tlIPTIONS (Continued from ~ ...ige 1)
Ocean Reef Bistorical Society, Inc.
Additional insured on General Liability and Business Auto Liability
AMS 25.3 (07/97) 3 of 3 #S49699/M49697