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Certificates of InsuranceACORD CERTIFICATE OF LIABILITY INSURANCE OPIDc4 ADVAN16 1 01/05/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown A Brovm Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 17757 US Highway 19 N, Ste 660 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 2456 Clearwater FL 33757-2456 Phone: 727-461-6044 Fax: 727-442-7695 INSURED Advanced Data Solutions, Inc. PO SOX 248 OLDSMAR FL 34677-0248 INSURERS AFFORDING COVERAGE NAIC # INSUBFR A. R..EEAXB �.,,...M, T... A— OP 29424 INSURER B'. 30104 INSUREflc'. 24740 INSURER : Lloyds of London 22000 IN$UflER E'. GU V CRAENC.I THE POI OF INSURANCE LISTED BELOW HAIL BEEN ISSUED TO THE INSURE° NAMED ABOVE FOR THE POLICY PERIOD IN°ILATE➢. NOTWI ISTAN01NG NV REQUIREMENT, TERM OR CONDITION OF ANY CONTAACTOROTHU DOCUMEN! WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFNBDEO BV THE POLICIES DESCRIBED HEREIN 16 SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH . POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN SEDUCED BY PAID CLAIMSNS WE POLICY EFFELl1VE PWLY EE%MTIp1 LWRB LT MD TYPE OF INSURANCE POLICY HUYBER pATENLUDDA'Y WTE YYNM'YI EACH OCCURRENCE 51,000,000 GENERAL LIIYUTY DAMAGE TO RENTED A X X COMMERCIAL GENERAL LIABILITY 219BAXO0961 07/17/08 07/17/09 PREMISESU AFUMBAII s300,000 MEDEXP("WXpI $10,000 CIAIMB MADE ❑OLCVB PUSONALSAOVINJURY A 1,000,000 GENERALAGGREGATE s 2,000,000 PRODUCTS-LOMI AGE f 2,000,000 GENT AGGREGATE LIMIT APPLIES PER LICY JECPOC POLICY WTOYOEILF U.M. Y COMBINED SINGLE OMIT S 1,000,000 C X ANY AUTO OICHB4781710 04/04/08 04/04/09 (CIII .ml BOULV INJURY $ ALL OWNED AUTOS (AW AXI X SCHEDULED AUTOS X BOOXY INUPY IS HIRED AUTOS NON OWNER AUTOS ==\—Y11/�11 Par.cdeenO X PNOPEBTYDAMAGE f { _ IPROPEFTYll GMPGELIAYLITY r — AUTOONLV-ACCIDENT f EA ACC f ANV AUTO SL OTXER THAN _ BR ELL° LIPS MTY EACH OCCURRENCE $ 3 CURCUM6MAOEAGGREGATE RIA OUCTIBLEM��TENTION 'I I f f LSC STAB- OTw WORILERSCOIIPEH LTIpN ANDTOBY LIMITS ER EL EACH ACCIDENT S 100,000 B EMPLOYERS' LIMUNY 21WECGA3774 02/21/08 02/21/09 E.L. DISEASE EA EMPLOYEE 5 100,000 AN Y PROPRIETOWPARTNEF/EXECUTIVE OFFI CERMEMBEB EXCLUDED? ELOISEASE-P«ICYLIMIT $ 500,000 II I'MIml,aunmr SPECIAL PROVISIONS bab Om ER D Professional H70812996 03/23/08 03/23/09 Aggregate 11000,000 Occurence 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES I UELEII RELIED BY EXDORIENENT I SPECIAL PROVIBONS Monroe County BOCC is also named as additional insured with resPect to General Liability and Auto Liability. MGNRG-4 SHOULD MY OF THE ABOVE DESCRIBED POLICIES RE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE MING INSURER WILL EN BE AN OR TO NAIL 30 OPYS WATTEM NOTICE TO TH E CUT FIXATE HOLDER NAMES TO THE LEFT, BUT FA I.E. E TO DO W SHA L Monroe County BOCC I NF09E NO OBLIGATION OR UA&IITY OF YL'I KIN D UPON THE IXSUREA. ITS 1GF51T8 OR 1100 Simonton Street, Room 268 key West FL 33040 REPRESFHTATIVEE K-1 CERTIFICATE OF LIABILITY INSURANCE °API31vD"07 DATE 02 M 7 Q} PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Carlisle Fields & Company, LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 1027 A►I. EFI ; Ti E E A E A ff ORDE D BY THE POLICIES 'BELOW. .a 1�C?I:N Cf VFRAGE NAIL# Clearwater FL 33758-7910 Phone: 727-797-0441 Fax:727-725-3663 - INSURED INSURER A_ Northern I ? surance Co an Advanced Data Solutions , Inc. Melodie Buell CPA 141 >Scarlet B.vd #A � Oldsmar FL 34677 R e rs' Ins ranee cTr any 32700 INst1RERc: custom Ca ualt Com an __�— ------____-- INSURER D_ IN 0 1�: ; Iv a �— - COVERAGES ' "'r THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE POLICY DATE MWDD/YYYY LIMITS GENERAL LIABILITY j EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES (Ea once} _± ; $ ;CLAIMS MADE 1 i OCCUR MED EXP {Any one person} i $ - ---- PERSONAL & ADV INJURY $ ------------ GENERAL AGGREGATE $ GEN`L AGGREGATE LIMIT APPLIES PER; PRODUCTS - COMPIOP AGG ' $ PRO POLICY JECT -- B X AUTOMOBILE -� --- LIABILITY ANY AUTO 4795673300 04/04/09 04/04/10 Ea accldent)SINGLELIMi7 $ 1000000 � XI BODILY INJURY $ {Per person} 4 ;ALL OWNED AUTOS SCHEDULED AUTOS C HIRED AUTOS f BODILY INJURY ! ; $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE ( $ (Per accident) I GARAGE LIABILITY *` ( AUTO ONLY - EA ACCIDENT $ � — I I f ANY AUTO j OTHER THAN EA ACC j $ �' AUTO ONLY: E AGG j $ EXCESS I UMBRELLA LIABILITY , i EACH OCCURRENCE $ i i OCCUR CLAIMS MADE L_,_ _._, _ I AGGREGATE $ DEDUCTIBLE I $ j RETENTION $ ; � ' � ! $ I WORKERS COMPENSATION X TORY LIMITS I j ER AND EMPLOYERS" LIABILITY N--- Y IN A j ANY PROPRIETOR/PARTNER/EXECUTIV WC0349783300 02/21/10 02/21/11 E.LEACH ACCIDENT j $ 100000 OFFICER/MEMBER EXCLUDED? (Mandatory inNH) I E-L DISEASE EAEMPLOYEEI $ 100000 1 es, describe under SPECIAL PROVISIONS below _ E.L. DISEASE - POLICY LIMIT $ 500000 OTHER � C ;Professional Lialb �H70912654 I 05/23/09 I 05/23/10 Oecurence 1000000 Deductibl 2500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Monroe County Board of County Commissioners are listed as additional insured in regards to the automobile policy. ,. wcr% r rria.n r r~ rl%AL vcr% SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO COUNTMO 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 County of Monroe IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Board of County Commissioners REPRESENTATIVES. Risk Management AUTHORIZED REPRE NTATIVE 1100 Simonton St. Key West FL 33040 1010410 - -0 A 1009/01) O 19 -2 CO ' rued. The ACORD name and logo are registered marks of ACORD DATEMM/DD/YYYY) •!RbrCERTIFICATE OF LIABILITY INSURANCE OP ID SA ADVAN07 05 11 10 oDuceR 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Carlisle Fields & Company, LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 1027 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Clearwater FL 3758-7910 Phone: 727-797- 441 Fax: 727-725-36 3 � ., _ -J�ljtt S AFFORDING COVERAGE NAIC # INSURED ! INSURER A: Ort ern Insurance Company URERB.- dwne s Insurance Company 32700 Advanced Data Solutions , I C.MAYISu ous on Casualt Com an j Melod !Buell CPA y p y 141 Scarlet Blvd #A -- T -- Oldsmar FL 34677 INSURER D-- n -i t COVERAGES 1 144�r'j,r,.. 14F, THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AB VE F�51k—Wff�LII IOD 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD ICY C/YYYY DATE MM/DICY DT I LIMITS GENERAL LIABILITY EACH OCCURRENCE $ PREMISES (Ea occurence) $ f COMMERCIAL GENERAL LIABILITY CLAIMS MADE u OCCUR I MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ j I GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT' AUTOMOBILE LIABILITY B X ANY AUTO 4795673300 04/04/10 04 O4 11 / / COMBINED SINGLE LIMIT (Ea accident) $ 1000000 BODILY INJURY (Per person) I $ ALL OWNED AUTOS; X SCHEDULED AUTOS BODILY INJURY Per accidI ent $ () X HIRED AUTOS ! X NON -OWNED AUTOS I ---j -- , PROPERTY DAMAGE $ i (Per accident) i GARAGE LIABILITY AUTO ONLY - EA ACCIDENT j $ j ANY AUTO 1 �.-- _ 1 EA ACC $ AUTO ONLY: AGGj$ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ — OCCUR L CLAIMS MADE AGGREGATE $ DEDUCTIBLE I $ � !$ RETENTION $ CC WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y / N A ANYPROPRIETOR/PARTNER/EXECUTIV OFri%EF�.'ldic���E3z R-* EXCLUDED? (Mandatory in NH) � If yes, describe under SPECIAL PROVISIONS below WC0349783300 02/21/10 02/21/11 I ' j ! i X TORY LIMITS ER El EACH ACCIDENT - - i $ 100000 -- - ---- —._ E.L. DISEASE - EA EMPLOYEE' $ 100000 ------ --- ! E.L. DISEASE - POLICY LIMIT $ 5 O O O O O OTHER � C Professional Li.ab I l H70912654 05 23 09 05 23 10 Occuren / / / / ce 1000000 ! 1 Deduct 2500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Monroe County Board of County Commissioners are listed as additional insured in regards to the automobile policy. LiGr% I I C nVLUr-M' LANGtLLATIVN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION COUNTMO 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 County of Monroe IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Board of County Commissioners REPRESENTATIVES. Risk Ma4nagement AUTHORIZED REPRE NTATIVE 1100 Simonton St. Key West FL 33040 I L ACORD 25 (2009101)©19 - .COserved. �C. The ACORD name and logo are registered marks of ACORD -� CERTIFICATE OF LIABILITY INSURANCE OP ID s5 °"'_ � rwvnxie os o3 io PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 83 Park Place Blvd., Ste 101 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 2456 (3 3 7 5 7- 2 4 5 6) AFFORDED BY THE POLICIES BELOW. Clearwater FL 33759 ivtu i Phone: 727-461-6044 Fax: 727 -442 -7695 RS-AFFORUING C VERAGE NAIC # INSURED j6kURER NSURER A: Hartfor Casua ty Insurance Co 29424 Advanced Data Solutions, Inc. INSURER C: ; PO BOX 248 OLDSMAR FL 34677-0248 PfIVIMPAMM 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. INSK LTR OWL NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYYYY POLICY EXPIRATION DATE MM/DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 PREMISES (Ea occurence) $ 3 0 0 0 0 0 A X X I COMMERCIAL GENERAL LIABILITY 21 SBAK00 9 61 0 7 / 17 / 10 0 7 17 11 CLAIMS MADE XX OCCUR MED EXP (Any one person) $ 10000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2000000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ EA ACC OTHER THAN $ ANY AUTO $ AUTO ONLY: AGG EXCESS I UMBRELLA LIABILITY 7 OCCUR F-1 CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE 1 ' $ $ RETENTION $ r WORKERS COMPENSATION AND EMPLOYERS, LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIV� W TATU- - TORY LIMITS ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) 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 is named as Additinal Insured with respects to General Liability. L CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION MONRO - 3 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Monroe County Florida IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 Simonton Street REPRESENTATIVES. Gato Building Key West, 33040 AUTH REPRESWTIVE ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ` L"r" CERTIFICATE OF LIABILITY INSURANCE OP ID S5 DATE(MM/DD/YYYY PRODUCER AI VANI6 10 / 04 / 10 Brown & Brown Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 83 Park Place Blvd., Ste 101 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 2456 (33'757-2456) LD R. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Clearwater FL 33759 (� COVERAG AFFORDED BY THE POLICIES BELOW. Phone:727-461-6044 Fax:727-442-7695 �1 1 INSURED INSURERS AFFOR ING OVERAGE NAIC # 0 SURE tf a cae 1ty insurance co 29424 SURE B: Advanced X)ata Solutions, Inc. INSURER C: PO BOX 248: _ OLDSMAR FL 34677-0248 COVERAGES NTN1¢vMRIFNT 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER nwr� GENERAL LIABILITY A I X X COMMERCIAL GENERAL LIABILITY 21SBAK00961 CLAIMS MADE ! X i OCCUR GENT AGGREGATE LIMIT APPLIES PER: POLICY ] PRO- JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY I ANY AUTO EXCESS / UMBRELLA LIABILITY ] OCCUR ] CLAIMS MADE DEDUCTIBLE RETENTION $ AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVI50 OFFICER/MEMBER EXCLUDED? I I (Mandatory in NH) I — If yes, describe under SPECIAL PROVISIONS below r r uN 1 r MMND/YYYY LIMITS EACH OCCURRENCE $ 1000000 07/17/10 07/17/11 PREMISES (Ea occurence) $ 300000 MED EXP (Any one person) $ 10000 PERSONAL BADVINJURY $ 1000000 GENERAL AGGREGATE $ 2000000 PRODUCTS - COMP/OPAGG $ 2000000 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ AUTO ONLY - EA ACCIDENT $ I OTHER THAN EA ACC $ AUTO ONLY: AGG $ EACH OCCURRENCE $ AGGREGATE $ $ D l $ . TORY LIMITS ER C ' E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ n r 1 e C uYtRAT10NS / LOCAT'IONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Monroe County Board of County Commissioners is an Additional Insured for General Liability Coverage only when required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO MONRO_4 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 Monroe County BOCC IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 Simonton Street, Room 268 REPRESENTATIVES. Key West FL '33040 AUTH REPRES�l�T�pTIVE ACORD 25 (200�/01) i,,// / The ACORD name and logo are registered marks of ACORD RD CORPORATION. All rights reserved. ,JE�!Rv CERTIFICATE OF LIABILITY INSURANCE OPID S5 DATE (MM/DD/YYYY) ADVANI6 10 04 10 PRODUCER THIS CERTIFICATE IS ISSUEffT9WMXff ER OF INFORMATIO Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 83 Park Place Blvd., Ste 101 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 2456 (33757-2456) ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOV Clearwater FL 33759 Phone: 727-461-60-44 Fax:727-442-7695 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Hartford Casualty Insurance Co 29424 INSURER B: INSURER C: Advanced Data Solutions, Inc. PO BOX 248 OLDSMAR FL 34677-0248 NSURERD: — 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MM/DD/YYYY LIMITS GENERAL LIABILITY I EACH OCCURRENCE $ lOOOOOO A X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR 21SBAK00961 07/17/10 07/17/11 f PREMISES(Eaoccurence) $ 300000 MED EXP (Any one person) ! $ 1 O000 PERSONAL& ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 2000000 POLICY PE O- LOC - AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ I ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 1 �/ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY:11 GGA EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR C1 CLAIMS MADE AGGREGATE $ I- $ _ DEDUCTIBLE _ $ r RETENTION $ $ WORKERS COMPENSATION - AND EMPLOYERS' LIABILITY Y / N '.. _ ' TORY LIMITS ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ — --- (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Monroe County Board of County Commissioners is an Additional Insured for General Liability Coverage only when required by written contract or agreement. t,r-K I IFI6A I M MULUr-K CANCELLATIVN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION MONRO- 4 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 Monroe County BOCC REPRESENTATIVES. 1100 West IFton Street, Room 268 AUTH REPRES�F�T ,TIVE� Key West ;FL 33040 %,� ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 25 (2009/01 AtEO!FD CERTIFICATE OF LIABILITY INSURANCE OP ID SR DATE(MM/DDIYYYY) �.r� 09/30 10 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 a en orsed. 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 I .. - --_ Carlisle Fields & Company, LLC P.O. Box 1027 Clearwater F:L 33758-7910 Phone_727-79'7-0441_ Fax:727-725-3663 _ INSURED Advanced Data Solutions , Inc Melody Buell CPA 141 Scarlet Alvd #A Oldsmar FL 34677 7(qtFi�COF€- - FAX- — EIOT Eai):_ — (AIC No): _ — ADDRESS: PRODUCER 4ToMER ID a: - - ADVAN07 iNSURERIS) AFFORDING COVERAGE NAIL M IMSURE_RA_: Northern Insurance Company INSURERBc Owners Insurance Company 32700 INSURER : Houston Casualty Company - INSURER D INSURER E COVERAGES CERTIFICATE NUMBER: RFVI3InN N[IMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED HELOVJ HAVE BEEN 1SSUEt) tU 114: INSURED NAMED ABOVE FOR Tiff: POLICY Pt RIOD INDICATED NOTWITHSTANDINGANYREQUIREMENTTERMORCONDIIIONOFANYCONTRACTOROTHERDOCUMENTWITHRLSPLCTTOWHICIITHIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS EXCLUSIONS ANO CONP[Torp S OF" SUCH POLICIES LIMITS SHOWN MAY HAW BEEN REDUCE DRY PAD CI AIMS FRSRT— LTR TYPE OF INSURANCE I RL wvDl POLICY NUMBER POLICY EFF POLICY EX� (MMIDDIYYYY) 01WOONYYY) LIMITS GENERAL LIABILITY - EACI, 011f'URRt NCI g COMMEItCU1l GENEItAI. LIABILITY OAMAGI- TORENIED PRE MISES IEaoccuncncc� S CLAIMS -MADE OCCUR MED LXP IAny one person 19 ---------- PERSONAL & ADV INJURY GENP_RAI AGGREGATE LGEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS • COMPIOP AGG c HOLICr . JECT LUC > AUTOMOBILE LIABILITY 1 COM(IINLI)SINGLI.1ltrifT $1000000 r B ANY AU TO 14795673300 04/04/11 (Ea acade�l) 104/04/10 HO(JILY INJURY (Po:r person) S ALL OWNED AUTOS -- BODILY INJURY (Pw acc�oenU a X SCHEUUI lD AUTOS X — PROPEHTY DAMAGE g X HIRE D AUTOS (Po' acc-dem X NON OWN[ UAUTOS - S- 12 S UMBRELLA LIAR OCCUR y ,/ EACH OCChRRENCI $ EXCESS LIAR 1 CU �� CLAIMS MADE �O AGGRE(,AIE $ DEDUCTIBLE g RETENTION S g A WORKERS COMPENSATION WC03497833uV 02/21/10 02/21/11 X AND EMPLOYERS' LIABILITY Y / N TUHYIIMItS E'RI - ANY PROPRI! TOR,PARTNERIEXECUTIVE^ EL EACHACCIDI NI S 100000 OFF)CERMIEMHER EXCLUDED? L � NIA — (Mandalory in NH) EL CISEASE EA t MPLOYEE $ 100000 If yyees descnbe under -- - 0 SCRIPTION OF OPERATIONS below EL DISEASE POt ICY l IMIT $ 500000 C • Professional Liab H70912654 06/02/10 06/02/11 Occurence 1000000 I Deduct 2500 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Sehodule, if more apace is required) CERTIFICATE HOLDER CANCELLATION County of Monroe Board of County Commissioners Risk Management 1100 Simonton St. Kev West FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE COUNTMO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD R CERTIFICATE OF LIABILITY INSURANCE '. rlisle Fields 6 Company, LLC . Box 1027 earwater FL 33758-7910 IPhone:127-797-0441 Fax:727-725-3663 Advanced Data Solutions , Inc. Melody Buell CPA 141 Scarlet blvd #A Oldsmar F1, 34677 OP ID SR -........-- ADVAN07 06/18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURER A. Northern Insurance Com an INSURER Owners Insurance Com an _ 3_2700 —INSURER C: Houston Casualty Com an INSURER D: INSURER E: VVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CCNOITION 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 PAfD CLAIMS. IR INSR TYPE OF INSURANCE POLICY NUMBER DgTE MM/DDT I DATE MEVDOM'YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ . COMMERCIAL GENERAL LIABILITY GETO"RENTf�— - — PREMISES(Eaoccurence) _ $ CLAIMS MADE J OCCUR MED EXP (Any one person) $ — - - -- PERSONAL & ADV INJURY f --- GENERAL AGGREGATE S GEN'LAGGREGATE LIMO -APPLIES PER: POLICY 71 PRO - ;PRODUCTS • COMP/OP AGG S JECT LOC AUTOMOBILE LIABILITY B X ANY AUTO 4795673300 ALL OWNED AUTOS jl� SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS GARAGE LIABILITY 7 ANY AUTO EXCESS I UMBRELLA LIABILITY nOCCUR CLAIMS MADE DEDUCTIBLE RETENTION S COMBINED SINGLE LIMIT S 1000DOO 04/04/10 04/04/11 (Eaaccidenl) BODILY INJURY (Per person) i BODILY INJURY (Per accdent) $ i PROPERTY DAMAGE S (Per accident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC S AUTO ONLY: AGG $ EACH OCCURRENCE $ AGGREGATE S S 5 $ AND EMPLOYERS' LIABILITY Y / N ORY LIMI ANY I X TTS I ER A . 0 FICER/MEM ER/EXCLUOEECUTIVg p7� WC0349783300 02/21/10 02/21/11 EL. EACH ACCIDENT (MandafotyinNH) .- 100000 If ea, describe under E.L.DISEASE - EA EMPLOYEE S 100000 SPECIAL PROVISIONS below OTHER E L. DISEASE-POLICYLIMIT $ 500000 C Professional Liab H70912654 06/02/10 06/02/111 Occurence 1000000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Deduct 2500 Scheduled veh: 2002 HOND ACCORD EX 1HGCG56642AO17688, 2006 Ford Ecomoline 1FTNE24W06DA70794 CERTIFICATE HOLDER County of Monroe Board of County Commissioners Risk Management 1100 Simonton St. Key West FL 33040 ACORD 25 (2009101) COUNTMO CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE TIfEREOF, 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 REPRESFNTATr— — ©19 -2 4 The ACORD name and logo are registered marks of ACORD OP ID: SA '44:--7oRD CERTIFICATE OF LIABILITY INSURANCE I DATE04/04D/YYYY) 4/04/11 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 CE IMPORTANT: If the certificate holder is an ADDI ONAL INPW �!} les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain po ties may require y a QC ament. A tement on this certificate does not confer rights to the certificate holder in lieu of such endorsement s . PRODUCER 727- 97-0441�p p 1 Q CONTACT Connelly, Carlisle, Fields 8 7Z-F-569-e6$3 NE Ext : FAX No): Nichols — - P.O. BOX 1027 EMAIL ADDRESS: Clearwater, FL 33757 PRODUCER VAN07 MONROE MER ID #: —_- RiQ V AAtA wT • n .• INSURFRISI AFFORDING COVERAGE NAIC # INSURED Advanced Data Solutions, Inc. INSURER A: morinern Insurance Company Melody Engle INSURER B: Owners Insurance Company 132700_ 141 Scarlet Blvd, Ste A INSURER C : Houston Casualty Company Oldsmar, FL 34677 —— - INSURER D : INSURER E : INSURER F : f^rl\/CCA/_CC L`GI?TICIftATF NI IMRFR- RFVISInN Nl1MRFR[ 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 LTRWVp TYPE OF INSURANCE ADDL UB POLICY NUMBER MM DD/YYYY MM DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE T RENTED -� $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE n OCCUR PREMISES Ea occurrence)_ MED EXP (Any one person) - $ I�� PERSONAL & ADV IN_J_UR_Y_ - - -- -- GENERAL AGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ POLICY PRO F JECTLOU AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT $ 1,000,00 (Ea accident) B ANY AUTO 4795673300 04/04/11 04/04/12 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident)l $ SCHEDULED AUTOS HIRED AUTOS - $ X PROPERTY DAMAGE (Per accident) X — NON -OWNED AUTOS ( I $ -- -- — UMBRELLA LIAB OCCUR EACH OCCURRENCE $ I EXCESS LIAR CLAIMS -MADE - AGGREGATE DEDUCTIBLE $ RETENT;0N WORKERS COMPENSATION STATU- OTH- TWC RY LIMIT ER AI, AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE WC0349783300 02/21/11 02/21/12 E_.L. EACH ACCIDENT $ 100,00 OFFICER/MEMBER EXCLUDED? F-1 N / A _ 100,00 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE' $ If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ 500,00 C lProf Liability H70912654 06/02/10 06/02/11 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) COUNTMO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN County of Monroe ACCORDANCE WITH THE POLICY PROVISIONS. Board of County Commissioners Risk Management AUTHORIZED REPRESENTATIVE Simonton Key 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: S5 A<74C>RD' CERTIFICATE OF LIABILITY INSURANCE DAT07/08D/YYYY) 07/08/11 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 nt on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 727-461-6 27�42_7695 Brown & Brown of Florida, Inc. tE-MAIL 83 Park Place Blvd., Ste 101 P.O. Box 2456 (33757-2456) Clearwater, FL 33759 J U L House Account - Select Coml T PHONE A/c No Exc : FAX A/c No : E R ll ADVAN Us O #: 6 INSURE S AFFORDING COVERAGE NAIC # INSURED Advanced Data Solutions, Inc. PO BOX 248 OLDSMAR, FL 34677-0248 RISKSK rtford C sualty Insurance Co 29424 INSURERRC 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. I LTR LTR TYPE OF INSURANCE A DL UB POLICY NUMBER Y EFF /Y MM/DDYYY POLICY EXP MM /DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1K OCCUR X 21 SBAK00961 07/17/11 07/17/12 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED PREMISES Ea occurrence) $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JFCT PRODUCTS - COMP/OP AGG $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS (:.t COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE - v... �: _ .....__... .'_ I 1 / .._. ......-. - EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC STATU- OTH- TO IT E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Monroe County Board of County Commissioners is an Additional Insured for General Liability Coverage only when required by written contract or agreement. MONRO-4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street, Room 268 ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 / - AUTHORIZED REPRESENTATIVE 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD ADVAN07 OP ID: MH .44c"RO, ki CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 01/30/12 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 D BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CE IFIC7ftMjUn IMPORTANT: If the certificate holder is an ADDIT NAt e- policy(ies) must a endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain poll ies n endorsement. A s tement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CT Connelly, Carlisle, Fields 8 Nichols P.O. Box 1027 Clearwater, FL 33757 727-669-0673 MONROE PHONE A/C No Eld : FAX A/C, No): E-MAIL S: — --� House Account RISK MANA I SURER(S) AFFORDING COVERAGE NAIC_# INSURERA: Northern Insurance Company INSURED Advanced Data Solutions, Inc. INSURER 13:Owners Insurance Company 1132700 Melody Shearin Engle 141 Scarlet Blvd, Ste A INsuRERc: i, Oldsmar, FL 34677 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 TYPE OF INSURANCE LTR I INSR UBR POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS L LIABILITY EACH OCCURRENCE $ _ COMMERCIAL GENERAL LIIABILITY F CLAIMS -MADE `—J OCCUR GEN'L AGGREGATE LIMIT APPLIES PER:/��PRODUCTS PRO- POLICY LOC : V `, RISK NA dy 1' WAI LV DAMA E TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ -COMP/OP AGG $ $ AUTOMOBILE LIABILITY COMBINED! LIMIT (Ea accident) $ 1,000,00 I— B , ANY AUTO X 4795673300 04/04/11 04/04/12 BODILY INJURY (Per person) $ 1 ALL OWNED ( x SCHEDULED AUTOS AUTOS rj X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LIAR CLAIMS -MADE $ DED RETENTION $ I $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A, WC0349783303 02/21/12 02/21/13 ORY A ITS TII OT 1 E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE) $ 100,00 E.L. DISEASE - POLICY LIMIT � $ 500,000 If yes describe under DLSCRIPI ION OF OPERATIONS below C 'Prof Liability I H71113165 06/02/11 06/02/12 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) COUNTMO Monroe County Board of County Commissioners 1100 Simonton St. 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 © 1988-2010 ACORD CORPORATION. All rights reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ADVAN07 OP ID: MH CERTIFICATE OF LIABILITY INSURANCE AT05102D/YYYY) r5/02/12 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 727-797-0441 Connelly, Carlisle, Fields & 727-669-0673 Nichols P.O. Box 1027 Clearwater, FL 33757 CONTACT NAME: PHONE FAX A/C No Ext : A/C No): E-MAIL ADDRESS: House Account INSURERS AFFORDING COVERAGE NAIC N INSURER A: Northern Insurance Company INSURED Advanced Data Solutions, Inc. INSURER B : Owners Insurance Company 32700 Melody Shearin Engle 141 Scarlet Blvd, Ste A INSURER C Oldsmar, FL 34677 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 U POLICY NUMBER MM/DDY� MMLDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY A A N PREMISES Ea occurrence $ CLAIMS -MADE E OCCUR � AP l i1iANA W MED EXP (Any one person) $ & ADV INJURY $ DPERSONAL GENERAL AGGREGATE $ W q�l t✓ V! 7 •• GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- LOC CG'. (L $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO X 4795673300 04/04/12 04/04/13 ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- A AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WC0349783303 02/21/12 02/21/13 T RY LIMIT ER E.L. EACH ACCIDENT $ 100,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ 100,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 600,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) C C. L"Rill 1lalh_ 1;q COUNTMO Monroe County Board of County Commissioners 1100 Simonton St. 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD OP ID: DW l DATE (MMIDD/YYYY) ,d►COR>D CERTIFICATE OF LIABILITY IN o7/09/,2 THIS S 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). CONTACT PRODUCER 727-461-6044 NAME: Brown & Brown of Florida, Inc. PHONE FAX 83 Park Place Blvd., Ste 101 727-442-7695 ANC , No, Excr _ JC No): P.O. Box 2456 (33757-2456) E-MAIL ADDRESS: Clearwater, FL 33759 PRODUCER ADVANI6 House Account - Select Coml CUSTOMER ID #: FORDING COVERAGE NAIC # INSURERS) AF Hartford Casualty Insurance Co 29424 INSURED Advanced Data Solutions, Inc. INSURER A: PO BOX 248 INSURER B : OLDSMAR, FL 34677-0248 INSURER C : INSURER D : INSURER E : _ INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS THIS IS TO TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH INDICATED. NOTWITHSTANDING ANY REQUIREMENT, BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS AND CONDITIONS U POLICY EFF POLICY EXP LIMITS INSR POLICY NUMBER MM/DD MMIDDIYYYYI LTR TYPE OF INSURANCE 1,000,00 GENERAL LIABILITY X '21 SBAK00961 07/17/12 07/17113 EACH OCCURRENCE $ PREMISES Ea occurrence $ RENT 300'�� A X COMMERCIAL GENERAL LIABILITY 10,00 CLAIMS OCCUR MED EXP (Any one person) $ -MADE PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: $ POLICY PRO LOC COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY By (Ea accident) DA ANY AUTO W T�1W BODILY INJURY (Per person) $ / ALL OWNED AUTOS t,., l/v BODILY INJURY (Per accident) $ ,wfr SCHEDULED AUTOS GL �* W PROPERTY DAMAGE $ (Per accident) HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE RETENTION $ WC STATU- OTH- TORY LIMITS ER WORKERS COMPENSATION E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N I A E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ (Mandatory in NH) If yes, describe under I DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Board of County Commissioners is an Additional Insured for Monroe County General Liability Coverage only when required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION CG ACORD 25 (2009/09) Monroe County Board of County Commissioners 1100 Simonton Street, Room 268 Key West, FL 33040 ©1988-2009 ACORD CORPORATIO117 N. All rights reserved. The ACORD name and logo are registered marks of ACORD MONRO-4 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 REP—R�ES^ENTAATIIV,E -' n n `ice"'" ACORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER Ut IrvruKmral Iv Brown &Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 17757 US Highway 19 N, Ste 660 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOV P.O. Box 2456 Clearwater FL 33757-2456 Phone:727-461-6044 Fax:727-442-7695 INSURED 141aScarlettBlvd., Ste.,AInc. Oldsmar FL 34677 DATE (MM/DD/YYYY) OP ID A$I INSURERS AFFORDING COVERAGE I NAIC # INSURER A: Hartford Casualty Insurance Co 29424 INSURERB: Auto Owners 18988 INSURER C: Hartford Underwriters Ins. Co. 30104 INSURER D: INSURER E: COVERAGES TO THE INSURED NAMED ABOVE ANDING FOR THE POLICY PERIOD INDICATED. NOTWITHSTOR THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED WITH RESPECT T WHICH THIS CERTIFICATE MAY BE ISSUED ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT TO S ALL THEE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT MAY LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICIES. AGGREGATE LIMITS LTR NSR TYPE OF INSURANCE POLICY NUMBER 21SBAR00 9 61 DATE MW DNY 07 / 17 / 05 DATE MM/DD/YY EACH OCCURRENCE $ 1,000,000 07 / 17 / 0 6 PREMISES Ea occurence $ 300,000 GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 10,000 CLAIMS MADE TOCCUR PERSONAL&ADVINJURY $ 1, 00X EPLI: $5,0 GENERAL AGGREGATE $ 2, 000, 000 PRODUCTS - COMP/OPAGG s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- LOC POLICY JECT 171 COMBINED SINGLE LIMIT (Ea accident) $ 5 0 0, 0 0 0 AUTOMOBILE LIABILITY 4625922200 02/25/05 02/25/06 X B ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ NON -OWNED AUTOS s PROPERTY DAMAGE (Per accident) $ _. AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY OTHER THAN EA ACC $ $ ANY AUTO ��' ,� . _ _. AUTO ONLY: AGG EACH OCCURRENCE $ EXCESS/UMBRELLA LIABILITY $ OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION $ - _ X TORY LIMITS ER WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 21WECGA3774 02/21/05 02/21/06 E.L. EACH ACCIDENT s100,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYE $ 100,000 OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE -POLICY LIMIT $ 500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Monroe County Board of County Commissioners is named as Additinal Insured with respects to General Liability. f`AAI!`FI I ATInN GtK I IrIGA I C P1UL.UCR - MONRO - 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Monroe County Florida NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Gato Building REPRESENTATIVES. Key West, FL 33040 AU R DREPRESENTATIVEE 7 I' �:^ v i -f- 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements. be waived or modified on the following contract. Contractor: Advances Data o t iQns._.__7ns Contract for: S anning Services Address of Contractor: 141 Scarlet Blvd., Suite A Oldsmar, Florida 34677 Phone: (813) 855-3545 Scope of Work: _ 5eanning In____ dexi ng„�pick.,_un t4anat7ement,etc. Reason for Waiver: Not Re_nui rPr1 nPr (rn�nt Attnrr,av Policies Waiver will apply to: Signature of Contractor Risk Management Date County Administrator appeal Date: Professional Liabilit Approved: Board of County Commissioners appeal: Approved: Meeting Date: Administration Instruction P4709,3 Not Approved: Not Approved: 1✓AX 104 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID D DATE(MM/DD/YYYY) ADVANI6 04 25 06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 17757 US Highway 19 N, Ste 660 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 2456 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Clearwater FL 33757-2456 Phone:727-461-6044 Fax:727-442-7695 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Hartford Casualty Insurance Co 29424 INSURERB: Progressive Insurance Company 24252 Advanced Data Solutions, Inc. INSURERC: Hartford Underwriters Ins. Co. 30104 141 Scarlet Blvd., Ste. A INSURERD: Oldsmar FL 34677 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. LTR INSR TYPE OF INSURANCE POLICY NUMBER DATEYMMIDD/YY ATE DMM/DD/YY LIMBS GENERAL LIABILITY EACH OCCURRENCE $ 1, 0 0 0, O 0 0 A X X COMMERCIAL GENERAL LIABILITY 21 SBAKOO 9 61 0 7/ 17 / 0 5 0 7/ 17 / 0 6 PREMISES (Ea occurence) $ 3 0 0, 0 0 0 CLAIMS MADE EX:] OCCUR MED EXP (Any one person) $ 10 , 0 0 0 PERSONAL & ADV INJURY $ 1, 000, 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY B ANY AUTO 034623900 04/04/06 04/04/07 COMBINED SINGLE LIMIT (Ea accident) $1000000 X ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ .. AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ ` DEDUCTIBLE !\ lJ $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS ER E.L. EACH ACCIDENT $ l O O O O O G, ANY PROPRIETOR/PARTNER/EXECUTIVE 21WECGA3 7 7 4 0 2 21 / / Q 6 O 2/ 21 / O 7 OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ l O O O O O yes, be under E.L. DISEASE - POLICY LIMIT $ 5 0 0 0 0 0 S ALP SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Monroe County Board of County Commissioners is named as Additinal Insured with respects to General Liability. CERTIFICATE HOLDER CANCFI 1 ATIAN MONRO - 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Monroe County Florida NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1100 Simonton Street Gato Building IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West, FL 33040 REPRESENTATIVES. ACORD 25 (2001/08) Ce, © ACORD CORPORATION 1988 !FE0®CERTIFICATE OF LIABILITY INSURANCEOP ID SA DATE (MMrDD/YYYY PRODUCER ADVAN07 01/11/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Carlisle Fields & Company, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 1027 E AFFORDED BY THE POLICIES BELOW. Clearwater FL 33758-7910 Phone . 727 797 0441 Fax . 727-725 3663 ORDING C VERAGE I NAIC # INSURED — — -- -- -- - ----------�-- ------ ------ I� NSURER A: Nort ern Insurance Company --- ------- - 1 SURE e s I surance Company 32700 Advanced Data Solu ions Inc . 141 Scarlet Blvd _ _ t! - - INSURE C: ous on asualt Co an --------- -----—-_- -- -- -+- - ------ Oldsmar FL 34 677 INSURER D: COVERAGES RISK MANAGEMENT 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. INS T--------- - -- -- ------ - -- ----- -- -- -- LIMITS EACH OCCURRENCE $ LTRINSR5 TYPE OF INSURANCE POLICY NUMBER -POLLLIC E TIVE DATE MM/DD/YYYY P LICY X I A I DATE MM/DD/YYYY GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY �_DAMAGE-TO- PREMISES (Ea occurence) $ ----- CLAIMS MADE F OCCUR --- -- -- MED EXP (Ary one persorq $ PERSONAL & ADV INJURY $ ----- 1� GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � -- � � PRO- I PRODUCTS -COMP/OP AGG $ ---------- --- - -- - -- - -- I JECT LOC �— AUTOMOBILE LIABILITY B X ANY AUTO 4795673300 04/04/09 04 04 10 COMBINED SINGLE LIMIT (Ea accident) ' $ 1000000 j ALL OWNED AUTOS — j i X 1 SCHEDULED AUTOS ! BODILY INJURY I (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY f (Per accident) $ r--- -- --- --- -- --- ----- i I PROPERTY DAMAGE (Per accident) j $ GARAGE LIABILITY ! i AUTO ONLY - EA ACCIDENT ( $ J ANY AUTO i---- r - - EA ACC OTHER THAN $ AUTO ONLY: - --- --- - }--- - ------ - __ - - AGG ' $ EXCESS / UMBRELLA LIABILITY i -- - — OCCUR ] CLAIMS MADE ✓ EACH OCCURRENCE AGGREGATE -- $ -- ! DEDUCTIBLE------------------- RETENTION $ - - --$— -- ------------ - ! $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY f YIN! . WC STA797 �X DORY LIMITS ER A ANY I OFFICER/MEMBERrEXCLU ED XECUTIVrq WC034 97 8330 0 - I 02 /21 / 0 9 ! 02 /21 / 10 i E.L. EACH ACCIDENT _ $100000 If es, describe under S EC IAL PROVISIONS below � � + _ I ....._. C),.�FA�r - t:1 E�•li�i .!"3YEE� r `_ " _� _ _ --------- - - ---- ----------- -- 100000 - -- -- - - ---- - - - - OTHER Y3 E.L. DISEASE POLICY LIMIT $ 5 0 O O O 0 C !Professional Liab 1H70912654 DESCRIPTION OF i 05/23/ 91._05 + 23/1 I Occurence ff-Iffseductibl 1000000 2500 OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT r SPECIAL PROVISIONS Monroe County Board of County Commissioners are listed as additional insured in regards to the automobile policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION COUNTMO 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 County of Monroe IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Board of County Commissioners Risk Management REPRESENTATIVES. 1100 Simonton St . AUTHORIZED REPRE NTATIVE e West FL 33040 ACORD 25 (2099/01 �. ©19 - .CO erved. Gam„ The ACORD name and logo are registered marks of ACORD