Certificates of Insurance
ACORDTM
PRODUCER
Aon Risk services, Inc. of Massachusetts
One Federal Street
Boston MA 02110 USA
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICA TE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
PHO~E- 866 283-7122
FAX- 847 953-5390
INSURERS AFFORDING COVERAGE
NAIC #
I~SURED
Raytheon Technical Services Company LLC
Global Headquarters
Risk Management/Insurance Dept.
870 Winter Street
waltham MA 02451-1449 USA
INSURER A:
INSURER B:
ACE American Insurance Company
22667
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INSURER C:
INSURER 0:
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LIMITS SHOWN ARE AS REQUESTED
Il'\SR ADD'
LTR Il'\SR
TYPE OF Il'\SURA~CE
POLICY l'\UMBER
POLICY EFFECTIVE POLICY EXPIRA TIOl'\
DATE(MM\DD\YV) DATE(MM\DD\YY)
06/01/08 06/01/09
LIMITS
A
~'ERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [!] OCCUR
HDOG20559512
General Liability
EACH OCCURRENCE
$1,000,000
PERSONAL & ADV INJURY
$1,000,000
$1,000,000
$1,000,000
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GENERAL AGGREGATE
GEN'L AGGREGATE LIMIT APPLIES PER:
~ POLICY
D PRO- D LOC
JECT
PRODUCTS - COMP/OP AGG
A
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON OWNED AUTOS
ISAH0796118-2
Business Auto policy
06/01/08
06/01/09
COMBINED SINGLE LIMIT
(Ea accident)
=
$1,000,000 Z
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BODILY INJURY
( Per person)
GARAGE LIABILITY
B ANY AUTO
EXCESS /UMBRELLA LIABILITY
D OCCUR D CLAIMS MADE
BODILY INJURY
(Per accident)
. . .
PROPERTY DAMAGE
(Per accident)
AUTO ONL Y - EA ACCIDENT
OTHER THAN EA ACC
AUTOONLY:
AGG
EACH OCCURRENCE
DDEDUCTIBLE
DRETENTION
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AGGREGA TE
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WORKERS COMPEl'\SA TIOl'\ Al'\D
EMPLOYERS' LIABILITY
ANY PROPRIETOR / PARTNER / EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes. describe under SPECIAL PROVISIONS
below
OTHER
E.L. DISEASE-POLICY LIMIT
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E.L. DISEASE-EA EMPLOYEE
DESCRIPTION OF OPERA T~ONS/LOCA TIONS/VEHICLES/EXCLUSIONS ;\DDED BY ~NOORSEMEI'){/~~~,.,"'OW' f".. f~, fi ~ ;\ ~
Re: Leased premlses at Key West Internatlonal Al rport. it't~~\sh~ii,..tatJ5e \~J1e Monroe County Board of County
Commissioners to be added as additional insured under the insurance policy(ies) listed above but solely with
respect to those matters for which Raytheon is required to provide indemnification under this agreement with the
Monroe County
Gato Building
1100 Simonton St.
Key West FL 33040 USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFlCA TE 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
~~.9"~~..~,#. t'a"~""'eu.
Attachment to ACORD Certificate for Raytheon Technical services Company LLC
The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage
afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy.
INSURER
I!\"SURED
Raytheon Technical services company LLC
Global Headquarters
Risk Management/Insurance Dept.
870 winter Street
waltham MA 02451-1449 USA
INSURER
INSURER
INSURER
INSURER
ADDITIONAL POLICIES
If a policy below does not include limit information, refer to the corresponding policy on the ACORD
certificate form for policy limits.
ADD'L POLICY !\"UMBER POLICY POLICY
I!\"SR I!\"SRD TYPE OF I!\"SURA!\"CE POLICY DESCRIPTIO!\" EFFECTIVE EXPIRA TIO!\" LIMITS
LTR DATE DATE
DESCRIPTION OF OPERATlONS!LOCATlONS!VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
additional insured and then only to the extent of the indemnification provided by Raytheon under this
agreement.
Certificate No:
570033479545
Certificate of Insurance
THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION. ONLY AND CONFERS NO RIGHT 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 Raytheon Technical Services Company, LLC
I
Libertx
Mutual@
I Waltham
MA 02451
NAME AND
ADDRESS
OF INSURED
~
870 Winter Street
is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions and
Conditions and is not altered by any requirement, term or condition of any contract or other document with respect to which this certificate may be issued.
TYPE OF POLICY
EXP DATE
o CONTINUOUS
o EXTENDED
III POLICY TERM
POLICY NUMBER
LIMIT OF LIABILITY
WORKERS
COMPENSA TION
1/1/2010
WC7 -611-004040-289
WA7-61 0-004040-449
COVERAGE AFFORDED UNDER WC
LA W OF THE FOLLOWING STATES:
OR,WI
All Other States Except
Monopolistic States:
ND,OH,WA,WV,WY,MA,RI
EMPLOYERS LIABILITY
Bodily In'ury by Accident
1 000 000 Each Accident
Bodily Injury By Disease
GENERAL LIABILITY
Bodily Injury By Disease
1 000 000
General Aggregate-Other than Products / Completed Operations
o OCCURRENCE
o CLAIMS MADE
Products / Completed Operations Aggregate
Bodily Injury and Property Damage Liability
Per Occurrence
RETRO DATE
Personal Injury
Per Person / Organization
Other
ther
AUTOMOBILE
LIABILITY
DOWNED
o NON-OWNED
o HIRED
Each Accident-Single Limit
B.1. And P.D. Combined
Each Person
Each Accident or Occurrence
Each Accident or Occurrence
OTHER
General Liability and Auto Liability N/A
ADDITIONAL COMMENTS
POLICIES PROVIDE FOR: USL&H COVERAGE, VOLUNTARY COMPENSATION AND ALL STATES COVERAGE
WITHIN THE U.S.A., ITS TERRITORIES & POSSESSIONS.
RE: Leased premises at Key West International Airport
· If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date.
SPECIAL NOTICE-OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS
AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.
IMPORTANT NOTICE TO FLORIDA 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 PRODUCER WHOSE NAME AND TELEPHONE NUMBER APPEARS IN THE LOWER
RIGHT HAND CORNER OF THIS CERTIFICATE. THE APPROPRlA TE LOCAL SALES OFFICE MAILING ADDRESS MAY ALSO BE OBTAINED BY CALLING THIS NUMBER.
Liberty Mutual
Insurance Group
NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.)
BEFORE THE STATED EXPIRA TION 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:
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~onroe County
Gato Building
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I - -(3'" "- Karyn Lessard
AUTHORIZED REPRESENT A TIVE
Weston / 0102
Riverside Office Park, 9 Riverside Road
1100 Simonton Street Weston MA 02493-2298 781-891-8900
~ey West FL 33040 ~ OFFICE PHONE
This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies
3/26/2009
DA TE ISSUED
NM 772