Certificates of Insurance
~~
PRODUCER
CERTIFICATE OF LIABILITY INSURANCE
R E C ~~ I
The Plastridge Agency-PBGO
10337 N ~litary Trail
Pa~ Beach Gardens FL 33410
Phone:561-630-4955 Fax:561-630-496
SEP
rican Insurance Co.
NAIC #
INSURED
09
American Underwater
17536 SE Conch Bar Ave.
Tequesta FL 33469
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.
INSURER E:
L TR NSR TYPE OF INSURANCE POLICY NUMBER
GENERAL LIABILITY
A X X COMMERCIAL GENERAL LIABILITY OMH2500959/11
CLAIMS MADE [!J OCCUR
08/30/09
X Marine Comml Liab
LOC
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
ANY AUTO
EXCESS I UMBRELLA LIABILITY
OCCUR D CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETOR/PARTNER/EXECUTIVD
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
~~~(;I~tS~~~Vls1o~s below
OTHER
LIMITS
$ 1000000
$ 50000
$ 5000
PERSONAL & ADV INJURY $ 1000000
GENERAL AGGREGATE $ 2000000
PRODUCTS - COMP/OP AGG $ 1000000
COMBINED SINGLE LIMIT $
(Ea accident)
BODIL Y INJURY $
(Per person)
BODIL Y INJURY $
(Per accident)
PROPERTY DAMAGE $
(Per accident)
AUTO ONLY - EAACCIDENT $
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EACH OCCURRENCE $
AGGREGATE $
$
$
$
$
E. L. DISEASE - EA EMPLOYEE $
E.l. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Monroe County Board of County Commisioners is listed as Additional Insured
with respects to General Liability. *10 days written notice for non-payment,
30 days all other reasons.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL * 1 0 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
CERTIFICATE HOLDER
C- C · ~ h'rt- oe---n .vi---
CANCELLATION
Monroe County BOCC
Fax #305-295-3179
Attn: Risk Mngmnt
1100 S~onton St.,
e West FL 33040
ACORD 25 (2009/01)
Room 268
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