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HomeMy WebLinkAboutCertificates of Insurance DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/17/2025 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 have ADDITIONAL INSURED provisions or 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 Cristina Mills NAME: PHONE FAX Cristina Mills 561-935-9263 (A/C, No, Ext):(A/C, No): E-MAIL 850 W Indiantown Road Suite B cristina.mills.vaa32i@statefarm.com ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # JupiterFL334587539 25178 State Farm Mutual Automobile Insurance Company INSURER A : INSURED INSURER B : AMERICAN UNDERWATER CONTRACTORS INC. INSURER C : 17536 SE CONCH BAR AVE INSURER D : INSURER E : JUPITERFL334691710 INSURER F : COVERAGESCERTIFICATE 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 ADD SUB POLICY EFF POLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE$ DAMAGE TO RENTED $ CLAIMS-MADEOCCUR PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: $ PRO- PRODUCTS - COMP/OP AGG $ POLICYLOC JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Ea accident) L89 3508-F01-59 12/01/202506/01/2026 ANY AUTO BODILY INJURY (Per person)1,000,000 $ 350 7191-B12-59C 08/12/202502/12/2026 OWNED SCHEDULED AYY BODILY INJURY (Per accident)1,000,000 $ AUTOS ONLYAUTOS HIRED NON-OWNED PROPERTY DAMAGE K88 4610-E25-59A 11/25/202505/25/2026 1,000,000 $ AUTOS ONLYAUTOS ONLY(Per accident) $ UMBRELLA LIAB EACH OCCURRENCE $ OCCUR EXCESS LIAB AGGREGATE CLAIMS-MADE $ DEDRETENTION$$ PER OTH- WORKERS COMPENSATION $ STATUTEER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ N / A OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE (Mandatory in NH) $ If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional Insured: Monroe County BOCC PO Box 30096 Duluth, GA 30096 CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County BOCC Insurance Compliance AUTHORIZED REPRESENTATIVE PO BOX 10085-FX 12/17/2025 This form was system-generated on DuluthGA30096 . © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD 1001486 2005 155279 205 01-19-2023 ~~ 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 @ 1988-2009 ACORD CORPORATION The ACORD name and logo are registered marks of ACORD