COI Expires 10/01/2010
CERTIFICATE OF COVERAGE
Certificate Holder
MONROE COUNlY BOARD OF COUNlY COM~ISSIONERS
MONROE COUNlY TOURIST DEVELOPMENT COUNCIL
PO BOX 1026
KEY WEST, FL 33041
Admh'istra~r
:Floiid~ 'League of Citiesj Inc.
Public Risk Services
P.o. Box 530065
Or~ndo, Florida',32853-oo65
Issue Date 9/24/09
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COVERAGES ~ ~ ,. -; [", :<,'
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EXCLUSIONS AND CONDmONS OF SUCH AGREEMENT . '. .__...,-w..., ._. .. -
AGREEMENT NUMBER: FMIT 0928
COVERAGE PERIOD: FROM 10/1/09
FLORIDA MUNICIPAL INSURANCE TRUST
COVERAGE PERIOD: TO 10/1/10 12:01 AM STANDARD TIME
COVERAGE PROVIDED BY:
TYPE OF COVERAGE - LIABIUTY
General Liability
00 Comprehensive General liability , Bodily Injury, Property Damage and
Personal Injury
00 Errors and Omissions liability
00 Supplemental Employment Practice
00 Employee Benefits Program Administration liability
00 Medical Attendants'/Medical Directors' Malpractice liability
00 Broad Form Property Damage
D Law Enforcement liability
[Xl Underground, Explosion & Collapse Hazard
Limits of Liability
* Combined Single limit
Deductible $1,000
Automobile Liability
00 All owned Autos (Private Passenger)
00 All owned Autos (Other than Private Passenger)
00 Hired Autos
00 Non-Owned Autos
Limits of Liability
* Combined Single limit
Deductible N/ A
Automobile/Equipment - Deductible
[Xl Physical Damage
Per Schedule - Comprehensive - Auto
TYPEOFCOVERAGE-PROPERTY
D Buildings D Miscellaneous
0 Basic Form 0 Inland Marine
0 Special Form 0 Electronic Data Processing
0 Personal Property 0 Bond
0 Basic Form
0 Special Form
0 Agreed Amount 'O\~
r~~ . ..
0 Deductible NI A ~ .
0 Coinsurance N/A q-cAQ-07
0 Blanket Y-
O Specific ovn~
0 Replacement Cost
0 Actual Cash Value ex
#
Limits of Liability on File with Administrator
TYPE OF COVERAGE - WORKERS' COMPENSATION
00
00
Statutory Workers' Compensation
Employers liability
$1,000,000 Each Accident
$1,000,000 By Disease
$1,000,000 Aggregate By Disease
o Deductible N/ A
o SIR Deductible N/A
Per Schedule - Collision - Auto
NA - Miscellaneous Equipment
Other
The limit of liability is $100,000 Bodily Injury and/or Property Damage per person or $200,000 Bodily Injury and/or Property Damage per occurrence. These specific
limits of liability are increased to $1,000,000 (combined single limit) per occurrence, solely for any liability resulting from entry of a claims bill pursuant to Section
768.28 (5) Florida Statutes or liability imposed pursuant to Federal Law or actions outside the State of Florida.
Description of Operations/Locations/Vehicles/Specialltems
RE: TDC Grant for Sombrero Beach Park
The certificate holder is hereby added as an additional insured, except for Workers' Compensation and Employers Liability, as respects
the member's liability for the above described item.
Designated Member
THIS CERTIACATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIACATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY
THE AGREEMENT ABOVE.
Cancellations
City of Marathon
8900 Overseas Highway
Marathon FL 33050
u.: hr,tfl1a-
SHOULD ANY PART OF THE ABOVE DESCRIBED AGREEMENT BE CANEELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN NOTICE TO THE
CERTIACATE HOLDER NAMED ABOVE, BUT FAlWRE TO MAIL SUCH NOTICE SHALL IMPOSE NO
OBUGATION OR UABIUlY OF ANY KIND UPON THE PROGRAM, ITS AGENTS OR REPRESENATIVES.
M
AUTHORIZED REPRESENATIVE