The URL can be used to link to this page

Certificates of InsuranceOP ID: NF .111. R CERTIFICATE OF LIABILITY INSURANCE °"'02/201"YYY' `-'� 02l20113 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. ff 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 endorsemen s . PRODUCER 305-294-sen INTACT The Fullers, Inc 305-292-4641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller PHONE FAX Arc Not: E-MAIL AM. CUSTOMER 10 0: BOYS&I INBU S AFFORDING COVERAGE NAIC 0 INSURED Boys & Girls Club of the INSURER A: Progressive Keys Area, Inc. 1400 United St #108 Key West, FL 33040 INSURER 0; INSURER C : INSURER 0; 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. ILTR NSR I TYPE OF INSURANCE SUER JIM POLICY NUMBER FF POLICY E7(P LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR - APP VDAMAGE BY W ' / //' ' V�I,w, � EACH OCCURRENCE $ TO RENTE. PREMI Ea ooaaranca $ MED EXP one ) S -i— { PERSONAL 6 ADV INJURY i GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ S POLICY PRO LOC A AUTOMOBRE LIABILITY ANY AUTO X 02545341-9 02126113 02126/14 COMBINED SINGLE LIMIT (Ee accident) f 1,000,000 BODILY INJURY (Per person) S ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per °°°dent) : NON -OWNED AUTOS t UMBRELLA LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAR DEDUCTIBLE 3 S RETENTION WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTNE Ya E.L. EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? (Mandatory In NH) NIA E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT S M yes describe under DESCRIPTION OF OPERATIONS betnw I I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addidrnwl Remerke Schedule, N nwre space Is required) 2005 Chevrolet Express G3 CRGVN 1GAHG39US61110423 2000 Ford Econoline OTHB 1FBNE31L461HA116394 I+G�TI[•If+A Ta: LL% nce L-AYh C1 I ATIeM1 MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County THE EXPIRATION DATE ACCORDANCE WITHPO THEREOF,Y OVI8 ONS NOTICE WILL BE DELIVERED IN 1100 Simonton Street Key West, FL 33040 A ITHOIBZED REPn ATN Norman Fuller ACORD 25 (2009109) ® IVBB- 009 A ORD GORPORATIOIY. All ngnu resemea. The ACORD name and logo are registered marks of ACT D rnuuuutn PAYCHEX INSURANCE AGENCY INC 210705 P : () - F : (888) 443 - 6112 PO BOX 33 015 SAN ANTONIO TX 78265 v-= v v LA %J 1 V THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LDER ---THIS CERTIFIqATE DOES NOT AMEND, EXTEND OR AFTER iT p OVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED ` RER &,T C1 t -Fire Ins Co IN§0RER B: BOYS & GIRLS CLUBS OF THE KEYS INC INSURER C: 1400 UNITED Sal S TE 108 INSURER D: KEY WEST FL 33,040 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. INSR POLICY EFFECTIVE POLICY EXPIRATION LTR I TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY LEACH OCCURRENCE $ COMMERCIAL GENERAL. LIABILITY I FIRE DAMAGE (Any one fire) I $ CLAIMS MADE L � OCCUR MED EXP GEN'L AGGREGATE LIMIT APPLIES PER: POLICY I I PE 0 I LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY OCCUR U CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND A EMPLOYERS' LIABILITY OTHER (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMPiOP AGG I $ COMBINED SINGLE LIMIT I $ (Ea accident) BODILY INJURY I $ (Per person) BODILY INJURY I $ (Per accident) PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EACH OCCURRENCE I $ AGGREGATE $ Is Is Is X IWC STATU- OTH- TORY LIMITS I I ER 76 WEG KO 0 211 0 5/ 2 9/ 10 0 5/ 2 9/ 11 E.L. EACH ACCIDENT $5 0 0, 0 0 0 E.L. DISEASE - EA EMPLOYEE $5 0 0 , 0 0 0 E.L. DISEASE - POLICY LIMIT $5 0 0 , 0 0 0 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the Insured's Operations. CC IFICATE HOL )ER ADDITIONAL INSURED; INSURER LETTER: Monroe County Board of County Commissioners 1100 SIMONTON ST KEY WEST, FL 33040 AN 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 (10 DAYS FOR NON-PAYMENT) 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. r AUTHOR1 D RE SENTATIVE C�-CAL ACORD 25-S (7/97) ° ACORD CORPORATION 1988 PAYCHEX INSURANCE AGENCY INC PO BOX 33015 SAN ANTONIO TX, 78265 N CV O (V O O W lf% r 0 0 0 N 02246 Monroe County Board of County Commissioners 1100 SIMONTON ST KEY WEST, FL 33040 ACORD 25-S (7/97) ACORPR, CERTIFICATE OF INSURANCE ISSUE DATE (M M/DD/YY) 06-07-2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Markel Insurance Company NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, P.O. BOX 2009 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Glen Allen. VA 23059-2009 CODE SUB -CODE INSURED Boys & Girls Club of the Keys Area, Inc. 1400 United St. #108 Key West, FL 33040 COMPANIES AFFORDING COVERAGE ---LETTER--------- VIARI�EL INSURANCE COMPANY COMPANY 41TV13 � U Y11I COMPANY C LETTER--�....� w .1 Cb 9 `, ti_' COMPANY COVERAGES LETTER E 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 PAin ri Awc TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS AGENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR. Ll OWNERS & CONTRACTOR'S PROT. 8502CY263142-6 03-25-2010 03-25-2011 GENERAL AGGREGATE $ 3,000,000 PRODUCTS-COMP/OPS AGGREGATE $ 1,000,000 PERSONAL &ADVERTISING INJURY $ 1,000,000 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 100,000 MEDICAL EXPENSE (Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per Person) $ HIRED AUTOS BODILY INJURY NON -OWNED AUTOS GARAGE LIABILITY (Per accident) $ PROPERTY DAMAGE EACH OCCURRENCE $ $ EXCESS LIABILITY UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM .:..f..:.. WORKER'S COMPENSATION STATUTORY LIMITS EACH ACCIDENT $ AND / DISEASE - POLICY LIMIT $ EMPLOYERS' LIABILITY DISEASE - EACH EMPLOYEE S A I OTHER Property I 8502CY263142-6 I 03-25-2010 103-25-2011 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Certificate holder is included as additional insured as lessor of premises. RE: Loc. #4, 30150 South Street, Big Pine Key, FL 33043 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO Monroe County Board of County Commissioners MAIL1() DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION 1100 Simonton Street OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR Key West, FL 33040 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Bruce A. Kay ELE ►CORD 25-S(7/90) (c) XtORD. CORPORATI ON 199( AGORD CERTIFICATE OF LIABILITYDATE INSURANCE TM 04-06-2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PAYCHEX INSURANCE AGENCY INC 210705 P : () - F : (8 8 8) 4 4 3 - 6112 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 33015 - SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE INSURED INSURER A:Twin City Fire Ins Co INSURER B: BOYS & GIRLS CLUBS OF THE KEYS INC INSURER C: 1400 UNITED ST STE 108 INSURER D: KEY WEST FL 33040 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. INSR TYPE OF INSURANCE LTR I POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD1YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE Li OCCUR FIRE DAMAGE (Any one fire) MED EXP (Any one person) $ I S PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS 1 BODILY INJURY (Per person) $ I $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT [_$ ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR U CLAIMS MADE EACH OCCURRENCE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY '� 6 WEC7 KO 0 211 0 5/ 2 9/ 10 X WC STATU- OTH- TORY LIMITS ER 0 5/ 2 9/ 11 E.L. EACH ACCIDENT S 5 0 0, 0 0 0 E.L. DISEASE - EA EMPLOYEE s500, 000 s500, 000 — E.L. DISEASE - POLICY LIMIT i OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the Insured's Operations. e, G CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County Board of EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE County Commissioners HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO 1100 S IMONTON ST OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. KEY WEST, FL 33040 AUTHOR) D E SENTATIVE HLUt1U L5-S (//U i) G ACORD CORPORATION 1988 AC CERTIFICATE OF LIABILITY INSURANCE Op Ip NF BOYSS-1 DATE (MMIDD/YYYY) 0 11 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fullers, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1432 Kennedy Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West FL 33040 Phones 3 0 5- 2 9 4- 6 6 7 7 Fax : 3 0 5- 2 9 2- 4 6 41 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Progressive Conmerc i a 1 Div INSURER B: Boys & Girls Club of the Keys Ar a, Inc. 14D 0 UnTted St. #10 8 Key West FL 33040 INSURER C: INSURER o: INSURER E: GVVEKAUES 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 y it DA NOW POLJICY DATEM LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE 7 OCCUR PREMISES EA o=ronce $ MED EXP (Any orm persm) PERSONAL & ADV INJURY GENERAL AGGREGATE S GEWL AGGREGATE LIMIT APPLIES PER: POLICY JPFC'T 1 FLOC -1 7 PRODUCTS - COMWOP AGO S A X AUTOMOBILE LIABILITY ANY AUTO 02545341-6 02/26/10 02/26/11 COMBINED SINGLE LIMIT (Eamccldent) $10 0 0 0 0 0 ALL OWNED AUTOS X SCHEDULED AUTOS BODILYINJURY (Per $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per addent) $ DAMAGE (Per accident) S '�APROPERTY GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO j OTHER THAN EA ACC AUTO ONLY: AGG : _ EXCESSAJANBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE 5 t DEDUCTIBLE e i RETENTION $ ' S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERVXECUTIVE LjL TORY LIMITS ER '"* E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? describe under MIAL PROVISIONS below CC ' E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 2005 Chevrolet $xprens G3 CRGVN IGAH039U551110493 2006 Ford Econoliue OTHS 1FBN$31L46HA16394 Monroe County is an additional insured G NCI'[ i iriuj% 1 C MVLUCK CANCELLATION NOMCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREBFO THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE To DO SO SHALL 1100 Simonton Street Rm 268 Monroe CoIMPOSE NO OBLIGATION OR UAWL17Y OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West FL 33040 IREPMENTATIVES. AUTHORIZED REPRESENTATI Norman Fuller ACORD 25 (2001108) 0 ACORD CORPORATION 1968 ACORDTm CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/01/2010 PRODUCER (305)294-2542 FAX (305)296-7985 The Porter Allen Company 513 Southard Street Key West, FL 33040 Frank McPherson 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 # INSURED Boys & Gi rl s Cl ub of the Keys Area, Inc 1400 B United Street Key West, FL. 33040 INSURER A: Markel Insurance Company INSURER B: INSURER C: INSURER D: INSURER E. COVERAnES 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. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DDIYY) POLICY EXPIRATION DATE (MM/DDNY LIMITS GENERAL LIABILITY 8 SO2CY263142 - 6 03/2 5/2010 03/2 5/2011 EACH OCCURRENCE $ 190009000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 1009000 CLAIMS MADE 1XI OCCUR MED EXP (Any one person) $ 59000 A X PERSONAL & ADV INJURY $ 190009000 GENERAL AGGREGATE $ 3 , 000 , 00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 110009000 PRO- LOC POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITYM Y AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO .- $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR TICLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND -WC STATU- OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED AT: LOC. 4) 30150 South St, Big Pine Key, FL 33043 Monroe County Board of County Commisioners 1100 Simonton Street Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENO OR R AUTHORIZED REPRESENTATIVE FRANK MCPHERSON A174739 ACORD 25 (2001/08) ©ACOAD CORPORATION 1988 ACORgR) CERTIFICATE OF INSURANCE ISSUE DATE (MM/DD/YY) 02-10-201 1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Markel Insurance Company RTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, P.O. Box 2009 �u lr TER THE OVERAGE AFFORDED BY THE POLICIES BELOW. Glen Allen, VA 23058-2009 F CO PANIES AFFORDING COVERAGE F C M N CODE SUB -CODE LETTER A ARKEL INSURANCE COMPANY COMPANY QrE COUVY INSURED Ri C Boys & Girls Club of the Keys Area, Inc. 1400 United St. #108 LETTER COMPANY D Key West, FL 33040 LETTER COMPANY E LETTER 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 —>AID CLAIMS- 0 TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE (MM/DD/YY) DATE (MM/DD/YY) A GENERAL LIABILITY GENERAL AGGREGATE $ 3,000,000 PRODUCTS-COMP/OPS AGGREGATE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE F_X] OCCUR. 8502CY263142-7 03-25-2011 03-25-2012 PERSONAL & ADVERTISING INJURY $ 1,000,000 EACH OCCURRENCE S 1,000,000 OWNERS & CONTRACTOR'S PROT. FIRE DAMAGE (Any one fire) $ 100,000 MEDICAL EXPENSE (Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) $ HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) S GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION _ _ STATUTORY LIMITS EACH ACCIDENT $ AND DISEASE - POLICY LIMIT $ EMPLOYERS' LIABILITY DISEASE - EACH EMPLOYEE Is A OTHER Property 8502CY263142-7 03-25-2011 03-25-2012 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Certificate holder is included as additional insured as lessor of premises. RE: Loc. #4, 30150 South Street, Big Pine Key, FL 33043 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO Monroe County Board of County Commissioners MAIL_10_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION 1100 Simonton Street OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR Key West, FL 33040 REPRESENTATIVES. 00 AUTHORIZED REPRESENTATIVE C'G Bruce A. Kay ELE ACORD 25-S(7/90) (c) KCORD CORPORATION 9990 ,4� "® CERTIFICATE OF LIABILITY INSURANCE 04-05D20111 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATI2=A RIGHTS UPON THE CERTIFICATE HOLDER. THIS OR ALT CERTIFICATE DOES NOT AFFIRMATIVELY OR NE R THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOE NOT C TRACT TWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTI ICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIO ALINSURED, the policy(ies) must be ndorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy, certain policie may requ pRn �1�r�int. A stat ment on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). A�f1 PRODUCER PAYCHEX INSURANCE AGENCY INC MONRo 210705 P:()- F:(888)443-6112 PO BOX 33015 RISK MA NAME: t): (A/c,No): (888) 443-6112 NT SAN ANTONI O TX 78265 CUSTOMER ID k: INSURER(S) AFFORDING COVERAGE NAIC of INSURED INSURER A : Twin City Fire Tns Co INSURER B BOYS & GIRLS CLUBS OF THE KEYS INC 1400 UNITED ST STE 108 INSURER C KEY WEST FL 33040 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 I N S R WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/VYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: I II PRODUCTS - COMP/OP AGG $ POLICY L � PRCT u LOC uI& $ AUTOMOBILE LIABILITY ,� COMBINED SINGLE LIMIT ANY AUTO �( (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS / PROPERTY DAMAGE (Per accident) $ NON -OWNED AUTOS $ $ UMBRELLA LIAB U OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB I CLAIMS -MADE \ DEDUCTIBLE $ rl � S RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEIIY / NII (Mandatory in NH) u N/ A 76 WEG K00211 05/29/201J 05/29/2012 X I WRY L MITS R E.L. EACH ACCIDENT _ $ 500,000 E.L. DISEASE - EA EMPLOYE S 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Monroe County Board of BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE County Commissioners 1100 S IMONTON ST KEY WEST, FL 33040 C.c DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZE2 19PRESENTATIVE ` / i, 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD ACORD TM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01-18-2012 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 AD be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain poll certificate holder in lieu of such endorsement(s). ies may ygyrp� �ry�ar�ment. A tatement on this certificate does not confer rights to the 1Wr'E1 V �1J PRODUCER CONTACT NAME: 51187 / Porter Allen Co Inc 513 Southard Street JAN 2 4 20 2PHONE h1 (A/C No, E. FAX t): (A/C No): Key West, FL 33040 E-MAIL ADDRESS: IRER(S) AFFORDING COVERAGE NAIC # MONROE CO INSI -- INSURED • MARKEL INSURANCE COMPANY -48970 Boys & Girls Club of the Keys Area, Inc. INSURER B: 1400 United St. #108 INSURER C: Key West, FL 33040 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. NSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY (MM/DD/YYYY) LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 ® COMMERCIAL GENERAL LIABILITY ❑ CLAIMS -MADE ® OCCUR ❑ ❑ ❑ 8502CY263142-8 03-25-2012 03-25-2013 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 ❑ GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- ❑ POLICY ❑ JECCT ❑ LOC PRODUCTS - COMP/OP AGG $ 1,000,000 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ❑ FD t% W COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ OWNED ❑ SCHEDULED ❑ ./ C'� A/ C' AALL UTOS AUTOSP ❑ HIRED AUTOS ❑ AUTOS ON -OWNED ❑ ❑ Y I— �` C'..�• I & 1 PROPERTY DAMAGE (Per accident) $ S ❑ UMBRELLA LIAB ❑ OCCUR ❑ ❑ _ EACH OCCURRENCE $ ❑ EXCESS LIAB ❑ CLAIMS -MADE AGGREGATE S ❑ DED ❑ RETENTION $ $ WORKERS COMPENSATION ❑ WC STATU- ❑ OTH- AND EMPLOYERS LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N/A ❑ TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate holder is included as additional insured as lessor of premises. RE: Loc. #4, 30150 South Street, Big Pine Key, FL 33043 CI!' ✓? C�y1 e�� CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1100 Simonton Street DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY Key West, FL 33040 PROVISIONS. 002 /1 AUTHORIZED REPRESENTATIVE JOS 6. Bruce A. Kay /ee 10 (c) 1988-2010 ACORD CORPORATION Pt f rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Is] ACORO" CERTIFICATE OF LIABILITY INSURANCE I DATE JMMID 2/23/12 THIS CERTIFICATE 13 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 pollcy(les) must be endorsed. K SUBROGATION IS WANED, subject to the terms and Conditions of the policy, certain policies may require an endorsement. A statement on this cerdficate does not confer rights to the PRODUCER 305-29677 N 4-6Aftw The Fullers, Inc 305-282-4641 PHONE FAX 1432 Kennedy Drive 6 MAIL AICNo): Key West, FL 33040 WIN Norman Fuller CUSTOMER ID go BOYS&I INS IIIAFFORDING COVERAGE NAIL N INSURED Boys & Girls Club of the INSURER A: PrOgrOSSIVIII Keys Area, Inc. INSURER a: 1400 United St. #108 INSURER C : Key West, FL 33040 INSURER o INSURER E : COVERAGE$ 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. WSR TYPE OF INSURANCE ADO SUM POLICY NUMBER POLICY EFF POLICY LIMITS GENERAL LIABILITY EACH OCCURRENCE S PREMI E Ea oeeurrenCa $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MED EXP Any one person) S PERSONAL A ADV INJURY S GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S 17 POLICY PRO LOC $ A AUTOMOBILE LIABILITY ANY AUTO X 02545341$ 0212611Z 07128h 3 COMBINED SINGLE LIMIT (Ea w0clard) $ 1,000,000 BODILY INJURY (Per person) S ALL OWNED AUTOS X SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per sockh M) $ PROPERTY DAMAGE (per accidWA) $ s NON-OWNEDAUTOS API D YR C,EMFN� $ UMBRELLA LIAR EXCESS LIAB CLAIMS -MADE WA /^ j Q 'ems c r � � v "" rl� g �I EACH OCCURRENCE $ HOCCUR AGGREGATE $ DEDUCTIBLE $ $ REENT1014 $ WORKERS COMPENSATION WC STA-T 0T11 AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORiPARTNER/EXECUTIVE E.L. EACH ACCIDENT S OFRCERMEMBER EXCLUDED? N I A (Mandatary In NH) E.L. DISEASE - EA EMPLOYE $ N yes describe urdsr DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LMNT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AHach ACORD 101, AddM10" Runwks Schedule, If mere apace Is requ! ) Monroe County 1100 Simonton Street Key West, FL 33040 C- v MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPHtATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTNORXZED Norman I ACORD 25 (2009109) The ACORD name and logo are registered 4404 of ACORD CORPORATION. All rights reserved. ACCORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM(DD/ 05-16-201012 THIS CERTIFICATEIS 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 ADDITIONALINSURED, the policy(ies) must be endorsed. If SUBROGATIONIS 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 CONTACT NAME: PAYCHEX INSURANCE AGENCY INC PHONE Ext: FAX (A/C, (888) 443-6112 210705 P:()- F:(888)443-6112 PO BOX 33015 ADDRESS: SAN ANTONI O TX 78265 CUSTOMER ID k: INSURER(S) AFFORDING COVERAGE NAIC k INSURED INSURER A : Twin City Fire Ins Co INSURER B BOYS & GIRLS CLUBS OF THE KEYS INC 1400 UNITED ST STE 108 INSURER : KEY WEST FL 33040 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 INSURANCEADOLSUBR LTR (INSR � WVD � POLICY NUMBER POLICY (MM/DD/YYYY) CYEXP (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE U OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) S My.; PERSONAL & ADV INJURY S JG GENERAL AGGREGATE $ ` PRODUCTS - COMP/OP AGG $ GENT AGGREGATE LIMIT APPLIES PER: POLICY U JET LOC T{ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ NON -OWNED AUTOS $ UMBRELLA LIAROCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBEREXCLUDED7 u (Mandatory in NH) N/ A 76 WEG K00211 05/29/2012 05/29/2013 X ORY LIMITS O R E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE S 500,000 E.L. DISEASE - POLICY LIMIT S 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Monroe County Board of BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE County Commissioners DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZE_Q REPRESENTATIVE 1100 SIMONTON ST KEY WEST, FL 33040 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD PAYCHEX INSURANCE AGENCY INC PO BOX 33015 SAN ANTONIO TX, 78265 04981 Monroe County Board of County Commissioners 1100 SIMONTON ST KEY WEST, FL 33040 ACORD 25 (2009/09) � ® A CERTIFICATE OF LIABILITY INSURANCE DATEIMM/DD/YYYYI 05-16-2012 THIS CERTIFICATEIS 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 policy0es) must be endorsed. If SUBROGATIONIS 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 PAYCHEX INSURANCE AGENCY INC 210705 P: () — F: (8 8 8) 4 4 3— 6112 PO BOX 33015 SAN ANTONI O TX 78265 CT NAME: PHONE (A/C No Ext): (AlC,Nol: (888) 443-6112 ADDRESS: PRODUC CUSTOMER ID A: INSURER(S) AFFORDING COVERAGE NAIC A INSURED INSURER A : Twin City Fire Ins Co INSURER B BOYS & GIRLS CLUBS OF THE KEYS INC 1400 UNITED ST STE 108 KEY WEST FL 33040 INSURER C INSURER D INSURER E INSURER F nr�wr wu rwwoeo. COVERAGES �artlIrn.AI r- imuntorn. --- THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT, INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE GENERAL LIABILITY INSR WVD POLICY NUMBER POLICY F (MM/DD(YYYY) (MM/DD/YYYY) LIMITS EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ CLAIMS -MADE u OCCUR MED EXP (Any one person) $ BY PERSONAL & ADV INJURY $ WTE x GENERAL AGGREGATE $ ,l[!/��ryyy� PRODUCTS - COMP/OP AGG S GEN'L AGGREGATE LIMIT APPLIES PER: , S PRO- I I U LOC c.l ! POLICY CT �J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO I BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ (Per accident) HIRED AUTOS I $ NON -OWNED AUTOS $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE I S DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION C STATU- OTH- RY LIMITS ER AND EMPLOYERS' LIABILITY Y/ N I i H ACCIDENT s 5 0 0, 0 0 0 A ANY PROPRIETOR/PARTNER/EXECUTIVE— OFFICER/MEMBEREXCLUDED7 N / A 76 WEG K00211 05/29/2012 05/29/2013 LE.L.DISEASE- EA EMPLOYE $500,000 EASE -POLICY LIMIT S 500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space is required) Those usual to the Insured's Operations. ketrt I Irm A I G nULUGn 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 nnn Anne Arnon r`nQDARATInIU All rights reserved ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) j ACORD TM CERTIFICATE OF LIABILITY INSURANCE 01-11-2013 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 C E ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDIT ONAL IN a po Icy les) must I EP endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain polic s may require an endorsement. A sl itement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER A V ? NTACT AME: PHONE FAX 51187 / Porter Allen Co Inc 513 Southard Street MOT1ROlE C No, Ext (A/C No): Key West, FL 33040 AIL RISK MANAGE INSURERS) AFFORDING COVERAGE NAIC # INSURED INSURER A: MARKEL INSURANCE COMPANY INSURER B: Boys & Girls Club of the Keys Area, Inc. INSURER C: 1400 United Street, Suite 108 INSURER D: Key West, FL 33040 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. NSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER ,MM/DD/YYYY) (MM/DD/YYYY) LIMITS OCCURRENCE S 1,000,0001 A GENERAL LIABILITYEACH ® COMMERCIAL GENERAL LIABILITY ® ❑ DAMAGE TO RENTED $ 100,000' PREMISES (Ea occurrence) Fin CLAIMS -MADE ® OCCUR MED EXP (Any one person) $ 5,000� ❑ 8502CY263142-9 03-25-2013 03-25-2014 PERSONAL & ADV INJURY $ 1,000,000 '❑ GENERAL AGGREGATE I $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 ❑ POLICY ❑ JECT ❑ LOC . $ AUTOMOBILE LIABILITY El❑ AP y � COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ❑ ANY AUTO BY (11r /1�/f .� �1 BODILY INJURY (Per accident) $ ❑ ALL OWNED ❑ SCHEDULED AUTOS AUTOS D �J GCj PROPERTY DAMAGE (Per accident) $ ❑ HIRED AUTOS ❑ NON -OWNED' tC/ AUTOS El El UMBRELLA UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCEEXCESS AGGREGATE $ LIAB ❑ DED ❑ RETENTION $ $ WORKERS COMPENSATION ❑ WC STATU- ❑ OTH- AND EMPLOYERS' LIABILITY Y/N TORY LIMITS ER E.L. EACH ACCIDENT 1 $ ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A f—I IJ 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 (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is included as additional insured as lessor of premises. RE: Loc. #4, 30150 South Street, Big Pine Key, FL 33043 CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1100 Simonton Street DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 / AUTHORIZED REPRESENTATIVE STY Bruce A. Kay 10 _ 4 g (c) 1988-2010 A O ORATION�ightsreserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACORO CERTIFICATE OF LIABILITY INSURANCE TE D05/22/DD//2013 05/22 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 endorsement(s). PRODUCER CONTACT Michael D. Holleman NAME: Work Comp Associates, Inc. P.O. Box 33297 NE (AIC,N., E.t): (561) 863-9581 ;u ,N,,: (561) 881-9745 : ORES": mail@WorkCompAssoc.com INSURER(S) AFFORDING COVERAGE NAIC M Palm Beach Gardens, FL 33420-3297 INSURER A: Retail First Insurance Company INSURED INSURER B: Boys & Girls Club of the Keys Area, Inc. 1400 United Street, Suite 108 INSURER C: INSURER D: INSURER E: Key West, FL 33040-3400 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. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ❑ OCCURgy AV rAlE I • A ENTCLAIMS-MADE •' Cl� EACH OCCURRENCE $ PREMISE S (Ea occurrence) $ MED (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PE LOC PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS ❑ ❑ $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE ❑ ❑ EACH OCCURRENCE $ AGGREGATE $ DED I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N❑ 0520446780000 5/29/2013 5/29/2014 X WC TATU- OTH- E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners 110 Simonton Street 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 1 ) @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD AICOR�® ` `la.•.� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 2/11/2014 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 endorsement(s). PRODUCER Regan Insurance Agency 90144 Overseas Hwy. Tavernier FL 33070 CONTACT Brenda Monroe NAME: PHONE (305) 852-3234 FAX Nolm (305)852-3703 EMAIL ,bmonroe@reganinsuranceinc.com INSURERS AFFORDING COVERAGE NAIC ff INSURERA:Nautllus Insurance CO 17370 INSURED Boys and Girls Clubs of the Keys Area Inc 1400 United Street STE 108 _KeyWest FL 33040 INSURER B : INSURER C : INSURERD: INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:14-15 GL 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 ADDLSUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP M /D /YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTffIT_ PREMISE Ea occurrence $ 100,000 A CLAIMS -MADE FX OCCUR X NN428639 /6/2014 /6/2015 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ Includ@ $ X POLICY JECT PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO I 1.t� �'u„ BODILY INJURY (Per person) $ Sy BY INJURY (Per accident) $ ALL OWNED SCHEDULED CDABODILY , AUTOS AUTOS NON -OWNED WAIMAT W ` C4WV PROPERTY DAMAGE $ HIRED AUTOS AUTOS j Per accident $ ��: l UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH. FR AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER!MEMBER EXCLUDED? ❑ N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT 1 $ If yes, describe under DESCRIPTION OF OPERATIONS below r-`1 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate holder is shown as an additional insured per policy forms, conditions, limitats and -- exclusions.77 _ 3a„ 74 G79 c ------------- lewinski-monique@monroecou Monroe County Board c/o Risk Management 1100 Simonton St Key West, FL 33040 of County Commissione 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 John Crowell/FTHOM ACORD 25 (2010/05) C 1938-2010 ACORD CORPURA I HJN. An rignts reservea. INS025 (201D05).01 The ACORD name and logo are registered marks of ACORD FULLERS INS AGCY 1432 KENNEDY DRIVE KEY WEST, FL 33040 1-305-294-6677 Certificate of Insurance Certificate Holder Insured ..............................................................................." Additional Insure....d BOYS..&GIRLS......CL..UB IN. C C MONROE COUNTY 1400 UNITED ST #108 1100 SIMONTON KEY WEST, FL 33040 KEY WEST, FL 33040 PROGREWYES Policy number: 02545341-6 Underwritten by: PROGRESSIVE EXPRESS INS COMPANY March 24, 2014 Pagel of 1 Agent ...................................... FULLERS INS AGCY 1432 KENNEDY DRIVE KEY WEST, FL 33040 This document certifies that insurance policies identified below have been issued by the designated insurer to the insured named above for the period(s) indicated. This Certificate is issued for information purposes only. It confers no rights upon the certificate holder and does not change, alter, modify, or extend the coverages afforded by the policies listed below. The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations, endorsements, and conditions of these policies. ........................................................................................................................ Policy Effective Date: Feb 26, 2014 Policy Expiration Date: Feb 26, 2015 Insurance coverage(s) Limits .................................................................................................................................. BODILY INJURY/PROPERTY DAMAGE $1,000,000 COMBINED SINGLE LIMIT .................................................................................................................................. UNINSURED MOTORIST $1,000,000 CSL NON-STACKED .................................................................................................................................. PERSONAL INJURY PROTECTION $10,000 W/$0 DED - NAMED INSURED ONLY Description of locationNehicles/Special Items Scheduled autos only 2005 CHEVROLET EXPRESS G3500 1 GAHG39U551110493 COMPREHENSIVE $500 DED COLLISION $500 DED .................................................................................... 2006 FORD ECONO/CLUB WGN 1 FBNE31 L46HA16394 COMPREHENSIVE $500 DED COLLISION $500 DED Certificate number O8314NET341 Yp R W4ANIA rr,�� •x CL Please be advised that additional insureds and loss payees will be notified in the event of a mid-term cancellation. F _ ZO.31 NV SZ � t b 41 77 OV Form 5241 (10102) AC40 E® CERTIFICATE OF LIABILITY INSURANCE 3i26/2o14 ) 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 endorsement(s). PRODUCER The Porter Allen Company, Inc. 513 Southard Street Key West FIB 33040 CONTACT NAME: PHONE (3O5)294-2542 FAX (305)296-7985 E-MAIL ,maria@porterallencompany.com ADRFSS INSURERS AFFORDING COVERAGE NAIC # INSURERAMarkel Insurance Company INSURED Boys & Girls Clubs of the Keys Area, Inc. 1400 United Street, Suite 108 ,Key West FI. 33040 INSURER B : INSURERC: INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:CL1432604154 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 OF INSURANCE ADDTYPE INSR WVDSUBRI POLICY NUMBER POLICY LIC MM/D Y EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occur ence $ 100,000 A CLAIMS -MADE a OCCUR X 8502CY263142 - 10 3/25/2014 3/25/2015 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OPAGG $ 1,000,000 $ X POLICY JECT PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS rPRPeOPPERT tDAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ —TTWC $ WORKERS COMPENSATION STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT If yes, describe under DESCRIPTION OF OPERATIONS below $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) ./ CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED RE: 30150 SOUTH STREETSTRT;ET BIG PINE KEY, FL. �BY Q WS— MIA FQ. Qi CERTIFICATE HOLDER =;';.' CANCELLATION Monroe Co Boaq Cg- NVu*-y t W;sioners 1100 Simonton Street Key West, FL 4-G7, d'ub0.1jiJ L; JId�t SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2010/05) / ©1988-2010 ACORNXORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD '4 CERTIFICATE OF LIABILITY INSURANCE D /DD/YYYY) 2/6/26/2015 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 - EPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. PORTANT: 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). PRODUCER NAME: Brenda Monroe Regan Insurance Agency PHONE FAX 90144 Overseas H E-MAIL - (305) 852-3234 . (305)e52-3�03 �"�'' ADDREss: bmonroe@ reganinsuranceinc . com im-c' a) Hrrumunma GVVCKAGF NAIC # Tavernier FL 33070 INSURERA:Nautilus Insurance Cc 17370 INSURED INSURER B : Boys and Girls Clubs of the Keys Area Inc INSURER C : 1400 United Street STE 108 INSURERD: INSURER E ,Key West FL 33040 INSURERF: COVERAGES CFIJTICif ATc wiaaoco.l r—1 a n_► - — ncviarvrn nvmor-m; 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 D POLICY NUMBER POLICY EFF MM/ POLICY EXP MM D/YY LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X 506613 /6/2015 /6/2016 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO REPTEff— PREMISES Ea occurrence — $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGG $ Include $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON-OWNAUTOS COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / NORY ANY PROPRIETOR/PARTNER/EXECUTIVE OrFiCErTdEMBER EXCLUDED-7 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- OTH- I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate holder is shown as an additional insured per policy forms, co ditions, limitations and exclusions. P B GEMENM DATE C WAIVER N/A _ C ` L- lewinski Monroe County Board of County Commissione c/o Risk Management two :01 NY S_ HVW S161 1100 Simonton St Key West, FL 33040 ijdoj3� 601 03111i lu•L 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 ....,er...� John Crowell/FTHOM Iv Taut%-ZU1U ACURD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD ACORD TM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03-20-2015 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. - S CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE slili 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). PRODUCER CONTACT NAME: PHONE FAX 51 187 / Porter Allen Co Inc 513 Southard Street (A/C No, Ext): (A/C No): E-MAIL Key West, FL 33040 ADDRESS: INSURERS) AFFORDING COVERAGE NAIC # INSURED INSURER A: MARKEL INSURANCE COMPANY INSURER B: Boys & Girls Club of the Keys Area, Inc. INSURER C: 1400 United Street, Suite 108 Key West, FL 33040 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. INSRi LTR TYPE OF INSURANCE ADDLISUBR', INSR WVDI, POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL LIABILITY! ® COMMERCIAL GENERAL LIABILITY ❑CLAIMS -MADE ®OCCUR ❑ ® ❑ 8502CY263142-1 1 03-25-2015 1 03 25 2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED I $ 100,000 PREMISES (Ea occurrence) MED EXP (Any one person) �� $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 PRODUCTS -COMP/OP AGG $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: RO- ❑ POLICY ❑ JECT ❑ LOC $ I AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ❑ APPRO By • GEMENT (/s x , ! COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ j ❑ ALL OWNED ❑ SCHEDULED j AUTOS AUTOS. HIRED AUTOS NON -OWNED I',' ❑ ❑ AUTOS WAIVER N/ C — BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) S UMBRELLA LIAB ❑ OCCUR EXCESS UAB ❑ CLAIMS -MADE ❑ ❑ EACH OCCURRENCE $ AGGREGATE '.. $ ❑ DIED ❑ RETENTION $ $ WORKERS COMPENSATION I ❑ WC STATU- ❑ OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE f—I OFFICER/MEMBER EXCLUDED? !I N/A ❑', III TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ i I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is included as additional insured as lessor of premises. RE: Loc. #2, 30150 South Street, Big Pine Key, FL 33043 RTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1100 Simonton Street DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY Key West, FL 33040 PROVISIONS. AUTHORIZED REPRESENTATIVE /f BWA ! Bruce A. Kay /S 10 (c) 1988-2010 AGMEY CORPORATION, ights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE TM DATE 03-20YYYY) 3-20-20 15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. C�4S CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE 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). PRODUCER CONTACT NAME: 51187 / Porter Allen Cc Inc PHONE FAX 513 Southard Street A/C No, Ext): (A/C No): E-MAIL Key West, FL 33040 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: MARKEL INSURANCE COMPANY 38970 INSURER B: Boys & Girls Club of the Keys Area, Inc. INSURER C: 1400 United Street, Suite 108 Key West, FL 33040 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. NSR LTR; TYPE OF INSURANCE ADDL INSR SUBR, WVD POLICY NUMBER POLICY EFF POLICY EXP MM/DD/YYYY '�. (MM/DD/YYYY) LIMITS A GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY �� ❑ CLAIMS -MADE ® OCCUR ® ❑ 8502CY263142-11 03-25-2015 '� 03-25-2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) I $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 �GEN'L AGGREGATE LIMIT APPLIES PER: ICI ❑ POLICY ❑ JECO- ❑ LOC PRODUCTS - COMP/OP AGG $ 1,000,000 -------- --- S AUTOMOBILE LIABILITY ICI ❑ ANY AUTO �;, ❑ ALL OWNED ❑ SCHEDULED Auros Auros NED ❑ HIRED AUTOS ❑ NON -OWNED ❑ ❑ ❑ ❑ P DA Ei WAIVER N/ ��GJVMENT /)�xn ,C�"_ ' 1T //��.) C C,4 yam/ (( COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $''i BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB ❑ OCCUR EXCESS LIAB ❑ CLAIMS -MADE ❑ ❑ EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION $ ❑ WC STATU- ❑ OTH- TORY LIMITS ER $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ry ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A li E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ G I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is included as additional insured as lessor of premises. RE: Wilder Road & Lytton Road, Big Pine Key, FL 33043 RTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners 1100 Simonton Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY Key West, FL 33040 PROVISIONS. AUTHORIZED REPRESENTATIVE BWA i /� �� Bruce A. Kay 10 (c) 1988-2010 ACMU-COOMPORATION ights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD FULLERS INS AGCY 1432 KENNEDY DRIVE KEY WEST, FL 33040 (W 1-305-294-6677 Certificate of Insurance Certificate Holder Additional Insured MONROE COUNTY 1100 SIMONTON KEY WEST, FL 33040 Insured ............. I ................. BOYS & GIRLS CLUB INC 1400 UNITED ST #108 KEY WEST, FL 33040 PR98RFff1YF® Policy number: 02545341-7 Underwritten by: PROGRESSIVE EXPRESS INS COMPANY March 31, 2015 Page 1 of 2 Agent .... I .......... I ............. FULLERS INS AGCY 1432 KENNEDY DRIVE KEY WEST, FL 33040 This document certifies that insurance policies identified below have been issued by the designated insurer to the insured named above for the period(s) indicated. This Certificate is issued for information purposes only. It confers no rights upon the certificate holder and does not change, alter, modify, or extend the coverages afforded by the policies listed below. The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations, endorsements, and conditions of these policies. . .................... Policy Effective Date: Feb 26, 2015 Expiration.D.26, 2016 '' "' .... Policy ate: . Feb Ins.urance coverage(s) Limits ..................................................... BODILY INJURY/PROPERTY DAMAGE ......................... . ............................................... $1,000,000 COMBINED SINGLE LIMIT ...................... UNINSURED MOTORIST ....... ....................................... $1,000,000 CSL NON -STACKED ............................................................ . PERSONAL INJURY PROTECTION ' $10,000 W/$0 DED -NAMED INSURED ONLY Description of LocationNehicles/Special Items Scheduled autos only ....... .................................. ............ ........ I................... 2005 CHEVROLET EXPRESS G35OO 1 GAHG39U55111O493 COMPREHENSIVE $500 DED COLLISION $500 DED ........................................................................... 2006 FORD ECONO/CLUB WGN 1 FBNE31 L46HAI63.94 ........ COMPREHENSIVE $500 DED COLLISION... $500 DED ................................................................................. 2013 CHEVROLET EXPRESS G350O 1 GAZGYFG4D1148005 COMPREHENSIVE $500 DED COLLISION $500 DED � AP EII NT WAIVER N/A E U rU C Icr I G X L� k, J Continued Policy number: 02545341-7 Page 2 of 2 Certificate number 09015NET341 Please be advised that additional insureds and loss payees will be notified in the event of a mid-term cancellation. Form 5241 (10102) A`.� EP CERTIFICATE DATE (MM/DD/YYYY) OF LIABILITY INSURANCE 04/13/201 5 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 JP ---.OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED RESENTATIVE 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). PRODUCER Michael D Holleman Work CompAssociates, Inc. PHONE INC, No, Ext): (561) 863-9581 ac, No), (561) 881-9745 P.O. Box 33297 ADDRESS: mail@WorkCompAssoc.com Palm Beach Gardens, FL 33420-3297 INSURERS AFFORDING COVERAGE NAIC 0 INSURER A: RetailFirst Insurance Company 10700 INSURED Boys & Girls Club INSURER B: INSURER C: of the Keys Area, Inc. INSURER D: 1400 United Street, Suite 108 INSURER E:INSURER Key West, FL 33040-3400 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 DD INSR UB WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEff $ 5 CLAIMS -MADE OCCUR MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS -COMP/OP AGG $ POLICY PRO- LOC JECT 5 AUTOMOBILE LIABILITY Ea accident $ ANY AUTO SCHEDULED 30DILYINJURY Perperson) $ ALL OWNED AUTOS AUTOSNON-O ODILY INJURY Per accident) $ HIRED AUTOS AUTOSWNED PROPERTY DAMAGE Per accident $ 5 UMBRELLA LIAB OCCUR EXCESS LIAR CLAIMS - EACH OCCURRENCE 5 AGGREGATE $ DED RETENTION E WORKERS COMPENSATION $ AND EMPLOYERS' LIABILITY Y/N X INCSTATU- OTH- TORYLIMMS ER ANY PROPRIETOR/PARTNER/EXECUTIVE EXCLUDER/EXECUTIVE E.L. EACH ACCIDENT $ 100'000 A (Mandatory R EXCLUDED? y n/a N 0520446780000 5/29/2015 5/29/2016 (Mandatory in In NH) H yes, describe under and E.L. DISEASE - EA EMPLOYEE $ 100,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is requlr ) y PROV END, W N/A '` 0 _ ' 1N)1oJ30�'8HOW CC. 0 ai0 CERTIFICATE HOLDER CANCELLATION 7 Monroe County Boar�tl)f I@uWV Ct�IiITJSIVnEW1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE 110 Simonton Street 080338 b03 03113 WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Key West, FL 33040 - (RC) ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 6 o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 71/27/2016 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 T THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING ORDER BY AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. PORTART: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to blithe 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 CONTACT Brenda MOATOe Regan Insurance Agency NAME:_ PHONE --- --_-- -- 90144 Overseas Hwy. A/c No Ex11l-(305) 852 3234 FAX - -7 E-MAIL - - -------_.- A/C No): (305) 852-3703 ADDRESS_ monroo reganinsuranceinc , com Tavernier___ FL 33070-----------INSURER(S)AMClRDINGCOVERAGE _ NAIC# INSURED -----_---___.__ INSURERA-Nautilus Insurance CO 1737D Boys and Girls Clubs of the Keys Area Inc IlusuRER B_ - - -- 1400 United Street STE 108 INSURERC:- -- - - INSURER D : INSURER E : --- Key West FL 33040 ---— _ COVERAGES INSURER F CERTIFICATE NUMBER:16-17 GL THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVEB OR 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. 4SR - ADDL UBR -- - _ TR TYPE OF INSURANCE POLICY EFF POLI EYC XP — X COMMERCIAL GENERAL LIABILITY POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A �- CLAIMS -MADE X OCCUR EA�OCCU�RRIE�CE $ 11000,000 A — X INN640165 2/6/2016 2/6/2017 GENT AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT LOC OTHER: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED 1 SCHEDULED AUTOS �� AUTOS HIRED AUTOS NON -OWNED - AUTOS UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE, I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBEREXCLUDED? -�IN/A (Mandatory in NH) If yes, describe under GE TO RENTED PREMISE�Ea occurrence)$ 100 , 000 MED EXP (Any one person) � $ _ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE i$ 2,000,000 PRODUCTS - COMP/OPAGG $ Included COMBINED SINGLE LIMIT $ ka accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) PROPERTY DAMAGE $ - - 'Peracaccident) EACH OCCURRENCE $ AGGREGATE $ E.L. EACH ACCIDENT - $ E.L. DISEASE - EA EMPLOYE $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certificate holder is shown as an additional insured per policy forms, exclusions. conditions, limitations and t'PRU to EMEM (, WAIVE N/ YES` CC � lewinski SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of :-out Commissione THE EXPI G RATION DATE THEREOF, NOTICE WILL BE DELIVERED IN C/O Risk Management •d 0�� ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St 5`101 Key West, FT. 33040 AUTHORIZED REPRESENTATIVE Joseph Roth/FTHOM� ACORD 25 01988-2014 ACORD CORPORATION All rights reserved. INS025 (2 01401) (2014/01) The ACORD name and logo are registered marks of ACORD ACORD TM CERTIFICATE OF LIABILITY INSURANCE r _DATE hr.,ar°'YY 20 "— - - February 3 2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INF013MATION 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(SI, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 1PORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the corms 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 51187 / Porter Allen Co Inc 513 Southard Street Key West, FL 33040 INSURED Boys & Girls Club of the Keys Area, Inc. 1400 United Street, Suite 108 Key West, FL 33040 CONTACT NAME: PHONE FAX (A/C No, Ext): (A/C No) E-MAIL ADDRFSS- INSURER(S) AFFORDING COVERAGE INSURER A: MARKEL INSURANCE COMPANY INSURER B: INSURER C: INSURER D: INSURER E: INSURER F• NAIC # 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. �Ift TYPE OF WVD POLICY NUMBER A GENERAL LIABILITY JEINSR COMMERCIAL GENERAL LIA ❑ CLAIMS -MADE ® O8502CY263142-13 PPLIES PER: N'L AGGREGATEIJECT POLICY ❑ ❑ LOC AUTOMOBILE LIABILITY i ❑ ❑ ❑ ANY AUTO ❑ ALL OWNED ❑ SCHEDULED AUTOS AUTOS ❑ HIRED AUTOS ❑ NON -OWNED i ❑ ❑ AUTOS UMBRELLA LIAB OCCUR ❑ ❑ ❑ EXCESS LIAB CLAIMS -MADE U DED ❑RETENTION 9 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N jo ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER ❑ N/A 1 EXCLUDED? (Mandatory in NH) If Yes, describe under DESCRIPTION OF OPERATIONS below POLICY EFF I POLICY EACH OCCURRENCE I S 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 03-25-2016 03-25-2017 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY 01s 0 OOO GENERAL AGGREGATE $ 3,000,000, PRODUCTS - COMP/OP AGG I S 1,000,0001i 'S 1 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) $ EACH OCCURRENCE $ .---- ----------I AGGREGATE S —� — S ❑ WC STATU- ❑ OTH- TORY LIMITS ER E.L. EACH ACCIDENT — E.L. DISEASE . EA EMPLOYEE $ E.L. DISEASE •POLICY LIMIT �$ -- DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedu , if more space is required) Certificate holder is included as additional insured as lessor of premises. RE: Wilder Road & Lytton Road, Big Pine Key, FL 33043 A =r. rnt,N r e nuwr=H CANCELLATION ---"--- - Monroe County Board of County Commissioners 1 100 Simonton Street 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 Bruce A. Kay (c) 1988-2010 ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD BWA 10 reserved. ACORD TM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) — ---- 02-03-2016 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. arum I AIM 1: It the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the rms 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 CONTACT 51 187 /Porter Allen Co Inc NAME: j PHONE i FAX 513 Southard Street (A/C No, Ext): (A/C No): Key West, FL 33040 E-MAIL ADDRESS:__ INSURER(S) AFFORDING COVERAGE NAIC # INSUREDINSURER AMARKEL INSURANCE COMPANY 8 70 Boys & Girls Club of the Keys Area, Inc. INSURER B: 1400 United Street, Suite 108 FINSURER C: -- Key West, FL 33040 INSURER D: — INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: J -- 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. -LTR1 TYPE OF INSURANCE A GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY ❑ CLAIMS -MADE ® OCCUR �GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ElPRO- JECT ❑ LOC AUTOMOBILE LIABILITY 1 ❑ ANY AUTO INSR WVDI POLICY NUMBER ® I ❑ 8502CY263142-13 I � - ❑ ALL OWNED ❑ SCHEDULED AUTOS AUTOS ❑ HIRED AUTOS ❑ NON -OWNED AUTOS UMBRELLA LIAB ❑ OCCUR ❑ ❑ EXCESS LIAB ❑ CLAIMS -MADE � ' DED ❑ RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE ?'/N N/A OFFICER/MEMBER EXCLUDED? =_J - (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below POLICY EFF POLICY EXP LIMITS EACH OCCURRENCE $ 1,000,0001 DAMAGE TO RENTED $ 100,000 PREMISES (Ea occurrence) 1 MED EXP (Any one person) $ 5,00 03-25-2016 03-25-2017 PERSONAL & ADV INJURY $ 1,000, 0, GENERAL AGGREGATE $ 3,000,000I PRODUCTS - COMP/OP AGG $ 1,000,0001 S COMBINED SINGLE LIMIT (Ea accident) rBODILY $ J I NJURY (Per person) $ BODILY INJURY (Per accident) $ i PROPERTY DAMAGE $ (Per accident) LEACHOCCURRENCE $ AGGREGATE -- - _❑ WC STATU ❑ OTH TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE —--- $ �I E.L. DISEASE - POLICY LIMIT $ —� Ll r� li DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) _ -- --- Certificate holder is included as additional insured as lessor of premises. PP RbVE NAGEMENT RE: 30150 South Street, Big Pine Key, FL 33043 1�-/ , iFaloj 304HOW WAIVER N/ YES �' CERTIFICATE HOLDER CANCELLATION Monroe County Board of County CommissionersQ� WVZ I a 6lQ{w1ig1�(]] 1100 Simonton Street • L ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY Key West, FL 33040 d 0 �R4YINS. ,a tl AUTHORIZED REPRESENTATIVE BWA Bruce A. Kay 10 - --- ACORD 25 (2010/05) marks of AC 0 D A CO ORATION. rights reserved. The ACORD name and logo are registered marks of ACORD AC'n 17I� OP ID: NF CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDO/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOL0.D RE .1 THIS RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the POIICy(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 endorsemen s . PRODUCER 305-294-6s77 NTACT The Fullers, Inc 305-292-4"1 PRONE FAX 1432 Kennedy Drive MAILEft Arc No: Key West, FL 33"0 ADDRESS: Norman Fuller TD,:BOYS&-1 INSU AFFORDING COVERAGE NAIL, INSURED Boys & Girls Club of the INSURER A: PrOCIP11165hie, Keys Area, Inc. 1400 United St. 0108 INSURERB: Key West, FL 33040 INSURERC: INSURER D : INSURER E : CAVFDAACQ -•------- UR RF: 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. LTR TYPE OF INSURANCE GENERAL LIABILITY NUMBER MMrLDD1YYYY E LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ KhNIED CLAIMS PREMISES s occurrence S MED EXP An "person) $ -MADE OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ ER: JECT LC PRODUCTS - COMP/OP AGG S S A" X 2645341-8 02126/16 02/26/17 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) f BODILY INJURY (Per accident) S SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) III AUTOS NON -OWNED AUTOS S s UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS* LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y 1 N OFFICERMEMBER EXCLUDED? !Mandatory In andNH) N yes, deseriee under DESCRIPTION OF OPERATIONS Wow N 1 A PPR E A pAT WAIV N/A YES _ _ MENT p l S WC STATU- OTH- f EL EACH ACCIDENT f E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (I►►Itach ACORD 101, AddIdooW Remarks Schedule, a male aace le roquhed) 2005 Chevrolet Express 03 CRGVN 1GAHG39U551110493 p 2006 Ford Econo/Club OTHB 1FBNE31L"HA18394 2013 Chevrolet Express G3 OTHB 1GAZGYFG4D1148005 CFRTIFICAT1•Ir11 n�D ` r- Monroe County 1100 Simonton Street Key West, FL 33040 MONRCON t�, n SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE W d S- 83J 91OZ ACCORDANCE Y�TH THE P9THEREOF, lCY PROVINOTICE IO g E WILL 13E DELIVERED 1N 0 jJ a G V J U 3 (i � Norman ALTHORIZ ormanol i1 r,; � I ACORD 23 (2009109) ACORD CORPORATION. All rights nsserved. The ACORD name and logo are registered niarks of CORD COOREP A�....i ® CERTIFICATE DATE (MM/DD/YYYY) OF LIABILITY INSURANCE 04/13/2016 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 endorsement(s). PRODUCER CONTACTMichael D Holleman Work CompAssociates, Inc. PHONE (A/C, No, Ext): (561) 863-9581 ,vC, No): (561) 881-9745 P.O. Box 33297 a DRESS: mail@WorkCompAssoc.com Palm Beach Gardens, FL 33420-3297 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: RetallFlrst Insurance Com)any 10700 Boys & Girls Club INSURER B: of the Keys Area, Inc. INSURER C: 1400 United Street, Suite 108 INSURER D: Key West, FL 33040-3400 INSURER E: COVERAGES CERTIFICATE NUMBER: INSURER F: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN NOTWITHSTANDING REVISION NUMBER: ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. 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 SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF INSR DD UB LTR TYPE of INSLIReMrc _ POLICY EFF POLICY EXP GENERAL - - -- LIABILITY •�•� •••� rvucT NUMtt-K MM/DDNYYY) (MM/DDNYYYl I LIMIT COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE A MED EXP 7onerson) PERSONALGENERAL LIMIT APPLIES PER:PRO- AGEN'LAGGREGATE PRODUCTS POLICY JECT LOC AUTOMOBILE LIABILITY Ea accident ANY AUTO 30DILYINJURY rson) SCHEDULED ALL OWNED AUTOS AUTOS HIRED AUTOS NON -OWNED ODILY INJURY iident Per accident UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS- EACH OCCURRENCE HMAnF AGGREGATE -LED I I RETENTION S WORKERS COMPENSATION A AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER EXCLUDED? y (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below n/a 0520446780000 5/29/2016 5/29/2017 X WCSTATU- OTH- TORY LIMITS ER E.L. DISEASE - EA EMPLOYEE E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 500 r— =J APPRO IEID B� EMENT VV �, c�✓� WAIVER N/A SF_ C,e.-h Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 110 Simonton Street AUTHORIZED REPRESENTATIVE Key West, FL 33040 - I/,-- �) iL�_ (RC; ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and l000 are realstered marks of ACORD f'll%oUKU TM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYW) o1-z7-2o17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFI CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, CATE HOLDER. THIS 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 policylies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the certain policy, 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 CONTACT 51187 /Porter Allen Co Inc NAME: PHONE FAX 513 Southard Street (A/C No, Ext): Key West, FL 33040 (A/C No): E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC # INSURED INSURER A: MARKEL INSURANCE COMPANY Boys & Girls Club of the Keys Area, Inc. INSURER B: 1400 United Street, Suite 108 INSURER C: Key West, FL 33040 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NoANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE SUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF CH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ;AGENERAL ADDL SUER POLICY EFF POLICY EXP TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY (MM/DD/YYYY) LIMITS LIABILITY ® COMMERCIAL GENERAL LIABILITY ® ❑ EACH OCCURRENCE b 1,000,000 DAMAGE ❑ ElCLAIMS-MADE® OCCUR TO PREMISES (Ea occurrence) ence) b 100,000 MED EXP (Any one person) b 5,000 8502CY263142-14 03-25-2017 03-25-2018 ❑ PERSONAL & ADV INJURY b 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE b 3,000,000 PRODUCTS - COMP/OP AGG b 1,000,000 ❑POLICY ❑ PRO- ❑ LOC JECT b AUTOMOBILE LIABILITY ❑ ❑ COMBINED SINGLE LIMIT ❑ ANY AUTO (Ea accident) b ❑ALL OWNED ❑ ULED BODILY INJURY (Per person) b BODILY INJURY (Per accident) b AUTOS AUTOS ❑ HIRED AUTOS ❑ NON -OWNED PROPERTY DAMAGE ❑ ❑ AUTOS (Per accident) b b UMBRELLA LIAB ❑ OCCUR ❑ ❑ EXCESS LIAB D CLAIMS -MADE EACH OCCURRENCE b ❑ DED ❑ RETENTION b AGGREGATE b WORKERS COMPENSATION - _ b AND EMPLOYERS' LIABILITY Y/N ❑ WC STATU- ❑ OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER ❑ N/A ❑ TORY LIMITS ER E.L. EACH ACCIDENT b EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE b If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT b ❑ ❑ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) Certificate holder is included as additional insured as lessor of premises. RE: 30150 South Street, Big Pine Key, FL 33043 P RU U 8 EMI ar. or5- WAI / ES y�G� Cc CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners 1100 Simonton Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE West, FL 33040 DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH TKey PROVISIONS. t AUTHORIZED REPRESENTATIVE Bruce A. Kay G e- �` a"'t'u— 10 ACORD 2b (2010/05) IVI 1000-cu I V At;0KU GUKPUHATION ights reserved. The ACORD name and logo are registered marks of ACORD AE UHD TM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01-27-2017 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 endorsement(s). PRODUCER CONTACT NAME: 51187 / Porter Allen Co Inc PHONE FAX 513 Southard Street (A/C No, Ext): (A/C No): Key West, FL 33040 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: MARKEL INSURANCE COMPANY Boys & Girls Club of the Keys Area, Inc. INSURER B- 1400 United Street, Suite 108 INSURER C: Key West, FL 33040 INSURER D: INSURER E: INSURER F: COVERAGES nC v 101UnII IY U M CtFf : 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. NSR ADDL SUBR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF POLICY EXP MM/DD/YYYY IMM/DD/YYYY) LIMITS A GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY ❑ CLAIMS -MADE ® OCCUR ® EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 8502CY263142-14 03-25-2017 03-25-2018 MED EXP IAny one person) $ 5,000 ❑ PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 POLICY El❑Jno- ❑ LOC S AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ❑ COMBINED SINGLE LIMIT (Ea accident) 8 ❑ ALL OWNED ❑ SCHEDULED AUTOS AUTOS ❑ HIRED AUTOS ❑ NON -OWNED ❑ ❑ AUTOS BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) S s UMBRELLA LIAB EXCESS LIAB O OCCUR ❑ CLAIMS -MADE ❑ ❑ EACH OCCURRENCE S DED ❑ RETENTION S AGGREGATE S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N/A ❑ ❑ WC STATU- ❑ OTH- TORY LIMITS ER S E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE 8 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE •POLICY LIMIT 8 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is included as additional insured as lessor of premises. RE: Wilder Road & Lytton Road, Big Pine Key, FL 33043 r AP CJV R ATEMENT DA WAI ER NIA/6 ESQ y/L CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners 1100 Simonton Street 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. J AUTHORIZED REPRESENTATIVE BSP Bruce A. Kay 10 G L ' ACORD 25 (2010/05) tr.1 laoo-cv 1v At'Qnu L:UMNURATION. Affrights reserved. The ACORD name and logo are registered marks of ACORD /V1I� DATE (MMIDD/YYY`I) %o® CERTIFICATE OF LIABILITY INSURANCE 2/11/2014 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 . CONTACT Brenda Monroe PRODUCER A PHONE (305) 852-3234 FAXIAIC (305)852-3703 Regan Insurance AgencyN. E-MAIL .bmonroe@reganinsuranceinc.com 90144 Overseas Hwy. INSURERS AFFORDING COVERAGE NAIC # Tavernier FL 33070 INSURER A:Nauti lus Insurance Co 17370 INSURED INSURERS: Boys and Girls Clubs Of the Keys Area Inc INSURERC: 1400 United Street STE 108 INSURERD: lKey Nest FL 33040 1 INSURER F: CERTIFICATE NUMBER:14-15 GL REVISION NUMBER: COVERAGES BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID EXCLUSIONS CY EXPCLAIMS ADDL SUBR DLICE LIMITS OF INSURANCE POLICY NUMBER $ 1,000,000 ITY EACH OCCURRENCE DAMAGE TO RENTED 100,000 $ AL GENERAL LIABILITY /6/2014 /6/2015 PRE I a o ce MED EXP An one person $ 5,000 S-MADE � OCCUR X 428639 rAGGREGATE PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2, OOO, OOO PRODUCTS-COMP/OPAGG $ Include TE LIMIT APPLIES PER:PRO LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED - - BODILY INJURY (Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON -OWNED P acc' ent HIRED AUTOS AUTOS Is OCCUR EACH OCCURRENCE $ UMBRELLA LIAB AGGREGATE $ EXCESS LIAB CLAIMS -MADE I DED I RETENTION WORKERSCOMPENSATION WC STATU- OTH- TORY LIMITS AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ A NIA E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below L L -I.— DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, B more space is required) an additional insured per policy forme, conditions, limitations and Certificate holder is shown as exclusions. NAGEMENT� DIF L;t � CAI 1 fUe - Ai - CERTIFICATE HOLDER CANCELLATION lewinski-monique@monroecou 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 Board of County Commissione c/o Risk Management AUTHORIZED REPRESENTATIVE 1100 Simonton St Rey West, FL 33040 John Crowell/FTHOM~ ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) INS025 (201005).01 The ACORD name and logo are registered marks of ACORD A'C �® CERTIFICATE OF LIABILITY INSURANCE DATE 2/6/2015Y) 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 endorsement(s). PRODUCER Regan Insurance Agency 90144 Overseas Hwy. Tavernier FL 33070 CONTACT Brenda Monroe NAME: pHONE (305) 852-3234 FAXtAIC, Nolm (305)852-3703 EMAIL .bmonroe@reganinsuranceinc.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Nautllus Insurance Co 17370 INSURED Boys and Girls Clubs of the Keys Area Inc 1400 United Street STE 108 JKey West FL 33040 INSURER B : INSURER C : INSURERD: INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:15-16 GL 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 A DDLSUBR POLICY NUMBER POLICY EFF MM/ ICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR X NN506613 /6/2015 /6/2016 DAMAGE TO RENTffD_ PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ Include X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE P accident $ NON -OWNED HIRED AUTOS AUTOS(Par UMBRELLA LIAR OCCUR EACH OCCURRENCE $ d AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION WC STATU- I JOTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OrFtCCM?,4EMBER EXCLUDED? ❑ A NIA E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is shown as an additional insured per policy forms, co ditions, limitations and exclusions. B GEMEENNT WAIV N/A V , � — cc.r% GEKTIFIGA I It HVLUtK GANt;tLLA I IUN JUdNUW lewinsk 1o* i m �MecouSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissione ACCORDANCE WITH THE POLICY PROVISIONS. c/o Risk Management CO :01 NV S_ HVa SiOZ AUTHORIZED REPRESENTATIVE 1100 Simonton St ►7• Key West, FL 33040 38003b 80.E 0311� _- John Crowell/FTAOM ACORD 25 (2010/06) INS025 (201005).01 U 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD FULLERS INS AGCY 1432 KENNEDY DRIVE KEY WEST, FL 33040 1-305-294-6677 Certificate of Insurance Certificate Holder ........................... Additional Insured MONROE COUNTY 1100 SIMONTON KEY WEST, FL 33040 Insured ............................... BOYS & GIRLS CLUB INC 1400 UNITED ST #108 KEY WEST, FL 33040 PROGREll/UE® Policy number: 02545341-7 Underwritten by: PROGRESSIVE EXPRESS INS COMPANY March 31, 2015 Page 1 of 2 Agent ............................. FULLERS INS AGCY 1432 KENNEDY DRIVE KEY WEST, FL 33040 This document certifies that insurance policies identified below have been issued by the designated insurer to the insured named above for the period(s) indicated. This Certificate is issued for information purposes only. It confers no rights upon the certificate holder and does not change, alter, modify, or extend the coverages afforded by the policies listed below. The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations, endorsements, and conditions of these policies. ........................................................................................................................ Policy Effective Date: Feb 26, 2015 Policy Expiration Date: Feb 26, 2016 Insurance coverage(s) Limits ................................................................................................................................. BODILY INJURY/PROPERTY DAMAGE $1,000,000 COMBINED SINGLE LIMIT ................................... ................................................. ......................... I................... UNINSURED MOTORIST $1,000,000 CSL NON-STACKED ................................................................................................................................. PERSONAL INJURY PROTECTION $10,000 W/$0 DED - NAMED INSURED ONLY Description of LocationNehicles/Special Items Scheduled autos only .................................................................................... 2005 CHEVROLET EXPRESS G3500 1 GAHG39U551110493 COMPREHENSIVE $500 DED COLLISION $500 DED 2006 FORD ECONO/CLUB WGN 1 FBNE31 L46HA16394 COMPREHENSIVE $500 DED COLLISION $500 DED .......................................................................................... 2013 CHEVROLET EXPRESS G3500 1 GAZGYFG4D1 148005 COMPREHENSIVE $500 DED COLLISION $500 DED AP E(v NT'�`WV441W4' /'Q� DATE ; C I C' it WAIVER N/A E ` G�: fl`IL ContiIn nued Policy number: 02545341-7 Page 2 of 2 Certificate number 09015NET341 Please be advised that additional insureds and loss payees will be notified in the event of a mid-term cancellation. Form 5241 (10102) DATE (MM/DD/YYYY) ACORD TM CERTIFICATE OF LIABILITY INSURANCE 03-20-2015 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 endorsement(s). PRODUCER CONTACT NAME: PHONE (A/C No, Ext): FAX (A/C No): 51187 / Porter Allen Co Inc 513 Southard Street E-MAIL ADDRESS: Key West, FL 33040 INSURERS) AFFORDING COVERAGE NAIC # INSURED Boys & Girls Club of the Keys Area, Inc. 1400 United Street, Suite 108 INSURER A: MARKEL INSURANCE COMPANY INSURER B: INSURER C: INSURER D: Key West, FL 33040 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 INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP (MM/DD/YYYY) LIMITS EACH OCCURRENCE $ 1,000,000 A GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY ® ❑ DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 ; MED EXP (Any one person) $ 5,000 ❑ ❑ CLAIMS -MADE ® OCCUR ❑ 8502CY263142 1 1 03 25 2015 03 25 2016 PERSONAL & ADV INJURY $ 1,000,000 ❑ GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 PRO- ❑ POLICY ❑ JECT ❑ LOC $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ❑ APPRO BY GEMENT COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ❑ ALL OWNED ❑ SCHEDULED _ RIVER N/ �/ �, BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ AUTOS AUTOS NON -OWNED ❑ HIRED AUTOS ❑ AUTOS (.. UMBRELLA LIAB ❑ EXCESS LIAR ❑ OCCUR CLAIMS -MADE ❑ ❑ EACH OCCURRENCE $ AGGREGATE S DED ❑ RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A ❑ ❑ WC STATU- ❑ OER TORY LIMITS ER $ E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is included as additional insured as lessor of premises. RE: Loc. #2, 30150 South Street, Big Pine Key, FL 33043 CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners 1100 Simonton Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY Key West, FL 33040 PROVISIONS. AUTHORIZED REPRESENTATIVE BWA Bruce A. Kay 10 _a iV/ --- vv... v...-.. ...... .y...., ..,.._"_' ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACORD TM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/LID/YYYY) 03-20 2015 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 endorsement(s). PRODUCER CONTACT NAME: 51187 / Porter Allen Co Inc PHONE FAX 513 Southard Street (A/C No, Ext): (A/C No): E-MAIL ADDRESS: Key West, FL 33040 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: MARKEL INSURANCE COMPANY INSURER B: Boys & Girls Club of the Keys Area, Inc. INSURER C: 1400 United Street, Suite 108 INSURER D: Key West, FL 33040 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. TWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE UED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF CH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. k TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES IEa occurrence) $ 100,000 ® COMMERCIAL GENERAL LIABILITY ❑ ❑CLAIMS -MADE ®OCCUR ❑ ® ❑ 8502CY263142-1 1 I 03 25 2015 03 25 2016 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 ❑ GENERAL AGGREGATE $ 3,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRO- ❑ POLICY ❑ JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 1,000,000 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED ❑ SCHEDULED AUTOS AUTOS ❑ HIRED AUTOS ❑ NON -OWNED ❑ ❑ AUTOS ❑ El '�f�GVMENT WAR N/ Cc.- r� s t l COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB ❑ OCCUR ❑ ❑ EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR ❑ CLAIMS -MADE ❑ LIED ❑RETENTION $ $ WORKERS COMPENSATION ❑ WC STATU- ❑ OTH- I AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N/A ❑ TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is included as additional insured as lessor of premises. RE: Wilder Road & Lytton Road, Big Pine Key, FL 33043 CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1100 Simonton Street DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY Key West, FL 33040 PROVISIONS. AUTHORIZED REPRESENTATIVE BWA Bruce A. Kay 10 (c) 1988-2010 AUDKD GOKPURAI[ON. Ay�rlgnts reserve0. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD V//� A� V� CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) 04/13/2015 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 endorsement(s). PRODUCER Work Comp Associates, Inc. P.O. Box 33297 Palm Beach Gardens, FL 33420-3297 NT CT Michael D Holleman (nic°°,"N, El): (561) 863-9581 ac, No): (561) 881-9745 E-MAIL ADDRESS: maorkCom Assoc.com ADDRESS: � P INSURERS AFFORDING COVERAGE NAIC a INSURER A: RetailFirst Insurance Company 10700 INSURED Boys & Girls Club of the Keys Area, Inc. 1400 United Street, Suite 108 Key West, FL 33040-3400 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: rnvoewr_ee r`FCTIFIP_ATF NUMRFR- 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 ADDLOUBR INSR WVD POLICY NUMBER POLICY EFF I MMIDD/YYYY POLICY EXP MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCETO S PRDAMAGERENTEU-- S COMMERCIAL GENERAL LIABILITY MED EXP (Any oneperson)5 CLAIMS -MADE 7 OCCUR PERSONAL & ADV INJURY S GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S $ POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LlVI1r_ Ea accident S 0DILY INJURY Per person S ANY AUTO 3,0Y INJURY Per accident S SCHEDULED ALL OWNED AUTOS AUTOS Per accident S HNON-OWNED HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HUAnF AGGREGATE $ EXCESS LIAB CLAIMS- DED I RETENTION E S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER EXCLUDED? Y (Mandatory In NH) n/a N 0520446780000 5/29/2015 5/29/2016 X TRYLWC LMTITS ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE S 100.000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is requi I y PROV ENT �,I W /A — U I t ` n� t! W 03 3089O PCCTICIf%ATC Yrll r%CD CANCFLLATION Cd"JiWAN' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Boar(VcV %U�ftl THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE 110 Simonton Street ��32� �0� 031U WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Key West, FL 33040 - ` (RC) W luau-LVlV ALVf%U VVRrVf[AI IV17. All lI�IIlS rCSC1 YCu. ACORD 25 (20101061 The ACORD name and logo are registered marks of ACORD ATE A111 C"R" CERTIFICATE OF LIABILITY INSURANCE D1/27/2016Y) 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 endorsement(s). PRODUCER CONTACT Brenda Monroe NAME: [R_g an Insurance Agency PHONE .Extl (305) 852-3234 AX No: (305)852-3703 IAIC,90144 Overseas Hwy. ADDRESS:b,nonroe@reganinsuranceinc.com Tavernier FL 33070 INSURED Boys and Girls Clubs of the Keys Area Inc 1400 United Street STE 108 A:Nautilus Insurance INSURER D : NAIC # 7370 Ke West FL 33040 I I y INSURER F COVERAGES CERTIFICATE N.IMRF216-17 GL RFVICIr1N NI IMRFR• 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 ADDL SUBRI POLICY EFF POLICY EXP LTR i TYPE OF INSURANCE POLICY NUMBER MM/DDNYYY) (MM/DD1YYYY1 LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE U OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 X NN640165 2/6/2016 2/6/2017 PERSONAL & ADV INJURY $ 1,000,000 _ ( AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 I _GENT R POLICY n PRO- ! J -, JECT LOC i PRODUCTS - COMP/OP AGG $ Included $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ BODILY INJURY (Per person) ANY AUTO $ ALL OWNED SCHEDULED AUTOS AUTOS $ BODILY INJURY (Per accident) NON -OWNED HIRED AUTOS AUTOS ! $ PROPERTY DAMAGE Per accident UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ZANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICER/MEMBER EXCLUDED? '. PER OTH- STATUTE ER E.L. EACH ACCIDENT $ - ....... _ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) 1 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is shown as an additional insured per policy forms, conditions, limitations and exclusions. fPRO ELF i EME1NTT WAI / YES C c� r� CERTIFICATE HOLDER t=;;,'"v Vdtill W CANCELLATION lewinski Monroe County Board of -Go u>}tCommissione c/o Risk Management 1100 Simonton St Key West, FL 33040��Jj� 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 Joseph Roth/FTHOM Oc 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) OP ID: NF ACOROE(M1DDlYYYV) � 0ERTIFICATE OF LIABILITY INSURANCE6 P�02JM411 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(les) 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 endorsemen s . PRODUCER 305-294-6677 CONTACT NAME: PHONE FAX A/C No Ext : A/C No: The Fullers, Inc 305-292�641 1432 Kennedy Drive Key West, FL 33040 Norman Fuller MAIL ADDRESS: PRODUCER BOYS81-1 c STOMER10k INSURERS AFFORDING COVERAGE NAIL 0 _ INSURED Boys & Girls Club of the INSURER A: Progressive INSURER B : INSURERC: Keys Area, Inc. 1400 United St. #108 Key West, FL 33040 INSURER D INSURER E INSURER F nnvCOAncc r`100711CH'ATC a111sIQCD. 17FVISIr1W NIIYRFW- 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 LSI TYPE OF INSURANCE POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMlDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ GE TO RENTED PREMISES Ea occurrence S COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) S _ CLAIMS-MADE1:1 OCCUR PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ L AGGREGATE LIMIT APPLIES PER' PRODUCTS - COMP/OP AGG S $ DPRO LOC M'POLICYJECI A AUTOMOBILE LIABILITY i ANYAUTO X 02545341-8 02/26116 I 02/26117 COMBINED SINGLE LIMIT accident)$ 1,000,00 E BODILY INJURY BODILY INJURY (Per person) ALL OWNED AUTOS E BODILY INJURY (Per accident) X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident $ $ NON -OWNED AUTOS $ LLA LIAR �OCCUR EACH OCCURRENCE $ AGGREGATE f __ -- S LIAR L CLAIMS -MADE i DEDUCTIBLE $ - $ RETENTION E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMB£R EXCLUDED? (Mandatory in NH) NIA A \I APR E DATE= YES WAIVER N/A ^ MENT ` G� "'YYY l � WC STATU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space In required( 2005 Chevrolet Express G3 CRGVN 1GAHG39U551110493 2006 Ford Econo/Club OTHB 1FBNE31L46HA16394 2013 Chevrolet Express G3 OTHB 1GAZGYFG4D1148005 CERTIFICATE HOLDER i Y) CANCELLATION MONRCON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County �� 91DZ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN — (� t-I,j (� y ACCORDANCE TH THE P LICY PROVISIONS. 1100 Simonton Street �� '% Pt[7 Key West, FL 33040IF AUTHORIZES REPR ENT t 6033b 80J 03`1!-1 Norman Fulle ,( � / ©1 88-2AV ACORD 25 (2009/09) The ACORD name and logo are registered arks of ACORD CORPORATION. All rights reserved. DATE TY ACORD TM _ _CERTIFICATE OF oNABLY NDICONFERS NO INSURANCE RIGHTS ON THE CERTIFICATE HOLDER. (THIS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 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). --- PRODUCER 51187 / Porter Allen Co Inc 513 Southard Street Key West, FL 33040 INSURED Boys & Girls Club of the Keys Area, Inc. 1400 United Street, Suite 108 Key West, FL 33040 CONTACT NAME: FAX INSURERM AFFORDING COVERAGE I NAIC # INSURER A: INSURER B. INSURER C: INSURER D: INSURER E: INSURER F: REVISION NUMBER: COVERAGES CERTIFICATE NUMlstn: THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE OF NOTWITHSTANDING ANY REQUIREMENT, TERM INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS ISSUED OR MAY PERTAIN, THE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. SUCH POLICIES. INSR ADDL SUBR POLICY EFF INSR WVD POLICY NUMBER (MM/DD/YYYY POLICY EXP LIMITS (MM/DD/YYYY) LTR TYPE OF INSURANCE EACH OCCURRENCE $ 1,000,000 A GENERAL LIABILITY ® ❑ DAMAGE TO RENTED S 100,000 PREMISES (Ea occurrence) ® COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE ® OCCUR MED EXP (Any one person) $ 5,000 ❑ 8502CY263142-1 3 03 25 2016 03-25 2017 PERSONAL & ADV INJURY $ 1,000,000 ❑ GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- ❑ POLICY ❑ JECT ❑ LOC $ _ _ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY ❑ ❑ (Ea accident) $ BODILY INJURY (Per person) $ ❑ ANY AUTO BODILY INJURY (Per accident) $ ❑ALL OWNED ❑ SCHEDULED AUTOS AUTOS PROPERTY DAMAGE $ ❑ HIRED AUTOS ❑ NON -OWNED (Per accident) AUTOS ❑ ❑ $ OCCUR El El OCCURRENCE $ AGGREGATE AGGREGATE $ UMBRELLA LIAB EXCESS LIAB CLAIMS -MADE S ❑ DED ❑ RETENTION S ❑ WC STATU- ❑ OTH- WORKERS COMPENSATION TORY LIMITS ER E.L. EACH ACCIDENT g AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A ❑ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE g (Mandatory in NH) E.L. DISEASE -POLICY LIMIT g If yes, describe under DESCRIPTION OF OPERATIONS below ❑ ❑ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is included as additional insured as lessor of premises. APPR V NAGEMENT RE: 30150 South Street, Big Pine Key, FL 33043 -NW 30;91410 WAIVER-C YES_ CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners n L �n n /y} z I 2� '7 O �,�� 6L�n �ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1100 Simonton Street DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY f ISIONS. Key West, FL 33040 i]�li ) LQ� AUTHORIZED REPRESENTATIVE B 0 Bruce A. Kay 10 (c) 1988-2010 A CO ORATION. rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD DATE (MM/DD/YYYY) I ACORD TM _CERTIFICATE OF LIABILITY INSURANCE February 3, 2016 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(les) 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). PRODUCER 51 187 / Porter Allen Co Inc 513 Southard Street Key West, FL 33040 INSURED Boys & Girls Club of the Keys Area, Inc. 1400 United Street, Suite 108 Key West, FL 33040 CONTACT NAME: E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE INSURER A: INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: NAIC # 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY (MM/DD/YYYY) LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 TO RENTED PREMISES PREMISES (Ea occurrence) $ 100,000 ® COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE ® OCCUR F] ® El 8502CY263142-13 03-25-2016 03-25-2017 MED EXP (Any one person) g 5,000i PERSONAL & ADV INJURY $ 1,000,000 ❑ GENERAL AGGREGATE $ 3,000,0001 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- ❑ POLICY ❑ JECT ❑ LOC PRODUCTS - COMP/OP AGG S 1,000,000 g AUTOMOBILE LIABILITY ❑ ❑ COMBINED SINGLE LIMIT (Ea accident) $ ❑ ANY AUTO BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ❑ ALL OWNED ❑ SCHEDULED AUTOS AUTOS ❑ HIRED AUTOS ❑ NON -OWNED AUTOS ❑ ❑ PROPERTY DAMAGE (Per accident) $ $ ---- - ---- UMBRELLA LIAB OCCUR ❑ - EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLAIMS -MADE $ I U DE D ❑ RETENTION 8 WORKERS COMPENSATION ❑ WC STATU- ❑ OTH- AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A ❑ TDRY LIMITS ER E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE g E.L. DISEASE -POLICY LIMIT S I If yes, describe under DESCRIPTION OF OPERATIONS below DI ESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Certificate holder is included as additional insured as lessor of premises. / RE: Wilder Road & Lytton Road, Big Pine Key, FL 33043 ` • -�( eel CERTIFICATE HOLDER Monroe County Board of County Commissioners 1100 Simonton Street Key West, FL 33040 CANCELLATION 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 BWA Bruce A. Kay 10 (c) 1988-2010 A CO ORATION. rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ® '4 n CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 04/13/2016 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 terns 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 MEO NTA Michael D Holleman Work Comp Associates, Inc. (AJCC,NN , EXt): (561) 863-9581 AI , No): (561) 881-9745 ADDRESS: mail@WorkCompAssoc.com P.O. Box 33297 INSURERS AFFORDING COVERAGE NAIC # Palm Beach Gardens, FL 33420-3297 INSURER A: RetailFirst Insurance Company 10700 INSURED Boys & Girls Club INSURER B: INSURERC: of the Keys Area, Inc. INSURER D: INSURER E: 1400 United Street, Suite 108 INSURER F: Key West, FL 33040-3400 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 ADDL SUBRPOLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY REMISES Fa occurrencel A R N ED $ CLAIMS -MADE DOCCUR ME EXP (Any oneperson) $ PERSONAL & ADXINJURY GENERAL AGGREGATE r GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - C i AGG 7P' POLICY JECT LOC r I AUTOMOBILE LIABILITY Ea accident 30DILY INJURY y rson rO :;0 ANY AUTO SCHEDULED ALL OWNED AUTOS AUTOS 30DILY INJURY dent $ NON -OWNED HIRED AUTOS AUTOS Per accident $•• UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HAGGREGATE $ EXCESS LIAB CLAIMS - DED I I RETENTION f $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N X YSTA IMITS OER E.L. EACH ACCIDENT $ 500,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEIMEMBER EXCLUDED? y (Mandatory in NH) If yes, describe under n/a N 0520446780000 5/29/2016 5/29/2017 E.L. DISEASE - EA EMPLOYEE $ 500.000 E.L. DISEASE -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) APPRO /E EMENT WAIVER N/A Monroe County Board of County Commissioners 110 Simonton Street 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 reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD