Certificates of InsuranceClient#: 73n4
ACORDTm CERTIFICATEINSURANCE
OF LIABILITY
DATE (MM/DD/YYYY)
11 /23/2009
PRODUCER
ISU Suncoast Insurance Assoc
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P.O. Box 22668
Tampa, FL 33622-2668
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
813 289-5200
INSURERS AFFORDING COVERAGE
NAIC #
137540
INSURED
A.D.A. Engineering, Inc.
8550 NW 33rd St, Suite 101
Doral, FL 33122
INSURER A: Beazley Insurance Company, Inc.
INSURER B:
INSURER C:
INSURER D:
INSURER E:
VUVtKACstS
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
LTR
DD'N
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YY
POLICY EXPIRATION
DATE MM DD/YY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
DAMAGE TO RENTED
PREMISES (Ea r
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICYF_� PR� LOC
PRODUCTS - COMP/OP AGG
$
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
HIRED AUTOS
NON -OWNED AUTOS
N.(Per
BODILY INJURY
accident)
$
r
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
$
$
RETENTION $
WORKERS COMPENSATION AND WC STATU- OTH-
EMPLOYERS' LIABILITY TORY LIMITS ER.
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
A OTHER professional BICAE00021105 10/18/09 10/18/10 $2,000,000 per claim
Liability $2,000,000 annl aggr.
-L I I - I I
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Professional Liability is written on a claims made and reported basis.
INECEPIT-7pA o _
CERTIFICATE HOLDER
Monroe County
Engineering Services;Attn: Judy Clark, P.E.
1100 Simonton Street
Room 216
Key West, FL 33040
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL �I , DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTIJORIZED REPRESS TATIVE
ACORD 25 (2001/08) 1 of 2 #S222304/M216008 BJM 0 ACORD CORPORATION 1988
,.r
A c oRo� CERTIFICATE O F L I A S I L I TY I N S U FAA N C E O P i p
DATE (MM/DD/YY
ADAEN-1
11/20/09
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ACEC/MARSH
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
701 Market St., Ste. 1100
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
St. Louis MO 63101
Phone: 800-338-1391 Fax: 888-621-3173
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Hartford Accident a Indemnity
22357
INSURER B:
A.D.A. Engineering, Inc.
Att : IVette Argudln
INSURER C:
8 � 5 0 NW 33 St . ,, Suite 101
Miami FL 33122
INSURER D:
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.
INSK
LTR
IJU'L
NSRC
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD
POLICY EXPIRATION
DATE MM/DD/YY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1j,0001000
A
X COMMERCIAL GENERAL LIABILITY
84 SBWCG2118
11 / 01 / 0 9
11 / 01 / 10
PREMISES Ea occurence
$ 300,r 000
CLAIMS MADE DX OCCUR
MED EXP (Any one person)
$ 10,000
X XCU
PERSONAL & ADV INJURY
$ 1, 0 0 0, 0 0 0
X lCONTRACTUAL LIAB .
PROFESSIONAL LIAS ZXCL
GENERAL AGGREGATE
$ 2, O O O r O O 0
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY X PRO- LOC
JECT
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$ 11000, 000
A
X ANY AUTO
84UEGPQ2 0 64
11 / 01 / 09
11 / 01 / 10
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per person)
$
X HIRED AUTOS
BODILY INJURY
X NON -OWNED AUTOS
(Per accident)
$
X Uninsured Motorst'
PROPERTY DAMAGE
$
X FL NoFaul t — Basic
(Per accident)
GARAGE LIABILITY
-
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
1
�-
EA ACC
$
OTHER THAN
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$ 3 1 0 0 0, 0 0 0
A
X OCCUR CLAIMS MADE
8 4 SBWCG2118
11101109
11 / 01 / 10
AGGREGATE
$ 3 , 0 0 0 , 0 0 0
DEDUCTIBLE
$
X RETENTION $ 10 , 0 0 0
$
WORKERS COMPENSATION AND
X TORY LIMITS ER
A
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
8 4 WEGLA3 8 5 4
11101109
11 / 01 / 10
E.L. EACH ACCIDENT
$ 1 0 0 0 � 0 0 0
i
OFFiCEi'Vo.."ov-DE : E::CLUGCG?
E.L. DISEASE - EA EMPLOYEE1
$ 1, 0 (1 0 , 0 0 0
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$ 1, 0 0 0 , 0 0 0
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
MONROE COUNTY ENGINEERING SERVICES IS INCLUDED AS ADDITIONAL INSURED FOR
ABOVE COVERAGES EXCEPT WC.
'kEC EIV ) '4 01t ' " IM
Ur-K I 1r1UA I t MULUtK CANCELLATION
MONROE COUNTY ENGINEERING
SERVICES
ATTN: JUDY CLARKE
1100 SIMONTON STREET, RM 216
KEY WEST FL 33040
MONROCT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE 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.
REPRESENTATIVE
KVVRV Au ILVV 1/Vo) C ACORD CORPORATION 1988
ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID KL
TM ADAEN-1
DATE (MMIDD/YYYY)
11/20/09
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ACEC/MARSH
701 Market St, , Ste. 1100
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
St. Louis NO 63101
Phone: 800-338-1391 Fax: 888-621-3173
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Hartford Accident a Indemnity
22357
INSURER B:
A.D.A. Engineering, Inc.
Att : IVette Argudln
8 � 5 0 . NW 33 St . , Suite 101
Miami FL 33122
INSURER C:
INSURER D:
INSURER E: _T
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.
IN5K
LTR
00'
NSRN
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDD
POLICY EXPIRATION
DATE MMIDD
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1, 0 0 0, 0 0 0
UAMAGt: 10 KLN 1 L:7
PREMISES Ea occurence
$ 300400
A
X COMMERCIAL GENERAL LIABILITY
84 SBWCG2118
11 / 01 / 0 9
11 / 01 / 10
CLAIMS MADE Ex] OCCUR
MED EXP (Any one person)
$ 10 , 0 0 0
PERSONAL S ADV INJURY
$ 1, 0 0 0, 0 0 0
X XCU
X
CONTRACTUAL LIAB •
GENERAL AGGREGATE
$ 2 , 0 0 0 , 0 0 0
PROFaSSIOML LIAR BXCL
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2 , 0 0 0 , 0 0 0
X PRO LOC
POLICYF--] JECT
A
AUTOMOBILE LIABILITY
X ANY AUTO
84UEGPQ2 0 64
11 / 01 / 0 9
11 / 01 / 10
COMBINED SINGLE LIMIT
(Ea accident)
$ 1, 0 0 0, 0 0 0
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
X HIRED AUTOS
X NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
X Uninsured Motorst
X FL NOFault- Basic
GARAGE LIABILITY
ANY AUTO
U
AUTO ONLY - EA ACCIDENT
$
EA ACC
OTHER THAN
$
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$ 3, 0 0 0, 0 0 0
A
X OCCUR El CLAIMS MADE
8 4 SBWCG2118
11 / 01 / 0 9
11 / 01 / 10
AGGREGATE
$ 3 , 0 0 0 , 0 0 0
$
$
DEDUCTIBLE
$
X RETENTION $ 10 , 0 0 0
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
8 4WEGLA3 8 5 4
11 / 01 / 0 9
11 / 01 / 10
X I TORY LIMITST I ER
E.L. EACH ACCIDENT
$ 1, 0 0 0 , 0 0 0
E.L. DISEASE - EA EMPLOYEE
$ Jr t3 p 0 , 0 t7 t3
OFrFi �r�r' -"ram WvDER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 1, 0 0 0 , 0 0 0
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
MONROE COUNTY ENGINEERING SERVICES IS INCLUDED AS ADDITIONAL INSURED FOR
ABOVE COVERAGES EXCEPT WC.
• WECE"JIVET) 4,0V0.
Y\
CERTIFICATE HOLDER CANCELLATION
MONROE COUNTY ENGINEERING
SERVICES
ATTN: JUDY CLARKE
1100 SIMONTON STREET, RM 216
KEY WEST FL 33040
MONROCT I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
,UTHORIED REPRESENTATIVE
ACORD 25 (2001 /08) ® ACORD CORPORATION 1983
Client#: 7304
ADAENG13
ACORDw CERTIFICATE OF LIABILITY INSURANCE
DATE (MWDD/YYYY)
11 /23/2009
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ISU Suncoast Insurance Assoc
P.O. Box 22668
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa, FL 33622-2668
813 289-5200
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Beazley Insurance Company, Inc.
37540
A.D.A. Engineering, Inc.
8550 NW 33rd St, Suite 101
Doral, FL 33122
INSURER e:
INSURER C:
INSURER D:
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM DD/YY
POLICY EXPIRATION
DATE MM/D
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED PREMISES (Ea accumaaw4—
$
MED EXP (Any one person)
$
CLAIMS MADE OCCUR
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
POLICY[__j PRO-- LOC
JECT
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
}
✓-
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
]OCCUR CLAIMS MADE
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
WC STATU- I JOTH-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
It
A
OTHER Professional
BICAE00021105
10/18/09
10/18/10
$2,000,000 per claim
Liability
$2,000,000 annl aggr.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Professional Liability is written on a claims made and reported basis.
-
IIIECEI�TJD f4aV252004
%or-K I IrI%..;A I C nULUt:K CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Monroe County DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ,,Q_ DAYS WRITTEN
Engineering Services;Attn: Judy Clark, P.E. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Room 216 REPRESENTATIVES.
Key West, FL 33040 AU OR%IZED REPRESE TATIVE
00K 0a tv
ACORD 25 (2001/08)1 of 2 #S222304/M216008 BJM 0 ACORD CORPORATION 1988
Client#: 1050545
ADAENG
ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDD/YYYY)
10/11/2013
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 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
USI Insurance Services, LLC
1715 N. Westshore Blvd. Suite 700
CONTACT
PHONEFAX
�� Ea : 813 321-7500 A/c No): 813 321-7525
E41A
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
Tampa, FL 33607
INSURER A: Beazley Insurance Company, Inc.
37540
INSURED
A.D.A. Engineering, Inc.
8550 NW 33rd St, Suite 202
Doral, FL 33122
INSURER B :
INSURERC:
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISInN NUIURFR-
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 CONTRACTOR 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.
RR
TYPE OF INSURANCE
NSRL
SNND
POLICY NUMBER
MMM/BR DDY EFF
POLICY EXP
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
AP 4
EM
PREMISES Ea o� rrence
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
,
GENERAL AGGREGATE
$
A� /A
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
POLICY jE a LOC
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per academy
$
HIRED AUTOS NON -OWNED
PAUTOS Rerr.' DAMAGE
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION $
$
WORKERS COMPENSATION
WC STATU- OTH-
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE Y / N
OFFICER/MEMBER EXCLUDED?
N / A
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
(Mandatory in NH)
M yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
A
Professional
V15WC71305O1
0/18/2013
10/18/2014
$2,000, per claim1
Liability
$2,OOO, nni agg�
_ r rTI
n
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
Professional Liability coverage is written on a claims -made basis. CD
CD
., CD
Cn
Monroe County
Engineering Services;Attn: Judy Clark, P.E.
1100 Simonton Street
Room 216
Key West, FL 33040
ACORD 25 (2010/05) 1 of 1
#511089305/M11088851
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
4k;P 01L 0&-Glt- Aa --
01988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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