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Certificates of Insurance THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MA Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- TIONS OF SUCH POLICIES. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DA TE (MM/DD/YY) POLICY EXPIRATION ALL LIMITS IN THOUSANDS DA TE (MM/DD/YY) GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY [XJ OCCURRENCE TBA OWNER'S & CONTRACTORS PROTECTIVE 7/3/89 GENERAL AGGREGATE PRODUCTS-COMP/OPS AGGREGATE 7 /3 /90 PERSONAL & ADVERTISING INJURY EACH OCCURRENCE FIRE DAMAGE (ANY ONE FIRE) MEDICAL EXPENSE (ANY ONE PERSON) AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY CSL $ BODIL Y INJURY (PER PERSON) $ BODIL Y INJURY ~EC~DENT) $ PROPE RTY DAMAGE $ OTHER THAN UMBRELLA FORM EACH OCCURRENCE $ WORKERS' COMPENSATION AND EMPLOYERS'LlABILlTY STATUTORY OTHER $ $ $ (DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS Eletrical Wiring Re: Human Resources Dept Risk Management Division Wing 2 Public Service Building Key West, Florida 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX. PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DA YS 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 UPO THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTA f .~. C/,(AJ /~. THIS IS TO CERTIFY THAT 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 MA Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS, AND CONDI- TIONS OF SUCH POLICIES, TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DA TE (MM/DDIYY) POLICY EXPIRATION DATE (MM/DDIYY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE GJ OCCURRENCE OWNER'S & CONTRACTORS PROTECTIVE TBA 7/'03/89 7/03/90 GENERAL AGGREGATE PRODUCTS-COMP/OPS AGGREGATE PERSONAL & ADVERTISING INJURY EACH OCCURRENCE FIRE DAMAGE (ANY ONE FIRE) MEDICAL EXPENSE (ANY ONE PERSON) AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY CSL $ BODIL Y INJURY (PER PERSON) $ BODIL Y INJURY ~~~DENT) $ PROPERTY DAMAGE $ WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY EACH OCCURRENCE OTHER THAN UMBRELLA FORM $ STATUTORY OTHER $ $ $ (DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE) TI~'F DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS ELECTRICAL WIRING HUMAN RESOURCES DEPT RISK MANAGEMENT DIVISION WING 2 PUBLIC SERVICE BLDG KEY WEST FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX. PIRA TION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1 0 DA YS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILU TO MAIL SUCH NO CE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF A K D UP THE C NY, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED PENT IVE -......- B x ~-~".~.~~ iI''Il CiERIll1 ISSUE DATE (MM/DD/YY) ;. PRODUCER 6/0ll/90 . 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. REGAN INSURANCE AGCY 901ll~ OVERSEAS HWY TAVERNIER FL 33070 SUB-CODE COMPANIES AFFORDING COVERAGE COASTAL ELECTRIC SERV INC ~:T 1 BOX 693J BIG PINE KEY FL 33013 COMPANY A LETTER OHIO CASUALTY INS CO COMPANY B LETTER COMPANY C LETTER COMPANY D LETTER COMPANY E LETTER CODE INSURED x COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR. OWNER'S & CONTRACfuR'S PROTo BR050276392 7/03/90 7/03/91 GENERAL AGGREGATE PRODUCTS-COMP/OPS AGGREGATE PERSONAL & ADVERTISING INJURY EACH OCCURRENCE 500 500 500 500 :',0 5 en ~ <( a: C) o a: 0- w a: <( ~ u.. o CJ) -J -J <( :c I- ~ W -J III ~ <( 0- ~ o <.) I- o Z ~ ~ a: o u.. CJ) I l- e; Z Z a: <( ~ r-: :::::> o o w CJ) <( I 0- C) Z W III ~ o z <(. CJ) LO C\J ~ a: o u.. o a: o <.) <( u.. o z o ~ <( a: <( > <( ~ CJ) I I- 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. .:CO :LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DD/YY) DATE (MM/DDIYY) ALL LIMITS IN THOUSANDS :A GENERAL LIABILITY AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY FIRE DAMAGE (Anyone fire) MEDICAL EXPENSE (Anyone person) COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE EXCESS LIABILITY EACH OCCURRENCE AGGREGATE OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY OTHER (EACH ACCIDENT) (DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE) en ~ ~ N ::> en &t) N DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESlRESTRICTIONS/SPECIAL ITEMS LECTRICAL WIRING E: TRAFFIC SIGNAL MAINTENANCE CONTRACT 0> co 0> i E: z o ~ <( a: o 0- a: o <.) o a: o <.) <C @ HUMAN RESOURCES DEPT RISK MANAGEMENT DIV WING 2 PUBLIC SERVICE BLDG KEY WLEST FL 330~O x e/liFl.f is;.''. ISSUE DATE (MM/DDIYY) 5/22/90 PRODUCER 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. REGAN INSURANCE AGCY 901i1 OVERSEAS HWY TAVERNIER FL 33070 COMPANIES AFFORDING COVERAGE CODE SUB-CODE COMPANY A LETTER OHIO CASUALTY INS CO COMPANY B LETTER COMPANY C LETTER COMPANY D LETTER COMPANY E LETTER INSURED COASTAL ELECTRIC SERV INC RT 1 BOX 693J BIG PINE KEY FL 33043 EXCESS LIABILITY EACH OCCURRENCE AGGREGATE en ~ <( a: C) o a: a.. w a: <( ~ LL o C/) ....J ....J <( I I- ~ W ....J CO t= <( a.. ~ o () I- o Z ~ ~ a: o LL C/) I l- e; Z Z a: <( ~ ~ :::::> o o w C/) <( I a.. C) z W CO ~ o z <(. C/) LO C\I ~ a: o LL o a: o () <( LL o Z o t= <( a: <( > <( ~ C/) I I- 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. CO ':LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DDNY) DATE (MM/DDNY) ALL LIMITS IN THOUSANDS It GENERAL LIABILITY E: R 0 5 0 2 7 6 392 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR. OWNER'S & CONTRACTOR'S PROTo 7/03/90 7/03/91 GENERAL AGGREGATE PRODUCTS-COMP/OPS AGGREGATE PERSONAL & ADVERTISING INJURY EACH OCCURRENCE 500 500 :.00 500 50 5 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY FIRE DAMAGE (Anyone fire) MEDICAL EXPENSE (Anyone person) COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY OTHER (EACH ACCIDENT) (DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE) I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESlRESTRICTIONS/SPECIAL ITEMS ~LECTRICAL.WIRING (i) ~ N :> C/) II) N HUMAN RESOURCES DEPT RISK MANAGEMENT DIV WING 2 PUBLIC SERVICE BLOG KEY WEST FL 33010 0> ex) 0> i I B z o t= <( a: o a.. a: o () o a: o () <( @ .~ F(ll FlJlWl '" )RKERS' ())\tPE\\\TIOS [\St_ >., \1l\ll\L\TI]fJ) BY f}]~1) .... PRODUCER 646 THE JOHN SONS INSURANCE AGENCY POBOX 2346 MARATHON SHORES, FL 33052 2346 INSURED COASTAL ELECTRIC SERVICE INC RT 5 BOX 786 B BIG PINE KEY, FL 33043 9514 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EX- TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ATTENTION CERTIFICATE HOLDER: If you have any questions, please contact SALL Y KARL at 1-800-226-3224, 2601 Cattlemen Road, Sarasota, FL 34232 COMPANIES AFFORDING COVERAGE Company Letter A FCCI/SELF INSURERS FUND Company Letter B: THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT WITHSTANDING 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, EXCWSIONS. AND CONDI- TIONS OF SUCH POLICIES. :0 JR TYPEININSUAANCE POLICY NUMBER GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCURRENCE OWNER'S & CONTRACTORS PROTECTIVE AUTOMOBILE LIABILITY ANY AUlD ALL OWNED, AUros SCHEDULED AUlOS HIRED AUroS NON-OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY OTHER THAN UMBRELLA FORM A POLICY EFFECTIVE POLICY EXPlRAnON DATE (MMIDDIYY) !MTE (IIMIDDIYY) ALL LIMITS IN THOUSANDS GENERAl AGGREGATE PROOUCfS.COMPIOPS AGGREGATE PERSONAL & ADVERTISING INJURY EACH OCCURRENCE FIRE DAMAGE (ANY O'4E FIRE) MEDICAL EXPENSE (ANY ONE PERSON) CSL $ BODILY INJURY ~7FrSON) $ BODILY INJURY ~~~DENT) $ PROPERTY DAMAGE $ EACH OCCURRENCE . WORKERS' COMPENSATION AND EMPLOYERS' LIABIlITY STATUTORY 718-10262-001-001 01/01/91 12/31/91 $ $ . OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I RESTRICTIONS I SPECIAL ITEMS MONROE COUNTY ENGINEERIN~ DEPT ATT BOARD OF COUNTY COMMISSIONERS PO BOX 1029 KEY UEST, FL 33040 1029 INITIAL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO SEND 1 0 DAYS WRITTEN ~ICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAIWRE TO MAIL S~H NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY "OF.J{Ny KIND UPON TH ' OM'ANY~ ITS AGENTS OR REPRESENTATIVE. A RIZED REPRESE ~TI "/1....,. t ~ ..--" 'tJ'"pl~~ '~ ...... At~ttlllt~ ~RTIFICA TE OF INSURANCE ISSUE DATE (MM~~D/y~-1 7-9-91 I HI ARtf_. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER REGAN INSURANCE AGENCY, INC. 90144 OVERSEAS HIGHWAY TAVERNIER, FLORIDA 33070 COMPANIES AFFORDING COVERAGE f~~~~NY A HARTFORD INSURANCE COMPANY f~T~~~NY B NSURED COASTAL ELECTRIC SERVICE, INC. RT. 1, BOX 693J BIG PINE KEY, FLORIDA 33043 f~T~~NY C ~~+-i~NY 0 COMPANY E LETTER COVERAGES 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. ;0 TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR. OWNER'S & CONTRACTOR'S PROTo GENERAL AGGREGATE $ PRODUCTS.COMP/OP AGG. $ PERSONAL & ADV. INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ MED. EXPENSE (Anyone person) $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON-OWNED AUTOS GARAGE LIABILITY 21 UECKQ9343 7/3/91 7/3/92 COMBINED SINGLE $ 500 ,000 LIMIT BODIL Y INJURY $ (Per person) BODIL Y INJURY $ (Per accident) PROPERTY DAMAGE $ EACH OCCURRENCE $ AGGREGATE $ STATUTORY LIMITS EACH ACCIDENT $ DISEASE-POLICY LIMIT $ DISEASE-EACH EMPLOYEE $ EXCESS liABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABI_Y OTHER ELECTRICAL WIRING DATE IN ITIAl " / ~L.'~ U") /,'"(L _~,__k.. , ~ 'j .;,....-,. ~ I J C: (, (~- '..1 ...~,) . ilESCRIPTION OF OPERA TIONS/LOCA TIONS/VEHICLES/SPECIAL ITEMS CEATIFICA TE HOLDER CANCELLATION MONROE COUNTY RISK MANAGEMENT WING II - ROOM 207 PUBLIC SERVICE BUILDING 5100 JR. COLLEGE ROAD KEY WEST, FLORIDA 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ 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 UP THE COMPANY,? AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENT A 1"7 ~.".~ ~ J f,-.. i/~O~ ~.RG~/Spp (' .__._.._ v ~/ ~~CORD CORPORATION 1990. ACORD 25..8 (7/90) AtDttlllt~ ec1RTIFICA TE OF INSURANCE '-j ISSUE DATE (MM/DD/YY) i REGAN INSURANCE AGCY 901~~ OVERSEAS HWY TAVERNIER FL 33070 7 /02/91 .1 HI Nlr~ CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE I DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE I POLICIES BELOW. i --------.; i I COMPANIES AFFORDING COVERAGE )RODUCER f~~~~NY A OHIO CASUALTY INS CO f~~~~Y B COASTAL ELECTRIC SERV INC RT 1 BOX 693J f:IG PINE ~(EY FL 330~3 f~T~~~Y C R~:elV~ l.;j;~~~ Mgmt. & Loss Control DATE NSURED f~fr~~NY 0 ra j .~~ AJ.. . ~ I ;' , ~ ~. " . I. --...... . _..~ '- · 6.('1; P t .,~. ;]~\." - " ) l 1..' L, ~ ~-.'~ ',.J" t~~~~NY E COVERAGES 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. ;0 TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY E: R 0 5 0 2 7 6392- X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR. OWNER'S & CONTRACTOR'S PROTo 7/03/91 7 / 03/ <;' 2 GENERAL AGGREGATE $ 500 , 000 PRODUCTS-COM PlOP AGG. $ 500 , 000 PERSONAL & ADV. INJURY $ 500 , 000 EACH OCCURRENCE $ 500 , 000 FIRE DAMAGE (Anyone fire) $ 50 , 000 MED. EXPENSE (Anyone person) $ 5 , 0 0 0 WORKER'S COMPENSATION AND EMPLOYERS' LIASttfry --. COMBINED SINGLE $ LIMIT BODIL Y INJURY $ (Per person) BODIL Y INJURY $ (Per accident) PROPERTY DAMAGE $ EACH OCCURRENCE $ AGGREGA TE $ ST A TUTORY LIMITS EACH ACCIDENT $ DISEASE-POLICY LIMIT $ DISEASE-EACH EMPLOYEE $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTbs NON-OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM OTHER DESCRIPTION OF OPERA TIONS/LOCA TIONS/VEHICLES/SPECIAL ITEMS ELECTRICAL WIRING INDEMNITY & HOLD HARMLESS THE COUNTY OFFICIALS EMPLOYEES AND ALL AGENTS CEATIFICA TE HOLDER I CANCELLA TION MONROE COUNTY PUBLIC WORKS ArT STAN ~{OWITZ BOX 1029 KEY WEST FL 33011 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL --19DAYS 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 COMPANY, ITS AGENTS OR REPRESENTATIVES. eO""', . \ AUTHWB~~tf[,h1A~r,gAI1'" (,::", E: _..~n .:. ~,~ ~-~,.) ,,'. ~ ~_C?R~~~RPO~A.!~~~~J ,<'i. (~ ACOFtD 25-$ (1/90) ..........~!.~.!!.~.I.I.,......................~:_~~~.~~~~I_.!!!i!_:g.~!!:.:.....:=;:.:}:..:.:.........:~.~;:..~...................:....... ISSUE DATE (MMIDDIYY) PRODUCER EYS INSURANCE AGENCY .0. BOX 500080 ARATHON FL 33050 OASTAL ELECTRIC SER INC T. 1, BOX 834, #B IG PINE KEY" FL 33043 COMPANY A BANKERS LETTER COMPANY B LETTER COMPANY \,;~~ C Risk Mgmt. & Loss Control LETTER COMPANY 0 DATE LEITER COMPANY E INSURED 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 PERTAI~ THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLlvIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER LIMITS ATE (MM/DDIYY) DATE (MM/DD/VY) CPP09275009000 7/03/92 7/03/93 GENERAL AGGREGATE $ 1 MMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ 1 LAIMS MADE lXJOCCUR. PERSONAL & ADV. INJURY $ 1 OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $ 1 FIRE DAMAGE (Anyone fire) $ MED.EXP. (Anyone person) $ BA09275009100 7/03/92 7/03/93 COMBINED SINGLE LIMIT $ 1 ALL OWNED AUTOS BODILY INJURY (Per person) $ 1 HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY V~. '~'''> :.::~:!)\_- EACH OCCURRENCE $ UMBRELLA FORM \)\"'\ \,..-/ AGGREGATE $ OTHER THAN UMBRELLA FORM \.."" WORKER'S COMPENSATION EACH ACCIDENT $ AND DISEASE-POLICY LIMIT $ EMPLOYERS' LIABILITY DISEASE-EACH EMPLOYEE $ OTHEIpROPERTY CPP09275009000 7/03/92 7/03/93 10,000 MEDICAL PYMT'S. BA09275009100 7/03/92 7/03/93 5,000 DESCRIPTION OF OPERATlONS/LOCATlONSNEHICLES/SPECIAL ITEMS o DAYS NOTICE FOR NON-PAYMENT, 45 DAYS FOR ALL OTHERS ERTIFICATE HOLDER SHOWN ABOVE ALSO LISTED AS AN ADDITIONAL INSURED. ONTRACT FOR TRAFFIC SIGNAL MAINTENANCE .... .......... .................... .... ............:?7.)~}:<P!!::H<.i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 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 COMPANY, ITS AGENTS OR REPRESENTATIVES. J MONROE COUNTY BOARD OF COUNTY COMMISSIONERS OR MONROE COUNTY 5100 COLLEGE ROAD KEY WEST FL 33040 .,...................,....,....... ......".. ......... '" ,......... ......'.. ........,.. '" ...........,... ...."...."........"...,... ... ".,.."., .... ....., ........,..",.., ..........,.....,. ..............., .. '....... '" ..............."... . ....,................... ... .... U..U..~~cpfj,.qp~M~'~ \\~GqijQ:\.*$~~(?(.)\ .,.".,....,.....,....,....,..." . ......"......,...,.............. . ,..,.,............,........,.... . .,....,........,...,......... . '..... . ........ ..... .... THIS ENDORSEM~NT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES POLICY NUMBER POLICY CHANGES EFFECTIVE 12/22/92 COMPANY BA 09-2750091-00 BANKERS INSURANCE COMPANY NAMED INSURED Coastal Electric Service, Inc. AUTHORIZED REPRESENTATIVE Keys Ins. Agency AGENT 1109/84-701 COVERAGE PARTS AFFECTED Commercial Auto Coverage Part CHANGES It is agreed that the mailing address is amended to read: Rte 1, Box 834 Suite B Big Pine Key, FL 33043 Received Risk Mgmt. & Loss Control DATE c2 -3 -7'-3 ~ INITIAL r7 ~0'-J l ~ ~:' '-" ~,,\....\... '. \..\ ((" ...., ~~'~ .. \ / -.._.~ .. . . 1/25/93sy Il12 0111 85 Authorized Representative Si Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983 Policy Change Number~ THolS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number --L POLICY NUMBER POLICY CHANGES EFFECTIVE 12/22/92 COMPANY BA 09-2750091-00 BANKERS INSURANCE COMPANY NAMED INSURED Coastal Electric Service, Inc. AUTHORIZED REPRESENTATIVE Keys Ins. Agency AGENT 1109/84-701 COVERAGE PARTS AFFECTED Commercial Auto Coverage Part CHANGES It is agreed that the LImit of Liability is increased to $1,000,000. The Auto Medical Payments Coverage is added as follows: LImit: $5,000. Covered Auto Symbol: 2 6~ ~(Q)\Y: '~D ' JAN 2 9 1993' Premiun for this endorsement $229. ADDITIONAL 1/25/93 sy IL12011185 Authorized Representative Signa Copyright, Insurance Services Office, Inco, 1983 Copyright, ISO Commercial Risk Services, Inco, 1983 j . I :':~~E: .:~< ':fi'+I<e:t;: ',~,{j)~l:f>:~ e<:'I::'::~IS>: ::'':::.;:.<n ~:Ajt:""'I:::: :':::;:::'::: ~C :i/>:: ::. F:;:cic)!:lf:g:,.:}.\\ ;.Y..', .;0::-::1::. '10', "~/.I<~~.:)\I;~,t::. "':':.;. :;~.n;~.'~~W:'.'.";i.<.:<::.~:.:/!!>:>::,. .., ..... . ,,, ISSUE DATE (MMIDO/YV) EYS INSURANCE AGENCY .0. BOX 500080 RATHON FL 33050 01 29 93 THIS TI A 188 D A MA R INFO LAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE '\ TYPE OF INSURANCE . .. .... . '. . . . .. ,.,. , . . . . . . . .. . . . -.. ." .. .. COMPANY A BANKERS LETTER COMPA~ y B l~ OASTAL ELECTRIC SER INC COM~ANY C T. I, BOX 834, #8 LEl1'ER IG PINE KEY I , FL 33043 CONPANV D l.ETTER COMPANY .. VCR"aftEllt ,.'.'. .....; . ". . .~H~:rO;~~IFY THA I I HE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE;~~~~~~~< INDICATED NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITlON OF ANY CONTRACT OR OTHER DOCUMENT CERTIFICAtE MAY BE ISSUED OH MAY PERTAI~ THE. -INSURANCE AFFORDED DY THE POlICIES OESCRIBEQJiE&EtN IS S EXCI USIONS AND CONDIT'ONS OF SUCH POU",IES. LIMITS SHOWN MAY HAVE BEEN REDUCED BV PAID C~ POUCY NUMBER ~LlCV BPI DATE (MMlQOIVY) 7 / 0 3/9 3 OENe:.AL AGGREGATE rnooucrs.-. COMPIOP AGCJ. rcnsoNAL & AOV. INJURY tAOH OCCURReNC~ nnc DAMAGE (Any one ~,.) ....ED.EXf". (Any ono pereon) 1 /03/92 7/03/93 COMBINED SINGLE UMIT SOOtL Y INJURY (Per perllOn) 800ll Y INJU qy (1:)8' accldent:1 . GENEAALlIAIILlTY CPP09 275009000 MERCIAL GENERAl LlASIU1Y LAIM9 MADE liJocCUR, ER'S & CONTRACTOR'S PROT, BA09275009100 PROPERTY DAMAGE OTHElpROPERTY I CPP09275009000 MEDICAL PYMT'S. BA09275009100 7/03/92 7/03/92 OtSEASE -POLICY LIM'T DISEASE -EACH EMPLOYEE 10,000 5,000 EXCE" UAIIUlY UMBRELLA FOOM OTHER THAN U"'BRELlA FORM WORKER" COMPDtUTfON AND EMPlOYERS' UA81UTY 7/03/93 7/03/93 DESCAlllnON OF OPEAAnON8iLOCATIONINEHIClE8/SPECIAL ITEMS AN ADDITIONAL INSURED. MONROE COUNTY BOARD OF COUNTY COMMISSIONERS OR MONROE COUNTY 5100 COLLEGE ROAD KEY WEST FL 33040 . ..'. ..... .' , .. '. . . .. .. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL _ nAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BlJT FAilURE TO MAIL SUCH NOTICE Sf-1Ia.lL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR AE?RESENTATrvES, .;~~~tt~~rf'~t.:,::::.': GOd 900 ?i ~7fi;;lE.f;i;) ~ 0P I/J-- <<~)......... .. ..> ....f. ... el)Ac:otJO'ct)Ffp;o,rAtfONf .. -, ...,,"" .. ". .... ., . " ,- ., , . .' . . . . , , . .... ,_ . I ' . .... . . ' . '" . . .. ,... ,. . ..I,8N:3Stb' :3JN't~nSN I S,l~::3>t 2850 E:t7l 508 vO:Ot bG-tO-868t FW~ ADMINlI\ImD BY mSC(\ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFI<;iTE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAClE AFFORDED BY THE POLICIES BELOW. 646 THE JOHNSONS INSURANCE AGENCY POBOX 2346 MARATHON SHORES FL 33052-2346 ATTENTION CERTIFICATE HOLDER: If you have any questions, please contact KATHY SONIER 1-800-226-3224, 260 1 Cattlemen Road, Sarasota, FI 34232-6249 COMPANIES AFFORDING COVERAGE COASTAL ELECTRIC SERVICE INC RT 5 BOX 786 B BIG PINE KEY FL 33043-9514 Company Letter A Company Letter B: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Chanle Number _ POLICY NUMBER BA 09-2750091-00 POLICY CHANGES EFFECTIVE 1/7/93 COMPANY BANKERS INSURANCE COMPANY NAMED INSURED AUTHORIZED REPRESENTATIVE Coastal Electric Service, Inc. Keys Ins. Agency AGENT 1109/84-701 COVERAGE PARTS AFFECTED Commercial Auto Coverage Part CHANGES Who is an insured(SECTION II) is amended to include as an insured the person or organization shown below as an insured but only with respect to liability arising out of your operations for that person or organizations. Monroe County, Monroe County Board of Commissioners, Its employees & Officals 5100 Junior College Rd., Key West, FL 33040 ~(QJWJ~ 1/25/93 sy Mp~a:fs~~ Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983 Il12011185 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ~(Q)fFJ~ j POLICY CHANGES Policy ChanJe Number POLICY NUMBER cPP 09 2750090-00 POLICY CHANGES EFFECTIVE 1/7/93 COMPANY BANKERS INSURANCE COMPANY NAMED INSURED Coastal Electric Service, Inc. AUTHORIZED REPRESENTATIVE Keyes Ins. Agency of Monroe AGENT 1109/84-701 COVERAGE PARTS AFFECTED Commercial Gen. Liab. Coverage Part CHANGES It is agreed that the Limits of Liability are hereby amended per the attached CG2502(11/85) Amendment of Limits of Insurance. It is further agreed tha the Rates & Premiums are amended as follows: Code No. Premium Basis RATE PrlCo All Other PREMIUM Prleo All Other 92478 b)96,700 4/810/19.286 465. 465. 2. Form CG2012(ll/85J Additional Insured State or political'Subdivisions Permit hereby attached & applicable. ~(Q)~~ Premiun for this endorsement $ 175.00ADDITIONA 1/25/93 sy Il12011185 Authorized Representative Signa Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983 POLICY NUMBER: cpp 09-2750090-00 COMMERCIAL GENERAL liABiliTY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF LIMITS OF INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE General Aggregate Limit Products-Completed Operations Aggregate Limit Personal & Advertising Injury Limit Limits Of Insurance 1,000,000 Each Occurrence Limit $ $ $ $ $ $ 1.000.000 1,000,000 1,000,000 Fire Damage Limit Medical Expense Limit 50 , 000 Any One Fire 5,000 Any One Person (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The limits of insurance shown in the Declarations are replaced by the limits designated in the Schedule or in the Declarations as subject to this endorsement with respect to which an entry is made. ~@WJ~ CG 25 02 11 85 Copyright, Insurance ~ervices Office, Inc., 1984 o POLICY NUMBER: Cpp 09-2750090-00 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL Y. ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. Stlte or Polltlc.1 Subdivision: SCHEDULE Monroe County, Monroe County Board of Commissioners, Its Employees & Officials 5100 Jr. College Rd. Key West, FL 33040 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured any state or political sub- division shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has Issued a permit 2. This insurance does not apply to: a. "Bodily injury:' "property damage:' "personal injury" or "advertising injury" arising out of op- erations performed for the state or municipality; or b. "Bodily injury" or "property damage" included within the "products-completed operations haz- ar d. " ~ /~,,\Q)\! \) r{/ C' ,J",I,'"",'" ',,', '-'i ,- , .: j _~.~ U .;.. ") . . CG 20 12 1 1 85 Copyright, 'Insurance Services Office, Inc., 1984 o 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. COMPANIES AFFORDING COVERAGE PRODUCER EYS INSURANCE AGENCY .0. BOX 500080 RATHON FL 33050 OASTAL ELECTRIC SER INC T. 1, BOX 834, fB IG PINE KEY" FL 33043 COMPANY A BANKERS INSURANCE CO. LETTER COMPANY B LETTER COMPANY C BY LETTER COMPANY D Cc,,'- LETTER COMPANY E INSURED 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 PERTAI~ THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLlvIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER UMITS ATE (MMIDDIYY) DATE (MM/DDIYY) GENERAL LlABIUTY CPP09275009001 7/03/93 7/03/94 GENERAL AGGREGATE $ 1 MMERCIAl GENERAl LIABILITY PRODUCTS-COMPIOP AGG. $ 1 LAlMS MADE [iJOCCUR. PERSONAL & ADV. INJURY $ 1 OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $ 1 FIRE DAMAGE (Anyone fire) $ MED.EXP. (Anyone person) $ AUTOMOBILE UABIUTY BA09275009101 7/03/93 7/03/94 COMBINED SINGLE ANY AUTO LIMIT $ 1 II OWNED AUTOS BODILY INJURY (Per person) $ 1 HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS UABIUTY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION EACH ACCIDENT $ AND DISEASE -POLICY LIMIT $ EMPLOYERS' UABIUTY DISEASE -EACH EMPLOYEE $ OTHEIpROPERTY CPP09275009001 7/03/93 7/03/94 10,000 MEDICAL PYMT'S. BINDER1455 7/03/93 7/03/94 5,000 DESCRIPnON OF OPERAnONS/LOCAnON8NEHICLE8ISPECIAL ITEMS o DAYS NOTICE FOR NON-PAYMENT, 45 DAYS FOR ALL OTHERS ERTIFICATE HOLDER SHOWN ABOVE ALSO LISTED AS AN ADDITIONAL INSURED. ONTRACT FOR TRAFFIC SIGNAL MAINTENANCE >><<)::::::L::::::>::UU::::u:::::n:nm::n:g::;<~;'::::::/..::<)::;::::i:.Uj:jjU H !i!i!i!! SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE /{ EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO ... MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE .. LEFT, BUT FAILURE TO MAIL CH NOTICE SHALL IMPO NO OBLIGATION OR .. LlAB ITV OF AN KIND UPO THE CO ANY, ITS AGE S OR REPRESENTATIVES. MONROE COUNTY BOARD OF COUNTY COMMISSIONERS OR MONROE COUNTY 5100 COLLEGE ROAD KEY WEST FL 33040 !~I.6q::.~:(l(")U::U:::~://H:://::H/ .,..............,..,.... , ,... ,.................,... ....... .....,............ .,.,.".......,..,....,., . ...................... .. .... ...,.......... ... .... . . . ...... .., .....,. ,.... ,. ......... ......,...,..... .............".... .... ... . ......,. ......., ..,. .... "" "'" ....... ......... CE'R T1F1C ATE: OF' IN:SU:R:ANCE ... i I~S~E ;~T~ ;;/~O/YY) 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 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 11141 r , TH I S I S TO CERT I FY THAT POL I C I ES OF INSURANCE LISTED BELOW HA VE BEEN I SSUED TO I Mt: 1"'~U"t:u 1'l~M!f) AeO v! f 6A TilE: POL I CY PER I OD INDICATED. NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OOct:1MENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY B.E ISSUED OR MAY PERTAIN, THE !NSURANCE AFFORDED BY THE ~JAtl\lf~~S D~I~i~"."HER'E"5 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES. CO L TR I FCClFUND \l;ORKERS' COMPE.'S~TION L\Sl Rt \(1 -\l)\ll'l~TERID 8Y FEISC0 PRODUCER 646 > The Johnsons Insurance Agency POBox 2346 Marathon Shores FL 33052-2346 INSURED COASTAL ELECTRIC SERVICE INC RR 1 BOX 834 BIG PINE KEY FL 33043-9533 ... < TYPE I N INSURANCE POLICY NUMBER .., ....... GENERAL LIABILITY ". - COMMERCIAL GENERAL LIABILITY : I CLAIMS MADE C OCCURRENCE OWNERS & CONTRACTORS PROTECTIVE r-- r- ..... AUTOMOBILE LIABILITY - ANY AUTO - - ALL OWNED AUTOS - SCHEDULED AUTOS HIRED AUTOS - - NON-OWNED AUTOS GARAGE LIABILITY - F(D~ .... EXCESS LIABILITY R OTHER THAN UMBRElLA FORM :;< I A ,.. WORKERS' COMPENSATION ATTENTION CERTIFICATE HOLDER: If you have any questions, please contact GERT MI LLER 1-800-226-3224, 260 1 Cattlemen Road, Sarasota, FI 34232-6249 COMPANIES AFFORDING COVERAGE .'. Company Letter A FeCI/SELF INSURERS FUND Company Letter B: APPROVED BY RISK ~.n. "--..-~.- Company Letter C: ByCOYJD-~L{- 9y-;-.. _~~ POLICY POLICY EFFECTIVE EXPIRATION DA TE (MM/DD/YY) DATE (MM/DD/YY) ALL L I M I TS I N THOUSANDS GENERAL AGGREGATE $ ... PRODUCTS-COMP/0PS AGGREGATE $ PERSONAL & ADVERTISING INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (ANY ONE FIRE) $ MEDICAL EXPENSE ~'E~YS3N~E $ . .... .. ~ ... .... . CSL $ BODIL Y INJURY (PER $ PERSON) BODIL Y INJURY (PER $ ACCIDENT) PROPERTY DAMAGE $ EACH OCCURRENCE $ $ STATUTORY ..... AGGREGATE . AND EMPLOYERS' LIABILITY 718-10262-001-001 01/01/94 12/31/94 OTHER .. .... . . . .' DESCRIPTION OF OPERATIONS/LOCATlONSIVEHICLES/RESTRICTlONS/SPECIAL ITEMS ELECT WIRING RE: TRAFFIC SIGN MAT CONT MONROE COUNTY ENGINEERING RISK MANAGEMENT PUBLIC SERVICE BLDG STOCK ISLAND KEY WEST FL 33040 ;$:~ m $ 500 (EACH ACCIDENT) ..... $ 1. 000 WISEASc..POllCY LIMIT} $ 500 (DISEASE-EACH EMPLOYEE) .. .... .... ... DBA: Received lusk Mgmt. & Loss Control a -//- fr _~ ~ Ilk... '. Di\TE INrfIA.L .. .... ....... SHOULD ANY OF THE ABOVE DESCR I BED POL I C I ES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO SEND DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABIL- ~TX OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVE. tUYHORIZED REPRESENTATIVE ~ tfZ /u~ z::.L~- .~ - ....,. <r"~ -- ----;;/ I~' ..... .:> ........ ..... .... ....... ... .... THIS 15 TO CERTIFY 7HAT POLICiES OF IN:URANCE LISTED BELO\AJ HAVE BEEN ISSUED TO THE INSURED N'4M~D~. E' FOR THE POLICY PE INDICATED. NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACWiftn1eTHERtA<lCU YYetf RESPECT TO W THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POL'el~~1~ESC~1B'~ IN IS SUBJECT TO ALL TH TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES. CO L T TYPE I N INSURANCE POLICY POLICY EFFECT I VE EXP I RA T ION DA TE (MM/DD/YY) DATE (MM/DD/YY) POL I CY NUMBER GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCURRENCE OWNERS III CONTRACTORS PROTECTIVE : :\. TE o~ l t....ITnAL AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY F(D EXCESS LIABILITY OTHER THAN UMBRelLA FORM WORKF-R~' COMPEN~ATION AND EMPLOYERS' LIABILITY 718-10262-001-001 01/01/93 12/31/93 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS DBA: ALL LI M I TS I N THOUSANDS GENERAL AGGREGATE $ PRODUCTS-COMP/OPS AGGREGATE $ PERSONAL & ADVERTISING INJURY EACH OCCURRENCE FIRE DAMAGE (ANY ONE FIRE) MEDICAL EXPENSE ~NRYs8N~E CSL $ BODIL Y INJURY (PER $ PERSON) BODIL Y INJURY (PER $ ACCIDENT) PROPERTY DAMAGE EACH OCCURRENCE $ $ 1 $ (DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO SEND 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABIL- ITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVE. AUTHORIZED REPRESENTATIVE ~ 5100 COLLEGE ROAD KEY WEST FL 33040 Company Letter A CE.R:-r:I:FfC:/l.-rE:.:.....OF........IN.S::URA:NCE:: THIS IS TO CERTIFY THAT POLICIES OF INSURANCE liSTED BELOW HAVE BEEN ISSUED TO THE INwm~IfWAM~J FO~E POLICY PERIOD INDICATED. NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OYJ:.f~R Ddt\ '~~E;:g"["T IO WHICH THIS CERTIFICATE MAY BE ISSUED OH MAY PERTAIN, THE INSURANCE AFFORDED BY THE POl!C!ES DESCRIBED HERE!N IS SUBJECT TO ALL THE TERMS, EXCLUS IONS, AND COND I T IONS OF SUCH POL I C I ES. co L T FCCIFUND "ORKERS' COMPF.\S~TIO~ I.\Sl R\. \(! .\J}\lLN1~iERID BY FEIS((' 646 THE JOHNSONS INSURANCE AGENCY POBOX 2346 MARATHON SHORES FL 33052-2346 ,COASTAL BLBCTRIC S8_Vi'ell IHe RR 1 BOX 834 BIG PINE KEY FL 33043-9533 TYPE I N INSURANCE POLICY NUMBER CLAIMS MADE D OCCURRENCE AUTOMOBILE LIABILITY ANY AUTO All OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY F(D OTHER THAN UMBRElLA FORM WORKERS' COMPENSA T ION AND EMPLOYERS' LIABILITY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERT I FICA TE HOLDER. TH I S CERT I FICA TE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ATTENTION CERTIFICATE HOLDER: If you have any questions, please contact GERT MI LLER 1-800-226-3224, 260 1 Cattlemen Road, Sarasota, FI 34232-6249 COMPANIES AFFORDING COVERAGE FCCI/SELF INSURERS FUND APPROVED BY RISK MANAGEMENT Company Letter B: Company Letter C: DBA: POLICY POLICY EFFECTIVE EXPIRATION DA TE (MM/DD/YY) DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS GENER~~ ~GGREGATE $ PRODUC-S-COMP OPS AGGREGATE $ PERSO~':~ & ~DVERTISING INJURY EACH CC:::uRRENCE CSL BODIL Y INJURY (PER $ PERSON) BODIL Y INJURY (PER $ ACCIDENT) PROPERTY DAMAGE $ EACH OCCURRENCE $ STATUTORY ,718-10262-001-001 01/01/94 12/31/94 (OISEASE-POliCY liMIT; (DISEASE-EACH EMPLOYEE) OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS MONROE COUNTY RISK MANAGEMENT 5100 COLLEGE ROAD KEY WEST FL 33040 $ $ 1 $ Receivea Risk Mgmt. & Loss Control I-;J~--?/ ~ t::>/c. DATE INI'l1AL SHOULD ANY OF THE ABOVE oESCR I BED POll C I ES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO SEND DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR lIABIL- I TY OF ANY KIND UPON THE COMPANY, I TS AGENTS OR REPRESENT A T I VE. L\UTHOR I ZEO REPRESENT A TIVE , ~('~~'V'~'='C',~\t~ GE:~'EFt~\l LtAE!tJTY COVERA,GE P/\,RT - OECLAJ~^T'nNS Policy No. CL 191 00307 INSURANCE IS PROVIDED BY THE COMPANY AS DESIGNATED BY AN [Xl (EACH A ST lXl Acceptance Insurance Company D Acceptanc ~llri~ IlQ;H.aRA0Qbt(i6ll! Named Insured and Mailing Address (No.,Slreel.TownorC~y.County.Slale.ZlpCode)' PLEASE EXAMINE THIS Coastal Electric Service, Inc. 1.12\Cei\re! ~995 DOCUMENT CA Route 1, Box 834, Suite "B" 0 r: C t:l\lsfQ~~& Loss Control IF ANY OF THERT.r..o.u'C'-f~m.m er* Big Pine Key, FL 33043 l' ~ ~1~ ltrutfW~UJ \ImI DATE - .2?- q 5- ; CONDITiONS VARY FROrvl INITIALto 07-31-96 ~ TH~~~:cT~M.~cQRPf;ilAiQt our NOTt FY rhtiiJ~g aSJd~\'lfA&hH(ab ve. ~~~Fi~lfi!~~ d~1H&~<ky, WE Policy Period*: From 07-31-95 IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS LIMITS OF INSURANCE General Aggregate Limit (Other Than Products-Completed Operations) $ Products-Completed Operations Aggregate Limit $ Personal and Advertising Injury Limit $ Each Occurrence Limit ~n r f.. I :~ f\ II U -.. $ Fire Damage Limit 'Viii \II!'... M EARNED $ Medical Expense Limit PRE M I U M A $ RETROACTIVE DATE CG 00 02 ONLY Cover~ge A of this Insurance does not apply to "bodily inju"'HI&~'te'r' which <Ffm'e~mr~~p Date, If any, shown here: ___~_one_ UN (En te. t e tete applies) 1 ,000,000. 1 ,000,000. 1 ,000,000. 1 ,000,000. 50,000. Excluded Any One Fire Any One Person DESCRIPTION OF BUSINESS AND LOCATION OF PREMISES Form of Business: D Individual D Joint Venture D Partnership D Organization (Other than Partnership or Joint Venture) Business Description*: Electric Service "Persons insured by Surplus Lines Carriers do not have the Location of All Premises You Own, Rent or Occupy: protection of the Florida Insurance Guaran~ A~t to the Route 1, Box 834, Suite "B", Big Pine Key, FL 33043 extent of any Right of Recovery for the obligatIon of an U Ii ensed Insurer". PREMIUM Classification Code No. Premium Basis Rate PremlOp PrlCo Advance Premium Prem/Op PrlCo Electrical Work -within buildings Additional Insured 'This policy Is subject to audit. per Form CG2010 Additional premiums generated as a result of audit are due and payable when billed.. 92478 Owner Plus One Excl. Excl. 1 ,286. Excl. 129. :s- ~ _ ~ ~ ;<. f'T1 ?1 2IIt '"0 '"0 :0 ~ o aJ -< :0 Vi :s: 3: > z .> J:) rT1 ~ ,.,., Z -t Total Advance Premium: $1,415.00 + Policy Fee: $25.00 + 50/0 State Tax: $74.85 + Inspection Fee: $57.00 = TOTAL: $1,571.85 FORMS AND ENDORSEMENTS Forms and Endorsements applying to this Coverage Part and made part of thrs policy at time of issuet: AL 2900 (10-93) with all forms referenced thereon. RICHARD F. HULL Surp1us lines Aeent #0043243374.20 This insurance is issued pursuant to the Florida Surplus Unes Law Countersigned:* August 10, 1995 CEH\bk Hull & Company, Inc., S1. Petersburg, FL #0191 Producer: Isaksen Insurance, Inc., Big Pine Key, FL 33043 *Entry optional if shown in Common Policy Declarations. tForms and Endorsements applicable to this Coverage Part omitted if shown elsewhere in the policy. THESE DECLARATIONS AND THE COMM POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND FO SAND DORSEMENTS, IF AN~ 'ROFf'Jf AIf J~J:I>SCHi!\'TtfE ,rpVrMRED POLICY. JDL 190 (2)-0 (6-93) Cc ~ ~ I UU \-Vlv',jWII, '-'IVI1 ~ ~ THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERnFlCATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. COMPANIES AFFORDING COVERAGE PRODUCER COMPANY A BANKERS INSURANCE COMPANY COMPANY nr r n u,. \.. U 1:1 T ti I ~ f\ MR ['OHJ tolYl C', , COASTAL ELECTRIC SERVICE, INC B nv ~~_~ --J?7'~/~ AND ROBERT & MELANIE NORMAND COMPANY Q' RT 1 BOX 834 SUITE B C nATf '~-..2/ ~ U BIG PINE KEY, FL 33043 COMPANY / I D WAIVER: N/A ~ YES ]"t'!r!l..mtrIrr:::fff:I::I:~:ff:IIr:::::fffff:::r:ff:r@ff:r:fff::fffff:r:fffffff:::rIIrIIIIrI::::::rr@f:~::f::fffm:ff::fiffiifl:I::I:::~r~:~fff:r::::I:fffffff:Ir:::::f:I:::::f:Irrrlffffffffffffff:::r::r:ff:r THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. RAY HAMPSON & ASSOCIATES INSURANCE AGENCY 102481 OVERSEAS HWY KEY LARGO FL 33037 INSURED CO LTR TYPE OF INSURANCE POUCY NUMBER POUCY EFFEcnYE POUCY EXPlRAnON DATE (MMIDDIYY) DATE (MMIDDIYY) UMITS ~ GEtERALUABILITY CPP09275009002 - X COMMERCIAL GENERAL LIABILITY TIiD CLAIMS MADE 00 OCCUR OWNER'S & CONTRACTOR'S PROT f-- 7/03/94 7/03/95 GENERAL AGGREGATE $1, 0 0 0 , 0 0 0 PRODUCTS cod~op AGG $1, 000 , 000 PERSONAL & ADV INJURY $1, 000 , 000 EACH OCCURRENCE $1, 000 , 000 FIRE DAMAGE (Anyone fire) $ 5 0 , 0 0 0 MED EXP (Any one person) $ 5 , 0 0 0 1,000,000 COMBINED SINGLE LIMIT $ ~ ~TOMOBILE UABILITY BAO 9275009102 07/03/94 07/03/95 ANY AUTO _ ALL OWNED AUTOS X SCHEDULED AUTOS - X HIRED AUTOS X NON-OWNED AUTOS f-- BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ ~AGE UABILITY THE PROPRIETOR! PARTNERs/EXECUTIVE OFFICERS ARE: OTHER RINCL EXCL AUTO ONLY EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ $ I STATUTORY LIMITS EACH ACCIDENT S DISEASE POLICY LIMIT $ DISEASE EACH EMPLOYEE $ JE ANY AUTO EXCESS UABILITY RUMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSAnON AND EMPLOYERS'~~ ~ DESCRPnON OF OPERAnONSILOCAnONSNEHICLESlSPECIAL ITEMS ADDITIONAL INSURED ON GENERAL LIABILITY POLICY: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ~~~~llt:::H9H.t:::::::::t:~~::tt:::t::t:tt:::I:tmI::::~::::::::::tttt:::::::I:::r:::~tt::~::::ttI::t:~:t:::::::::::t::~f::::::t:::::::::."!_!p~!!m:~:I:t:::::::::::::::::::::I::::tItt::tt::t:tt:IIt~::::::t:~:::::::II:::::::t:::::Ir:::tt::~:::::t:::::::::::::1I::::::::::II:::::::::r~:~~::::! SHOULD ANY OF THE ABOVE DESCRBED POUCES BE CANCELLED BEFORE THE EXPlRAnON DATE THEREOF. DIE ISSUING COMPANY WILL ENDEAVOR TO MAL ~ DAYS WRITTEN NOncE TO THE CERlFICATE HOLDER NAMED TO THE LEFT, BUT FALURE TO MAL SUCH NOnCE SHALL IMPOSE NO OBUGAnON OR UABILITY OF ANY KIND UPON ~Y. ITI-.-. ~ENTS OR REPRESENTAnvES. AUTHORIZED REPRESENTA~, ol/jf h ,- :iBMn*~imli..UI::::I:::::::i::::::::t:II:::::::::tttf:I:::::~~~~::::f:I:::~:t:::::::::::~::::::t:~::::::ffft:I:f::::~ff:~:::::~::~:t:~:~:~::ff::fmI~::::i:lli:~~~:i::::::t;:::i::~:::~::~m:m:W:tr:{::::::::m~_i:.~M.n!:i.: MONROE COUNTY PUBLIC WORKS 5100 COLLEGE ROAD KEY WEST FL 33040 Insurance Com ant TH I S CERT I FICA TE I S I SSUED AS A MATTER OF I NFORMA T ION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 646 . The Johnsons Insurance Agency PO Box 2346 Marathon Shores FL 33052-2346 ATTENTION CERTIFICATE HOLDER: If you have any questions, please contact GERT MI LLER 1-800-226-3224, 2601 Cattlemen Road, Sarasota, FI 34232-6249 COMPANIES AFFORDING COVERAGE COASTAL ELECTRIC SERVICE INC RR 1 BOX 834 BIG PINE KEY FL 33043-9533 Company Letter A Company Letter B: THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURE ED A E IIO~ TM 100 INDICATED. NOT WITHSTANDING 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. co L T TYPE I N INSURANCE POL I CY NUMBER POLICY POLICY EFFECTIVE EXPIRATION DA TE (MM/DD/YY) DATE (MM/DD/YY) ALL L I M I TS I N THOUSANDS COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCURRENCE GENERAL AGGREGATE $ PRODUCTS-COMP!OPS AGGREGATE $ EACH OCCURRENCE PERSONAL & ADVERTISING INJURY $ $ $ $ FIRE DAMAGE (ANY ONE FIRE) MEDICAL EXPENSE ~~~YS3N~E AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY OTHER THAN UMBRELLA FORM CSL $ BODIL Y INJURY (PER $ PERSON) BODIL Y INJURY (PER $ ACCIDENT) PROPERTY DAMAGE $ EACH OCCURRENCE $ $ Insurance Compan!l 718-10262-001-001 01/01/95 12/31/95 500 $ 1 000 $ C \wi (EACH AcrtnENT) (DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE) EXCESS LIABILITY WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY OTHER DESCRIPTION OF OPERA TIONS/LOCA TIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS TRAFFIC SIGNAL MAINT REPAIR CONTRACT DBA: MONROE CTY PUBLIC WORKS ATTN WENDY KEY BUXTON 5100 COLLEGE RD KEY WEST FL 33040 SHOULD ANY OF THE ABOV.E DESCR I BED POL I C I ES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO SEND DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABIL- T OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVE. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. COMPANIES AFFORDING COVERAGE RAY HAMPSON & ASSOCIATES INSURANCE AGENCY 102481 OVERSEAS HWY KEY LARGO FL 33037 COMPANY A EMPIRE FIRE & MARINE INS CO INSURED COASTAL ELECTRIC SERVICE I INC co:ANY APPROVED BY RiSK MANAGEME~T AND ROBERT & MELANIE NORMAND COMPANY BY ~~ ~ ~~A RT 1 BOX 834 SUITE B C ~ BIG PINE KEY, FL 33043 COMPANY Dft.TE '-" J?-02/ --~ I D / THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POUCY NUMBER POUCY EFFEcnYE POUCY EXPIRATION DATE (MMIDDIYY) DATE (MMIDDIYY) UMRS GENERAL UABIUTY COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR OWNER'S & CONTRACTOR'S PROT GENERAL AGGREGATE s - ANY AUTO 02/15/95 02/15/96 Received Risk Mamt. & Loss Cont(1)1 DA TE ~p - :z-/ - ?.....s.. ~ PRODUCTS COMP/OP AGG S PERSONAL & ADV INJURY S EACH OCCURRENCE S FIRE DAMAGE (Anyone fire) S MED EXP (Any one person) $ 1,000,000 COMBINED SINGLE LIMIT $ A. AUTOMOBILE UABILITY CL4 5182 6 _ ALL OWNED AUTOS Jl SCHEDULED AUTOS _ HIRED AUTOS NON-OWNED AUTOS BODILY INJURY (Per person) S INITIAL BODILY INJURY (Per accident) S ~ PROPERTY DAMAGE $ ~ARAGE UABIUTY ANY AUTO f-- AUTO ONLY EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT S AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ S EXCESS UABIUTY ~ UMBRELLA FORM "I OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS'UABIJTY THE PROPRIETOR! PARTNERs/EXECUTIVE OFFICERS ARE: OTHER RINCL EXCL I STATUTORY LIMITS ;-~CH ~CCIDENT _____ ._.._. .l__.__h_._ .____________ DISEASE POLICY LIMIT S DISEASE EACH EMPLOYEE $ DESCRIPTION OF OPERATlONSILOCATlONSNEHICLESlSPECIAL ITEMS CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ON THE POLICY TRAFFIC SIGNAL MAINTENANCE CONTRACT WITH MONROE COUNTY SHOULD ANY OF THE ABOVE DESCR.ED POUCES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WLL ENDEAVOR TO MAIL ~ DAYS WRIlTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAL SUCH NO'ftI'C QUAI I IMPOSE NO OBUGATION OR UABIUTY KEY WEST, FL 33040 OF ANY KIND UPON THE ~~, ITS~G.Ps OR REPRESENTATIVES. ~~ ;R::~7L~r.J.lf I hAd; Jtj~ &~I~~f_lirrllrr:iiiiii:iii:ifffff'J~11ft11111':::1111f'JtJJJtf'Jrttm:::;:J:::11111ft'ttt~::'J:::::"f:'t1tt'J::::tJJr::::::::::::Jm1f:::.{m:~~{mt:tigtKi.~__@d.; MONROE COUNTY & MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 5100 JUNIOR COLLEGE ROAD ACCEPTANCE INSURANCE COMPANIES 222 South 15th Street, Suite 600 North Omaha, Nebraska 68102 l~hls endorsement Is EFFECTIVE 07-13-95 and made part of Policy Number: CL 19100307 Issued to: Coastal Electric Service, Inc. GENERAL LIABILITY FORMS LIST -L.. ---X- ---X- --X- ---X- ISO/CO# AM 0500 AL 2101 AL 2102 AL 2903 CLP-J 1 UNIFORM# ED. DATE 11/92 1 0/93 1 0/92 05/94 02/94 GENERAL ENDORSEMENTS General Provisions Endorsement General Exclusions and Limitations Endorsement Delete - Non-Renewal Notice Premium Basis Designation Endorsement Policy Jacket (Monoline Policies) COVERAGES AND LIMITATIONS -L.. JDL 190(2) 06/93 Commercial General Liability Coverage Part Dec (Monoline Policies) CL 150 06/93 Commercial General Liability Coverage Part Dec (Pkg Policies) CL 170 06/93 CGL Coverage Part - Extension of Declarations --X- CG 0001 CL 113 1 0/93 Commercial General Liability Coverage Form Form 221 07/92 Professional Liabiity Insurance CG 0033 CL 116 1 0/93 Liquor Liability CG 0419 CL 236 11/85 Hired & N on-Owned Auto Liability ---X- CG 2010 CL 690 1 0/93 Additional Insured - Owners, Lessees or Contractors (Form B) CG 2011 CL 247 11/85 Additional Insured - Managers or Lessors of Premises CG 2139 CL 699 1 0/93 Contractual Liability Limitation AL 2007 04/94 Products - Completed Operations Aggregate Limit AL 2008 04/94 Professional Liability Insurance Coverages (Bridge) AL 2009 04/94 Detective or Patrol Agency Endorsement AL 2010 04/94 Lost Key Coverage Endorsement AL 2011 04/94 Additional Insured - Medical Director AL 2012 05/94 Errors and Omissions Extension AL 2013 05/94 Amendment to Other Insurance Condition AL 2014 05/94 Specified Products Liability AL 2015 07/94 Wood Destroying Organism Inspection Coverage Endorsement AL 2016 09/94 Property Damage Extension Endorsement AL 2116 09/94 Sexual and/or Physical Abuse Liability Coverage Form AL 2400 06/94 Contractors Special Conditions EXCLUSIONS CG 2104 CL 267 11/85 Exclusion - Products/Completed Operations CG 2116 CL 268 11/85 Exclusion - Designated Professional Liability --X- CG 2135 CL 683 1 0/93 Exclusion - Coverage C - Medical Payments CG 2138 CL 275 11/85 Exclusion - Personal Injury and Advertising Injury CG 2145 CL 282 11/85 Exclusion - Fire Damage Legal Liability --X- CG 2147 CL 701 1 0/93 Employment Related Practices Exclusion --X- AL 2104 03/93 Subsidence Exclusion AL 2105 05/94 Physical & Sexual Abuse Endorsement AL 2107 02/94 Assault and Battery Exclusion x AL 2108 03/93 Lead Contamination Exclusion AL 2109 04/94 Participants Exclusion AL 2111 05/94 Advertisers Liability Exclusion Others as described: AL 2900 1194 The forms marked above will be considered a part of this policy. ACCEPTANCE INSURANCE COMPANIES Acceptance Insurance Company Acceptance Indemnity Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY GENERAL PROVISIONS ENDORSEMENT Provision included if box marked. [i] Service of Suit It is agreed that in the event of the failure of the Company hereon to pay any amount claimed to be due hereunder, the Company, at the request of the Insured (or Reinsured), will submit to the jurisdiction of any court of competent jurisdiction within the United States and will comply with all requirements necessary to give such Court jurisdiction and all matters arising hereunder shall be determined in accordance with the law and practice of such court. Further, pursuant to any statute of any state, territory or district of the United States which makes provision therefore the Company hereon hereby designates the Superintendent, Commissioner or Director of Insurance, or other officer specified for that purpose in the Statute or his successor or successors in office as their true and lawful attorney upon whom may be served any lawful process in any action, suit or proceeding instituted by or on behalf of the insured (or reinsured) or any beneficiary hereunder arising out of this contract of insurance (or reinsurance), and hereby designate the above-named as the person to whom the said Officer is authorized to mail such process or a true copy thereof. ~ MINIMUM EARNED PREMIUM ENDORSEMENT It is hereby agreed and understood that in the event of cancellation or endorsement of this policy, the minimum earned premium shall not be less than $354.. D MINIMUM AND DEPOSIT ENDORSEMENT Contrary to anything contained herein, it is understood and agreed that the Company's annual minimum and deposit premium is $ . AM 0500 1192 ACCEPTANCE INSURANCE COMPANIES Acceptance Insurance Company Acceptance Indemnity Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL EXCLUSIONS AND LIMITATIONS ENDORSEMENT ASBESTOS EXCLUSION This policy does not apply to any "Personal Injury,IIIIBodily Injury," or "Property Damage" arising out of or resulting from Asbestos. The company shall not have any duty to defend any suit against the Insured seeking damages on account of any such injury. DEDUCTIBLE ENDORSEMENT Amount $ 250.00 per claim. 1. The Company's obligation under the Bodily Injury or Property Damage Liability Coverages to pay damages on behalf of the insured applies only to the amount of damages in excess of deductible amount stated above. 2. The deductible amount applies under the Bodily Injury or Property Damage Liability Coverage to all bodily injury or property damages sustained by one person or organization, as the result of anyone occurrence. 3. The deductible amount stated shall also apply towards investigation, adjustment and legal expenses incurred in the handling and investigation of each claim, whether or not payment is made to claimant, compromise settlement is reached or claim is denied. 4. The terms of the policy, including those with respect to (a) the Company's right and duties with respect to the defense of suits and (b) the insured's duties in the event of an occurrence apply irrespective of the application of the deductible amount. 5. The Company at its sole election and option, may either: (a) pay. any part or all of the deductible amount to effect settlement of any claim or suit, and upon notification of the action taken, the named insured shall promptly reimburse the Company for such part of the deductible amount as has been paid by the Company; or (b) simultaneously upon receipt of notice of any claim or at any time thereafter, call upon the insured and request said insured to pay over and deposit with the Company all or any part of the deductible amount, to be held and applied by the Company as herein provided. The failure of the insured to promptly comply with the Company's request, pursuant to this subdivision, shall constitute a breach of the policy contract with the same force and effect as if this policy did not cover the particular accident, incident or occurrence which created the particular claim or claims with reference to which the deposit of the deductible amount or amounts had been requested. Nothing herein AL 2101 1093 Page 1 of 2 contained shall be held to vary, waive, alter or extend any of the Declarations, Schedule of Coverages, Insuring agreements, Exclusions and Conditions of the policy other than as stated above. POLLUTION EXCLUSION This policy does not apply to: (1) IIBodily Injuryll or IIProperty Damagell arising out of the actual, alleged or threatened discharge, dispersal, release or escape of pollutants: (a) at or from premises you own, rent or occupy; (b) at or from any site or location used by or for your or others for the handling, storage, disposal, processing or treatment of waste material; (c) which are at any time transported, handled, stored, treated, disposed of, or processed as waste by or for you or any person or organization for whom you may be legally responsible, or (d) at or from any site or location on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations (i) to test for, monitor, clean up, removal, contain, treat, detoxify or neutralize the pollutants, or (ii) if the pollutants are brought on or to the site or location by or for you. (2) Any loss, cost or expense arising out of any governmental direction or request that you test for, monitor, clean up, remove, contain, treat, detoxify or neutralize pollutants. Pollutants means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fume, acids, alkalis, chemicals and waste materials. Waste materials includes materials which are intended to be or have been recycled, reconditioned or reclaimed. PUNITIVE DAMAGES EXCLUSION It is agreed that this policy excludes any claim for punitive or exemplary damages whether arising out of acts of the insureds, insured's employees or any other person. All other terms and conditions of this policy remain unchanged. AL 2101 Page 2 of 2 ACCEPTANCE INSURANCE COMPANIES Acceptance Insurance Company Acceptance Indemnity Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Delete-Nonrenewal Notice This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM The following change is made: It is agreed under SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 9. When we Do Not Renew, is deleted in its entirety. Al 2102 1092 Acceptance Insurance Companies 222 South 15th Street, Suite 600 North Omaha, Nebraska 681 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PREMIUM BASIS DESIGNATION ENDORSEMENT The Premium Basis shown on the Declarations page and identified by a keyletter(s) in parenthesis apply as follows: Kev Letter Premium Base How Rates Applv (a) Area per 1 ,000 square feet (c) Total Cost per 1 ,000 of total costs (m) Admissions per 1 ,000 admissions (p) Payroll per 1 ,000 payroll (s) Gross Sales per 1 ,000 of gross sales (u) Units Per unit (describe) (t) Other Describe These premium basis are as outlined in the Insurance Service Office's Commercial Lines Manual Classification Table and Division Six General Liability Sections. AL 2903 (5-94) CL 690 (10-93) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 10 10 93 ADDITIONAL INSURED-OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. SCHEDULE Name of Person or Organization: Monroe County (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. CL 690 (10-93) CG 20 10 10 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 CL 683 (10-93) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 21 35 1 0 93 EXCLUSION-COVERAGE C-MEDICAL PAYMENTS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description and Location of Premises or Classification: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) With respect to any premises or classification shown in the Schedule, coverage C. MEDICAL PAYMENTS (Section I) does not apply and none of the references to it in the Coverage Part apply. The following is added to SUPPLEMENTARY PAYMENTS (Section I): 8. Expenses incurred by the insured for first aid administered to others at the time of an accident for "bodily injury" to which this insurance applies. CL 683 (10-93) CG 21 35 10 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 CL 701 (10-93) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 21 47 10 93 EMPLOYMENT-RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to paragraph 2., B. Exclusions of COVERAGE A-BODILY INJURY AND PROPERTY DAMAGE LIABILITY (Section I-Coverag- es): This insurance does not apply to: "Bodily injury" to: (1) A person arising out of any: (a) Refusal to employ that person; (b) Termination of that person's employment; or (e) Employment-related practices, policies, acts or omissions, such as coercion, demotion, evalu- ation, reassignment, discipline, defamation, harassment, humiliation or discrimination direct- ed at that person; or (2) The spouse, child, parent, brother or sister of that person as a consequence of "bodily injury" to that person at whom any of the employment-related practices described in paragraphs (a), (b) or (e) above is directed. This exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury. CL 701 (10-93) CG 21 47 10 93 The following exclusion is added to paragraph 2., Exclusions of COVERAGE B-PERSONAL AND AD- VERTISING INJURY LIABILITY (Section I-Coverag- es): This insurance does not apply to: "Personal injury" to: (1) A person arising out of any: (a) Refusal to employ that person; (b) Termination of that person's employment; or (e) Employment-related practices, policies, acts or omissions, such as coercion, demotion, evalu- ation, reassignment, discipline, defamation, harassment, humiliation or discrimination direct- ed at that person; or (2) The spouse, child, parent, brother or sister of that person as a consequence of "personal injury" to that person at whom any of the employment-related practices described in paragraphs (a), (b) or (e) above is directed. This exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury. Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 Acceptance Insurance Companies 222 South 15th Street, Suite 600 North Omaha, Nebraska 68102 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SUBSIDENCE EXCLUSION It is agreed that this policy shall not apply to any claim of liability for Bodily Injury or Property Damage caused by, resulting from, attributable or contributed to, or aggravated by the subsidence of land as a result of landslide, mudflow, earth sinking or shifting, resulting from you operations or your subcontractor's operations. AL21 04 0393 ACCEPTANCE INSURANCE COMPANIES 222 SOUTH 15th STREET, SUITE 600 NORTH OMAHA, NEBRASKA 68102 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LEAD CONTAMINATION EXCLUSION It is agreed that the insurance does not apply to Bodily Injury, Personal Injury or Property Damage arising out of the ingestion, inhalation or absorption of LEAD in any form. AL 2108 0393 PLEAse'READ YOUR POLICY POLICY NUMBERCA 0-41-'9-~t;Q-O This'" dEIclarC:'.ions Page/Amended Declaration page with the policy jacket identified by the form and edition date indicated col11,s"lttes the \.at>ove numbered po Ii cy. 6 8 88 Previous pol icy no. Form 90 Ed. 1 1 *** THIS AMENDED DECLARATION SUPERSEDES PRIOR DECLARATION PAGE EFFECTIVE 07/11/95 *** COASTAL ELECTRIC INC PAGE 1 OF 4 DECLARATIONS RT 1 BOX 834 STE B NAMED INSURED BIG PINE KEY F L 33043 ~ ISAKSEN INS INC E PO BOX 431923 ~ BIG PINE KEY FL 33043 progfEl.uVe companier 1-800-444-4487 Policy period 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED I NSURED AS STATED HERE I N FROM JUL 11, 1995 TO JUL 11, 1996 ENDORSED EFFECTIVE: J U L 1 1, 1 995 CA-27492 PROGRESSIVE AMERICAN INS. CO. P.O. BOX 94739, CLEVELAND, OHIO 44101 The insurance afforded is only with respect to such and so many of the following coverages as are indicated with respect to each described vehicle. The limit of the company's liability against each such coverage shall be as stated herein, subject to all the terms of this policy having reference thereto. SCHEDULE OF COVERAGES AND L I M I TS OF L I AB I L I TY COVERAGES A SINGLE LIMIT BODILY INJURY AND PROPERTY DAMAGE LIABILITY $1,000,000 EACH OCC C MEDICAL PAYMENTS $ 2,000 EACH ACCIDENT D COMP OR FTCAC STATED AMT SEE SCHEDULE OF COVERED VEH FOR DED E COLLISION OR UPSET-STD AMT SEE SCHEDULE OF COVERED VEH FOR OED I UN/UNDERINSURED MOT $1,000,000 EACH OCC (NON-STACKED) BASIC PERSONAL INJURY PROTECTION $10,000 LIMIT/PERS. LESS NO DED. PER PERSON FOR NAMED INSURED AND DEPENDENT RELATIVES FULL TERM PREMIUM CHARGES $852 $25 ~228 506 308 $32 WITH WORKERS COMP APPROVED BY RIS~~~ . BY- ~ ~ OR-It::" C~~ DATE ?- a ?--...s- WAIVER: NIA ~YES FILING FEES TOT. CHARGES DUE TO CHANGE TOTAL TERM PREMIUM ATTACHMENT IDENTIFIED BY FORM NUMBER $25.00 $742.00- $1,976.00 1839 1652 (05-88) 2011 (05-88) 2029 (05-94) 6865 (05-94) 2068 (05-94) 1197 (05-88) (08-93) 1198 (08-93) 1602 (10-87) DRIVERS PAGE LOSS PAYEE PAGE 2 4 , COVERED VEH PAGE 3 PUC-N OTH-N Any loss under parlt I I is payable as interest may appear to named insured and above loss payee: prost. Premium BultJ,;,t: Fin. Resp. Filed: Fo.(,WhSHD: Case No: R~79 %Factor UsJPO. 00 C3 AE1 952L~ LIRI 10.0 CAICS11C . 1113 (5-88) Received Risk Mgmt. & Loss Control 0, ? y_a1~ DATE 4- ~O ~ ADDITIONAL INTEREST COpy /)W IN ITIAL cc: ~.LB-A~ ~ By Authorized Representative Counters i gned: CVFL0714940023Ell13Al1 PLEASE READ YOUR POLICY POLICY NUMBERCA 0-41-'9-~'iQ-O This declarations Page/Amended Declaration page with the pol icy jacket identified by the form and edition date indicated cOI1lJS1ites the above numbered pol icy. Previous policy no. Form 6908 Ed. 1188 *** THIS AMENDED DECLARATION SUPERSEDES PRIOR DECLARATION PAGE EFFECTIVE 07/11/95 *** COASTAL ELECTRIC INC PAGE 2 OF 4 DECLARATIONS RT 1 BOX 834 STE B NAMED INSURED BIG PINE KEY FL 33043 A G E N T ISAKSEN INS INC PO BOX 431923 BIG PINE KEY Policy period 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED I NSURED AS STATED HERE I N FROM JUl 11, 1995 TO JUl 11, 1996 ENDORSED EFFECTIVE: J U l 11, 1995 Fl 33043 progreuVe compilnier 1-800-444-4487 CA-27492 PROGRESSIVE AMERICAN INS. CO. P.O. BOX 94739, CLEVELAND, OHIO 44101 The insurance afforded is only with respect to such and so many of the fol lowing coverages as are indicated with respect to each described vehicle. The limit of the company's liability against each such coverage shall be as stated herein, subject to all the terms of this policy having reference thereto. SCHEDULE OF DR IVERS DVR NO DRIVER NAME 01-01 ROBERT 02-02 MELANIE R NORMAND NORMAND liCENSE # N655770572660 N655556597640 OOB VIOl/ACC SR22 STA ABC 0 MSC REQ TUS 07/26/57 0 0 0 0 00 N 07/24/59 0 0 0 0 00 N M M Any loss under parlt I I is payable as interest may appear to named insured and above loss payee: pro1. Premium Bu~J,t: Fin. Resp. Filed: For ,W'hom: Case No: R,Q79 %Factor UsJPO. 00 C3 AE1 9522~ CTRI 10.0 CAICS11C Counters i gned: By Author i zed Representat ive 111 3 (5-88) CVFL00101287L1113.A2 PLEASE'READ YOUR POLICY POLICY NUMBER CA 0-4 1-' 9- ~l;Q-O This de'clara!ions Page/Amended Declaration page with the pol icy jacket identified by the form and edition date indlcatea cotflJS1ttes the 'ilbove numbered pol icy. 88 Previous pol icy no. Form 6908 Ed. 11 *** THIS AMENDED DECLARATION SUPERSEDES PRIOR DECLARATION PAGE EFFECTIVE 07/11/95 *** COASTAL ELECTRIC INC PAGE 3 OF 4 DECLARATIONS RT 1 BOX 834 STE B NAMED INSURED BIG PINE KEY FL 33043 A G E N T ISAKSEN INS INC PO BOX 431923 BIG PINE KEY Policy period 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED I NSURED AS STATED HERE I N FROM JUL 11, 1995 TO JUL 11, 1996 ENDORSED EFFECTIVE: J U L 11, 1995 FL 33043 progreuVe companier 1-800-444-4487 CA-27492 PROGRESSIVE AMERICAN INS. CO. P.O. BOX 94739, CLEVELAND, OHIO 44101 The insurance afforded is only with respect to such and so many of the following coverages as are indicated with respect to each described vehicle. The limit of the company's liability against each such coverage shall be as stated herein, subject to all the terms of this policy having reference thereto. S CH E 0 U LEO F COVE RE 0 VE H I C L E S VEH NO 1-01 DR TRADE NO YR NAME 95 FORD BODY TYPE FLATBED SERIAL NO lFDLE47F4SEA18693 DVR VEH TER RAD DSC DSC SCH CLS NO ZIP IUS COD PCT 5 C03 96 33043 100 761 35 VEH NO BI/PD $852 MED PAY LIABILITY PREMIUM BY VEHICLE RENT REIN UM/UIM PIP $25 $308 $32 PHYSICAL DAMAGE PREMIUM BY VEHICLE $500 PREM $228 COLLISION OED PREM ON-HOOK LIMIT OED PREM VEH TOTAL $1,951 VEH COMP OR FT/CAC NO TYPE OED 1 COMP $500 $506 I I I CT Any loss under Part is ~~~~e as interest may apj>ear to named insured and above loss payee: 0f1r9d+ Premium BUdg'kQO. 00 Fin. Resp. Fil&J AE 1 9~~CWh~;J;:R I 1 u. 0 CA I CS 11 ((:ase No: R/R %Factor Used: Counters i gned: By Author i zed Representat ive 111 3 (5-88) CVFL00101287Lll13.A3 PLEASE READ YOUR POLICY POLICY NUMBER CA 0-4 1-7 9- ~r;Q-O This declarations Page/Amended Declaration page with the pol icy jacket identified by the form and edition date indlcatea col1l,:s1ttes the above numbered pol icy. Previous pol icy no. Form 6908 Ed. 1188 *** THIS AMENDED DECLARATION SUPERSEDES PRIOR DECLARATION PAGE EFFECTIVE 07/11/95 *** COASTAL ELECTRIC INC PAGE 4 OF 4 DECLARATIONS RT 1 BOX 834 STE B NAMED INSURED BIG PINE KEY FL 33043 A G E N T ISAKSEN INS INC PO BOX 431923 BIG PINE KEY Policy period 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED I NSURED AS STATED HERE I N FROM JUL 11, 1995 TO JUL 11, 1996 ENDORSED EFFECTIVE: J U L 11, 1995 FL 33043 progreuve companier 1-800-444-4487 CA-27492 PROGRESSIVE AMERICAN INS. CO. P.O. BOX 94739, CLEVELAND, OHIO 44101 The insurance afforded is only with respect to such and so many of the following coverages as are indicated with respect to each described vehicle. The limit of the company's liability against each such coverage shall be as stated herein, subject to all the terms of this policy havi ng reference thereto. LOS SPA Y E E VEH NO NAME 1 TIB BANK OF THE KEYS ADDRESS PO BOX 1907 CITY/STATE BIG PINE KEY ZIP CODE FL 33043 LOSS PAYABLE CLAUSE - FORM 1602 (10-87) WE AGREE WITH YOU TO CHANGE YOUR POLICY AS FOLLOWS: 1. WE WILL PAY THE LOSS PAYEE NAMED IN THE POLICY FOR LOSS TO YOUR INSURED AUTO, AS THE INTEREST OF THE LOSS PAYEE MAY APPEAR. 2. THE INSURANCE COVERS THE INTEREST OF THE LOSS PAYEE UNLESS THE LOSS RESULTS FROM FRAUDULENT ACTS OR OMISSIONS ON YOUR PART. 3. CANCELLATION ENDS THIS AGREEMENT AS TO THE LOSS PAYEE1S INTEREST. IF WE CANCEL THE POLICY WE WILL MAIL YOU AND THE LOSS PAYEE THE SAME ADVANCE NOTICE. 4. IF WE MAKE ANY PAYMENT TO THE LOSS PAYEE, WE WILL OBTAIN HIS RIGHTS AGAINST ANY OTHER PARTY. Any loss under parlt I I is payable as interest may appear to named insured and above loss payee: pro!}. Premium BultJ;,t: Fin. Resp. Filed: For ,Whom: Case No: R,Q79 %Factor UsJPO. 00 C3 AEl 9522~ CTRI 10.0 CAICSllC Counters i gned: By Author i zed Representat ive 1113 (5-88) CVFL00101287Lll13.A4 . . progre.rn/e COmpanlef ADDITIONAL INSURED The person or organization named below is a person insured with respect to such liability coverage as is afforded by the policy but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this agreement will be excess insurance over any other valid and collectible insurance. NAME OF PERSON OR ORGANIZATION: MOMROE CO 5100 COLLEGE RD KEY WEST FL 33040 All other parts of this policy remain unchanged. This endorsement changes Policy No.: 0 - 4129359 - 0 Issued to (Name of Insured): COASTAL ELECTRIC INC Endorsement Effective: 07/11/95 Expiration: 07 /11/96 Form No. 1198 (8-93) CVFL0624940043L 11980 11 PLEAse- READ YOUR POLICY POLICY NUMBER CA 0-4 1- '9- ~J;Q-O This daclarc-.tions Page/Amended Declaration page with the policy jacket identified by the form and edition date indicated cor1l,sH!tes the ~ above numbered pc)l i cy. Previous pol icy no. Form 6908 Ed. 1188 DECLARA T IONS NAMED INSURED COASTAL ELECTRIC INC RT 1 BOX 834 STE B BIG PINE KEY FL 33043 PAGE 1 OF 4 A G E N T Policy period 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED I NSURED AS STATED HERE I N FROM JUL 11, 1995 TO JUL 11, 1996 ISAKSEN INS INC PO BOX 431923 BIG PINE KEY FL 33043 pro!JIP.r.rVe companier 1-800-444-4487 CA-27492 PROGRESSIVE AMERICAN INS. CO. P.O. BOX 94739, CLEVELAND, OHIO 44101 The insurance afforded is only with respect to such and so many of the following coverages as are indicated with respect to each described vehicle. The I imit of the company's I iabi I ity against each such coverage shall be as stated herein, subject to all the terms of this pol icy having reference thereto. SCHEDULE OF COVERAGES AND L I M I TS OF L I AB I L I TY COVERAGES A SINGLE LIMIT BODILY INJURY AND PROPERTY DAMAGE LIABILITY $1,000,000 EACH OCC C MEDICAL PAYMENTS $ 2,000 EACH ACCIDENT D COMP OR FTCAC STATED AMT SEE SCHEDULE OF COVERED VEH FOR DED E COLLISION OR UPSET-STD AMT SEE SCHEDULE OF COVERED VEH FOR DED I UN/UNDERINSURED MOT $1,000,000 EACH OCC (NON-STACKED) BASIC PERSONAL INJURY PROTECTION $10,000 LIMIT/PERS. LESS NO DED. PER PERSON FOR NAMED INSURED AND DEPENDENT RELATIVES FULL TERM PREMIUM CHARGES $1246 $38 ~323 734 308 $44 WITH WORKERS COMP FILING FEES TOTAL POLICY PREMIUM $25.00 $2,718.00 ATTACHMENT IDENTIFIED BY FORM NUMBER 1839 1652 (05-88) 2011 (05-88) 2029 (05-94) 6865 (05-94) 2068 (05-94) 1197 (05-88) (08-93) 1198 (08-93) 1602 (10-87) DRIVERS PAGE LOSS PAYEE PAGE 2 4 , COVERED VEH PAGE 3 PUC-N OTH-N Any loss under parlt I I is payable as interest may appear to named insured and above loss payee: prog Premium Bu'~t: Fin. Resp. Fil~3 AEO 9520f rhE~:AS 10.0 CA I CS 11 ease No: R~794 %Factor Used: Countersigned: 1113 (5 - 88) ADDITIONAL INTEREST COpy Authorized Representative CVFL060 1950023L 1113.A 1 PLEASE READ YOUR POLICY POLICY NUMBERCA Q-41-'9- ~C\Q-O This declarations Page/Amended Declaration page with the pol icy jacket identified by the form and edition (fate indlcatea cot1ll1ld'tes the above numbered po Ii cy. Previous pol icy no. Form 6908 Ed. 1188 DECLARA T IONS NAMED INSURED COASTAL ELECTRIC INC RT 1 BOX 834 STE B BIG PINE KEY FL 33043 PAGE 2 OF 4 A G E N T ISAKSEN INS INC PO BOX 431923 BIG PINE KEY Policy period 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED I NSURED AS STATED HERE I N FROM JUl 11, 1995 TO JUl 11, 1996 FL 33043 progre.oi/e companier 1-800-444-4487 CA-27492 PROGRESSIVE AMERICAN INS. CO. P.O. BOX 94739, CLEVELAND, OHIO 44101 The insurance afforded is only with respect to such and so many of the following coverages as are indicated with respect to each described vehicle. The limit of the company's liability against each such coverage shall be as stated herein, subject to all the terms of this policy having reference thereto. SCHEDULE OF DR IVERS DVR NO DRIVER NAME 01-01 ROBERT 02-02 MELANIE R NORMAND NORMAND liCENSE # N655770572660 N655556597640 VIOl/ACC SR22 STA DOB ABC D MSC REQ TUS 07/26/57 0 0 0 0 00 N M 07/24/59 0 0 0 0 00 N M Any loss under parlt I I is payable as interest may appear to named insured and above loss payee: pro'4 Premium BultJ;,t: Fin. Resp. FilCd3 AEO 9520{ rhCC)'AS 10.0 CA I CS 11 ease No: R.Q79 %Factor Used: Counters i gned: By Author i zed Representat i ve 111 3 (5-88) CVFl00101287Lll13.A2 PLEA&~ READ. YOUR POLICY . . .... . POLICY NU~~ERCA Q-41-'9-~"Q-O This d~clar~.tlons Page/Amended Declaration page with the policy Jacket Identified by the form and edition (late mdlcatea col'fl~ttes the . ab6ve nU":lbered poJ icy. Prev i ous po Ii cy no. Form 6908 Ed. 1188 DECLARATIONS NAMED INSURED COASTAL ELECTRIC INC RT 1 BOX 834 STE B BIG PINE KEY FL 33043 PAGE 3 OF 4 A G E N T Policy period 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED I NSURED AS STATED HERE I N FROM JUL 11, 1995 TO JUL 11, 1996 ISAKSEN INS INC PO BOX 431923 BIG PINE KEY FL 33043 proJIIP.ui/e companier 1-800-444-4487 CA-27492 PROGRESSIVE AMERICAN INS. CO. P.O. BOX 94739, CLEVELAND, OHIO 44101 The insurance afforded is only with respect to such and so many of the following coverages as are indicated with respect to each described vehicle. The limit of the company1s liability against each such coverage shall be as stated hereinl subject to all the terms of this policy having reference thereto. SCHEDULE OF COVERED VEH I CLES VEH NO 1-01 DR TRADE NO YR NAME 95 FORD BODY TYPE FLATBED SERIAL NO lFDLE47F4SEA18693 DVR VEH TER RAD DSC DSC SCH CLS NO ZIP IUS COD PCT 5 C03 96 33043 100 824 5 VEH NO BI/PD $1,246 MED PAY LIABILITY PREMIUM BY VEHICLE RENT REIN UM/UIM PIP $38 $308 $44 PHYSICAL DAMAGE PREMIUM BY VEHICLE $500 PREM $323 COLLISION OED PREM ON-HOOK LIMIT OED PREM VEH TOTAL $2,693 VEH COMP OR FT/CAC NO TYPE OED 1 COMP $500 $734 I I I CT Any loss under Part is ea--raqJe as interest may ap'pear to named insured and above loss payee: 0l1r9b Premium Budget: Fin. Resp. Fil&J AEO 9'f!olqyh~.Q;AS 1 u. 0 CA I CS 11 ((;ase No: R/R %Factor Used: Counters i gned: By Author i zed Representat ive 111 3 (5-88) CVFL00101287Lll13.A3 PL~ASE READ YOUR POLICY POLICY NUMBERCA 0-41-'9- ~c;Q-O This declarations Page/Amended Declaration page with the pol icy jacket identified by the form and edition aate indlcatea corrlp'llftes the above numbered pol icy. . Previous policy no. Form 6908 Ed. 1188 DECLARA T IONS NAMED INSURED COASTAL ELECTRIC INC RT 1 BOX 834 STE B BIG PINE KEY FL 33043 PAGE 4 OF 4 A G E N T ISAKSEN INS INC PO BOX 431923 BIG PINE KEY Policy period 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED I NSURED AS STATED HERE I N FROM JUL 11, 1995 TO JUL 11, 1996 FL 33043 prO!lreuw compilnier 1-800-444-4487 CA-27492 PROGRESSIVE AMERICAN INS. CO. P.O. BOX 94739, CLEVELAND, OHIO 44101 The insurance afforded is only with respect to such and so many of the following coverages as are indicated with respect to each described vehicle. The limit of the company's liability against each such coverage shall be as stated herein, subject to all the terms of this policy having reference thereto. LOS SPA Y E E VEH NO NAME 1 TIB BANK OF THE KEYS ADDRESS PO BOX 190] CITY/STATE BIG PINE KEY ZIP CODE FL 33043 LOSS PAYABLE CLAUSE - FORM 1602 (10-8]) WE AGREE WITH YOU TO CHANGE YOUR POLICY AS FOLLOWS: 1. WE WILL PAY THE LOSS PAYEE NAMED IN THE POLICY FOR LOSS TO YOUR INSURED AUTO, AS THE INTEREST OF THE LOSS PAYEE MAY APPEAR. 2. THE INSURANCE COVERS THE INTEREST OF THE LOSS PAYEE UNLESS THE LOSS RESULTS FROM FRAUDULENT ACTS OR OMISSIONS ON YOUR PART. 3. CANCELLATION ENDS THIS AGREEMENT AS TO THE LOSS PAYEE1S INTEREST. IF WE CANCEL THE POLICY WE WILL MAIL YOU AND THE LOSS PAYEE THE SAME ADVANCE NOTICE. 4. IF WE MAKE ANY PAYMENT TO THE LOSS PAYEE, WE WILL OBTAIN HIS RIGHTS AGAINST ANY OTHER PARTY. Any loss under parlt I I is payable as interest may appear to named insured and above loss payee: pro'l. Premium BultJ;,t: Fin. Resp. Fil~3 AEO 9520{ 6'hCCl'AS 10.0 CA I CS 11 ease No: R~79 %Factor Used: Counters i gned: By Author i zed Representat ive 1113 (5-88) CVFL00101287Lll13.A4 . . prollre.D7/e companle.r ADDITIONAL INSURED The person or organization named below is a person insured with respect to such liability coverage as is afforded by the policy but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this agreement will be excess insurance over any other valid and collectible insurance. NAME OF PERSON OR ORGANIZATION: MOMROE CO 5100 COLLEGE RD KEY WEST FL 33040 All other parts of this policy remain unchanged. This endorsement changes Policy No.: 0 - 4129359 - 0 Issued to (Name of Insured): COASTAL ELECTRIC INC Endorsement Effective: 07/11/95 Expiration: 07 /11/96 Form No. 1 198 (8-93) CVFL0624940043L 1 1980 11 /ItOgre.rrVe compsnier . .. DATE OF NOTICE 08/21/95 ISSUED BY PROGRESSIVE AMERICAN INSURANCE CO. **** NOTICE OF REINSTATEMENT **** L LIENHOLDER ~ MONROE COUNTY S 5100 COLLEGE RD P KEY WEST FL 33040 A Y E E THE INSURANCE POLICY LISTED BELOW WHICH WAS CANCELLED IS NOW REINSTATED AS OF THE DATE SHOWN. --_._---_._..;::;~~..'""-'--.. ~'" ROBERT & MELANIE NORMAND RR 1 BOX 834-B BIG PINE KEY FL 33043 E D POLICY NUMBER r INCEPTION DATE CA 04210522-0107/11/95 .~ REINSTATEMENT WILL TAKE EFFECT 08/17/95 12:01 A.M. I PREMIUM DUE $0.00 THANK YOU FOR YOUR PAYMENT. YOUR CANCELLATION DID NOT TAKE EFFECT AS INDICATED IN A PREVIOUS NOTICE. ********************************************************************* YOUR NEXT PAYMENT WILL BE $90.12. YOU WILL RECEIVE A BILL IN THE NEAR FUTURE. ISAKSEN INS INC PO BOX 431923 ~ BIG PINE KEY FL 33043 E N T ADDITIONAL INTEREST COASTAL ELECTRIC RR 1 BOX 834 B BIG PINE KEY FL 33043 6167 (5-88) LIENHOLDER'S COpy CVFLOl1488L6167L1 CORCV 02 EZ RBD910 95231 C3AE1 Received Risk Mgmt. & Loss Control t-z r -'1)- Z;tJ DATE INITIAL PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Isaksen Insurance Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P · o. Box 431 923 Received ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Big Pine Key, FL 33043 Risk Mgmt. & Loss .-9ncrol COMPANIES AFFORDING COVERAGE_____u__m INSURED ---~----------- :~~:l ~--1-::3:::------~=-~! r ~:~i ~~____._~___________.__.__ Coastal Electric Service, Inc. B R t 5 Box 834 Sui t e B COMPANY Big Pine Key, FL 33043 c COMOANY-/ 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. ~XCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. n__ __ .__. j CO TYPE OF INSURANCE i POLICY NUMBER II POLICY EFFECTIVE I POLICY EXPIRATION I LIMITS I L TR DATE (MMlDDIYY) I DATE (MMlDDIYY) I i GE~ERAL LIABILITY i COMMERCIAL GENERAL LIABILITY Diu I ! CLAIMS MADE n OCCUR -----J OWNER'S & CONTRACTOR'S PROT 1 GENERAL AGGREGATE $ r- ~RO~UCT~~OMP/OP_~_____________ , PERSONAL & ADV INJURY $ I EACH OCCURRENCE $ r-------------~----------------- !I RE E~~~~~~~~~~Ei__~ !_________________ , MED EXP (Anyone person) $ , AUTOMOBILE LIABILITY '------, A i ANY AUTO ALL OWNED AUTOS ---1 X I SCHEDULED AUTOS ----l HIRED AUTOS NON-OWNED AUTOS i COMBINED SINGLE LIMIT $ 4210-522-0 7/11/95 7/11/96 I ,------------------------------------- --- ----,- ----------------------- ------1 : BODILY INJURY I ! (Per person) $ 50 000 I ;C--- -------------- ------------------r---~----______________ . BODILY INJURY (Per accident) . $ 100 000 I --------------u---------__-t-_________~-__________ -I ! $25 I PROPERTY DAMAGE ANY AUTO BY_ ~~UTO ONLY - EA A9CIDENT i OTHER THAN AUTO ONLY: . .........,.. .". ....-,...,..-..., ....." '--" . . . . . . . . . . . . . . . . , . , . . , . . . . . , . , . , . . . . . . , . , . .. ... ........',....... ., ". .- ,.. ... . .. ......- . .,.. " . ........ ......., ... ......- ,.. ..... ..-..-,.. ..... ..... ,.. '.,... ...,. .., ... '.. """ ....................~.....~"'.. GARAGE LIABILITY L-_, (>::,::::::.:: I' - DATt _______________~~CH ~C~IDENT J~------______________ _ __ __~ AGGREGATE : $ I ~~~CH OC9}~RE~~________~______________________ 1 AG~EGA TE ____________ ---!-----------------J $ I _-1T~~~I~JNs L__IOl~- r:.J]:;:/i>:i/,<U/;'.U':iY,UIljALJ EL EACH ACCIDENT . $ . i-------------_______t-______________________ --- ---1 i :~ ~:::::: : :~~~:~~~~;----------I , EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY \VA!VER: THE PROPRIETOR! PARTNERS/EXECUTIVE OFFICERS ARE: OTHER 1--- ~!INCL : 1 EXCL DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS Certificate Holder is also an additional insured 1990 Olds Trofeo vin#05245 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Mon roe Co un t y EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Risk Man a g erne n t De pt. l.O..- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, S 1 00 C 0 11 e g e R 0 a d BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Key West, FL 33040 ITS :AGENTS OR REPRESENTATIVES. I i I ~NSURED I I WA~~C~O~~R~D~~'~I~~lql~I~~..IU~~~I~~.I~~.~ll~llil\.??~llil~1I9MI~10MII~.W~I~.~wrm.WG~q~~~;;~~~W ~m0~~>>>>>>>>0.>>>>>>~>>~~~~~.~~~~~,~~~~~~r;~1 II PRODUCER 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. --------- COMPANIES AFFORDIf'fg~Q'!ER~GILu_u___._ I COMPANY -- - I A __!!: 0 g r ess ~.~~.-.-~u-_____~__u___ ___u u~ COMPANY I B I MONROI COUN1y __________~ COMCANY CONITRUCT~ MANAQ~) I 11...1111' _ - J -9 - ____un _I, COMPANY .. , I -_ I( c:. - "" D ,_~ ; uUTHisulSuTOCERTIFYTHATTHEPOLICiESOFulNSURANCELisTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD i INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS i 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 CLAI~S: ----------------------------1 I I I Isaksen Insurance Inc. P . O. Box 43 1 9 2 3 ", Big Pine Key, Fll 33043 Coastal Electric Service Inc. Rt 5 Box 834 Suite B Big Pine Key, FL 33043 CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE I POLICY EXPIRATION DATE (MMlDDIVY) DATE (MMlDDIVY) LIMITS GENERAL LIABILITY i COMMERCIAL GENERAL LIABILITY V\./01 i CLAIMS MADE I -1 OCCUR ~~ L-_, OWNER'S & CONTRACTOR'S PROT A ~OMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS ~ SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS 4129-359-0 7/11/95 7/11/96 GENERAL AGGREGATE ~-----------------i PRODUCTS - COM PlOP AGG i $ I PERSONAL & ADV INJURY ";-------:~:=J EACH OCCURRENCE . $ ! FIRE DAMAGE (Anyone fire)--r;-------- -----------, ----------------------------1 MED EXP (Anyone person) i $ ! i COMBINED SINGLE LIMIT $ 1 , 000 , 000 I -~-~._._------------_._._------_._-----~~----_._- BODIL Y INJURY $1 I. (Per person) I ----.------------.~------------------1 BODILY INJURY I (Per accident) $ I -------------------------------- --------1 I I PROPERTY DAMAGE $ DATl ~~UTO ONLY - ~~~~IDE~!..__~~~~.~~J ~ ~r==E: -!~~~~!~C~~*~T~;;~_;;;_~;;;;.:~~;=l AGGREGATE $ I ~~~ OC9:lB~~~_g_~_________~-~-_____ ------ --- ------f AGGREGATE $ ! ,-.----____n_____. ----------------;------------------. -- - ---.-.. i GARAGE LIABILITY ANY AUTO BY_ ~ EX~.ESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY \Af~, !\lER: THE PROPRIETOR! P ARTNERS/EXECUTIVE OFFICERS ARE: OTHER [--I I WC STATU- 10TH- ,:.::::;:::>/:<:::::::::::::.::'>::::-: . i TORY LIMITS' .1~l:>:::2:.i::::::>_L~L.2L~L_ : EL EACJi~CIDE!i"!:_____h'____~____h___________u_ ! ._EL DISEASE ~~OLl~~~'I__~______u______ EL DISEASE - EA EMPLOYEE $ ! i INCL ~-l EXCL DESCRIPTION OF OPERA TIONSlLOCA TIONSNEHICLESlSPECIAL ITEMS Certificate Holder is also an additional insured 1995 Ford E450 Bucket Truck vin #18693 :....lIIIII:~:::li;:~:::::::i:itt:~mi;:!::i@it:~:::;;i::Jt::i::mi::mi:im:::W:i:i:ili:::::::@;::n::ti;:i::;:m::m:@m::~;m:r~~_:::i::::i:::I:m:;:i:::m:;::::::ii~::m:i::i:mii~i:i:i:;!::~t::I:m::::i:::::i::I::i::~!i~:i:I::m;I:::n::i:;:::~:~::::!~::::~:::::::::::::::::::::::~::::::::~:::::t::::: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL -1Q. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO AIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY progreoVe companier Received Risk Mgrrlt. & Loss Control /-- q- clv 2;;~,/ ~: (}-^r'-./'v~~ DATE OF NOTICE DATE INITIAL 01/02/96 ISSUED BY PROGRESSIVE AMERICAN INSURANCE CO. **** NOTICE OF REINSTATEMENT **** A ADDITIONAL INTEREST D MONROE CO ~ 5100 COLLEGE RD I KEY WEST FL 33040 N T THE INSURANCE POLICY LISTED BELOW WHICH WAS CANCELLED IS NOW REINSTATED AS OF THE DATE SHOWN. ~ COASTAL ELECTRIC INC S RT 1 BOX 834 STE B ~ BIG PINE KEY FL 33043 E D POLICY NUMBER I INCEPTION DATE CA 04129359-0 07/11/95 I REINSTATEMENT WILL TAKE EFFECT 01/11/96 12:01 A.M. I PREMIUM DUE so.oo THANK YOU FOR YOUR PAYMENT. YOUR CANCELLATION DID NOT TAKE EFFECT AS INDICATED IN A PREVIOUS NOTICE. ********************************************************************* YOUR NEXT PAYMENT WILL BE $185.90. YOU WILL RECEIVE A BILL IN THE NEAR FUTURE. ISAKSEN INS INC A PO BOX 431923 G BIG PINE KEY FL 33043 E N T LIENHOLDER TIB BANK OF THE KEYS PO BOX 1907 BIG PINE KEY FL 33043 6167 (5-88) ADDITIONAL INTEREST'S COpy CVFLOl1488L6167AI CORCV 02 EZ RBD910 9600 1 C3 Cc ' 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. _~___ ________________. COMPANIES AFFORDING__~ct'le~~G_~_____ PRODUCER Isaksen Insurance, P. O. Box 431923 Big Pine Key, FL. Inc. 33043 Inc. e Ins. Co. INSURED Coastal Electric Service, Rt. 1, Box 834, Suite B Big Pine Key, FL. 33043 ssive COMPANY D I 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. fT~-T TYPE OF INSURANCE POLICY NUMBER I Pgi~i~::;g~~~ I~~~:(~=~N r -------~-----LIM:- --------- GENERAL LIABILITY A. X I COMMERCIAL GENERAL LIABILITY L.-~ CLAIMS MADE l X J OCCUR ~_____. OWNER'S & CONTRACTOR'S PROT CL19100307 7/31/95 I 7/31/96 ~ENERAL A~GREGATE ----J-L! ' 000 , 000 ___I '_" PRO, DUCTS - COMP/OP ~GG -'-_ I", LL_ 0 0 0 ~ 0 0 Q11 . PERSONAL & ADV INJURY : $ 1 , 000 , 000 : EA~H OCCURRENCE --------~-~--:-o50- I-------~---+---~-- '- '1 ! FIRE DAMAGE (Any one fir~LL_____2_~LQQQ__ I MED EXP (Anyone person) . $ i : COMBINED SINGLE LIMIT $ 1 , 000 , 000 I B;~I~~ INJU~~------~- -:---~----.------I (Per person) , ~~-------~-------'---------------l I BODILY INJURYl j I (Per accident) $ , ~-------------_.,---_._._------_._---! ! I PROPERTY DAMAGE $ AUTOMOBILE LIABILITY , ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS CA04129359-0 7/11/95 '7/11/96 GARAGE LIABILITY ANY AUTO BY AUTO ONLY - EA ACCIDENT $ UMBRELLA FORM I OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY V'f\.lVF.R: l .:::.:.:::::.:.::.:.....?:.....::......:...........::.:...:.-.1 ,-OTI-!~!~~~ AUTO ONLY: " .. '::":"._~":':':''':.:...! ~__._~________EAC~_~CC!Q~_._$____.______~_________ _ --------1 AGGREGATE $ ! _EACH O~~RR~!'J.-9_~__.________~___________ __ ____ __________J -,~QQ REGA T~___~___________~_________________ _____ __ __; .---1I~~L__flit~821fE22Jj2i..j.:J__1 EL EACH ACCIDENT $ i -----..----------------------------....-- - - u_ ----.1 EL DISEASE - ~9gCY L1~____!__________'________ _ _ ---r EL DISEASE - EA EMPLOYEE $ THE PROPRIETOR! PARTNERS/EXECUTIVE OFFICERS ARE: OTHER i .INCL ~----~ I EXCL DESCRIPTION OF OPERA TIONSlLOCA TIONSNEHICLESJ8PECIAL ITEMS ~~ftl~~~a[grftora~~ ~Mc~i~oT~Mcid~i~fo~~~91nsured Electrical repair & installation abd traffuc signal installation : :! SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ~ Monroe County Risk Management 5100 College Road Key West, Florida 33040 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL --1.0- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH OTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON T AUTHORIZED REPRESENTAT J! .:-.,'.:-:.:~:~::~::I~::t:::::::~:::::::::::~::::::::::~:::J::::~,::ii:i~:I:~l~iI:~:i::j::::~:~:~::::i::~i:::~:~::i:;::::J:::l':RBI:~_:i.i CERTIFICATE OF INSURANCE: COAST-1 PROOUCER The Johnsons Insurance Agency 13361 Overseas Highway Marathon FL 33050 305-289-0213 CSR SG 05 10 96 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. -----------------------------.-.------------------------------.---- ------------------------------------------------------------- COMPANIES AFFORDING COVERAGE COMPANY A FCC I vVt L(f1,( Jl t", INSURED ------------------------------------------------------------------- Coastal Electric Service 1 Box 834 Ste B Big pine Key FL 33043-9533 COMPANY B Rece i\red ----------------------1i,lsK-~~1fll~~-ttr~~t:~ni.ttM---------------- -~~:_------------~!:~~:~--~:~~~~~~:_-----------_. COMPANY 1l\1 11'1 A I. __..~._.:..,~~~__..___'"__._,...,__. D > COVERAGES <.=......=...........===:=.:.:=.==:.=================.=..=...=...====.=..............=..........................==..: 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. --------------------------------------------------------------------------------------------------------------------------------- CO LTR TYPE OF INSURANCE POL I CY NUMBER POLICY EFF POliCY EXP DATE (MM/DD/YY) DATE(MM/DD/YY) LIMITS ------------------------------- --------------------------- --------------- -------------- ---------------------------------- GENERAL LIABILITY [ ] COMMERCIAL GEN LIABILITY [ ] CLAIMS MADE [ ] OCC. ] OWNERS.S & CONTRACTOR.S PROTECTIVE ] ] GENERAL AGGREGATE PROD-COMP/OP AGG. PERS. & ADV. INJURY EACH OCCURRENCE FIRE DAMAGE (ANY ONE FIRE) MED. EXPENSE (ANY ONE PERSON) AUTOMOBILE LIABILITY [ ] ANY AUTO [ ] ALL OWNED AUTOS [ ] SCHEDULED AUTOS [ ] HIRED AUTOS [ ] NON-OWNED AUTOS [ ] [ ] ()~ Ie, ~K-. COMB. SINGLE LIMIT BOOILY INJURY (PER PERSON) "R ~ / .~, YES BODILY INJURY (PER ACCIDENT) PROPERTY DAMAGE ------------------------------- --------------------------- --------------- -------------- ------------------- -------------- GARAGE LIABILITY [ ] ANY AUTO [ ] [ ] AUTO ONLY (EA ACC) OTHER / AUTO ONLY: EACH ACCIDENT AGGREGATE ------------------------------- --------------------------- --------------- -------------- ------------------- -------------- EXCESS LIABILITY [ ] UMBRELLA FORM [ ] OTHER THAN UMBRELLA FORM EACH OCCURRENCE AGGREGATE ------------------------------- --------------------------- --------------- -------------- ------------------- -------------- WORKERS COMP. AND EMP. L lAB. THE PROPRIETOR/PARTNERS/ A EXECUTIVE OFFICERS ARE: 001WC96A10262 --~--~-~~~~:_-~-~~~~:_------ --------------------------- OTHER )STATUTORY LIMITS EACH ACCIDENT 1000000 01/01/96 01/01/97 DISEASE-POl. LIMIT 1000000 DISEASE-EACH EMP. 1000000 -DESCRIPTIQN OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS---------------------------------------------------------------------- Electr1cal Contractor /traffic signal maintainance onroe County Risk Management ey Bahleda 5100 College Road ey West FL 33040 > CERTIFICATE HOLDER <.=.===============:==========:======> CANCELLATION <===.=====.....===..====.=...=====.====...=======:====== MONCO-3 SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEfORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1 0 DAYS WI I TTEN NOT I CE TO THE CERT I FICA TE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMB Y,ITS AGENTS REPRESENTATIVES. _ACORD 25-S (3/93) ~c: ~ ;;('~ ,1tu.:b AUTHORIZED REPRESENTATIVE William Danaher Insurance COmptlfU THIS CERTIFICATE IS ISSUED AS A MATTEr C INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED "Y THE POLICIES BELOW. tv~ PRODUCER 646 The Johnsons Insurance Agency PO Box 522346 Marathon Shores FL 33052-2346 ATTENTION CERTIFICATE HOLDER. If you have any questions, please contact GERT MILLER 1-800-226-3224, 260 1 Cattlemen Road, Sa~asota, FI 34232-6249 COMPANIES AFFORDING COVERAGE COASTAL ELECTRIC SERVICE INC 127 INDUSTRIAL ROAD UNIT 3 BIG PINE KEY FL 33043-9533 Company Letter A Company Letter B: GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCURRENCE OWNERS. CONTRACTORS PROTECTIVE APPROVFD ov RICV ~ ~ ~-.' ~r,Cf\K~JTI . "p "'1\\"'~\'1" _.', / BY GENERAL AGGREGATE $ AGGREGATE THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, T~ INSURANCE AFfORDED BY THE POLICIES DeSCRIBED HEREiN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES. CO l T TYPE I N INSURANCE POL I CY NUMBER POLICY POLICY EFFECTIVE EXPIRATION oA TE (MM/DD/YY) DATE (MM/DD/YY) ALL L I M I TS I N THOUSANDS DATE C>~ 1(;;, PRODUCTS-COMP/OPS AGGREGATE $ C'-~!:-- PERSONAL & ADVERTISING INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (ANY ONE FIRE) $ MEDICAL EXPENSE ~'E~YS8NNE $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY \V'\ 1 \1 F. R: CSL $ BODIL Y INJURY (PER PERSON) BODIL Y INJURY ~E~IDENT) $ $ lnsurtlllCC Compon!l PROPERTY DAMAGE $ EACH OCCURRENCE OTHER THAN UMBRelLA FORM $ $ WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY OOl-WC96A-I0262 01/01/96 01/01/97 (EACH ACCIDENT) (DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE) OTHER DESCRIPTION OF OPERA TIONS/LOCA TlONS/VEHICLES/RESTRICTIONS/SPECIAl ITEMS MONROE COUNTY RISK MGMT ATTN: KAY BAHLEDA 5100 COLLEGE RD KEY WEST FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO SEND 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABIL- ITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVE. c c ' elJ(;I^If::::~1 .~ Le{O (L;- ~~v>./ PLEASE READ YOUR POLICY POLICY NUMBER CA 0-4 1- '9- ~';;Q-1 This declar~tions Page/Amended Declaration page with the pol icy jacket identified by the form and edition date indicated col'fl,s1ites the above r.umbe, ~d po Ii cy. 1 1 94 ' Previous policy no. Form 1050 Ed. DECLARATIONS NAMED INSURED COASTAL ELECTRIC INC 127 INDUSTRIAL RD 3 BIG PINE KEY FL 33043 PAGE 1 OF 3 ~ ISAKSEN INS INC E PO BOX 431923 ~ BIG PINE KEY FL 33043 progref.li/e companier Policy period 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED I NSURED AS STATED HERE I N FROM JUL 11, 1996 TO JUL 11, 1997 flecelveci CA-27492 PROGRESSIVE AMERICAN INS. CO. P.O. BOX 94739, CLEVELAND, OHIO 44101 ......__.z=~;:=:_ 9~ n~:frlA.L . . ~J-,..~-,.~.... 1-800-444=44a-7''''- -. The insurance afforded is only with respect to such and so many of the following coverages as are indicated with respect to each described vehicle. The I imit of the company's I iabi I ity against each such coverage shall be as stated herein, subject to all the terms of this pol icy having reference thereto. SCHEDULE OF COVERAGES AND L I M I TS OF L I AB I L I TY COVERAGES A SINGLE LIMIT BODILY INJURY AND PROPERTY DAMAGE LIABILITY $1,000,000 EACH ACC C MEDICAL PAYMENTS $ 2,000 EACH ACCIDENT D COMPOR FTCAC STATED AMT SEE SCHEDULE OF COVERED VEH FOR DED E COLLISION OR UPSET-STD AMT SEE SCHEDULE OF COVERED VEH FOR DED I UNINSURED MOTORIST BI $l,OOO,OOO/PERS. 1,000,000 IACC. (NON-STACKED) BASIC PERSONAL INJURY PROTECTION $10,000 LIMIT/PERS. LESS NO DED. PER PERSON FOR NAMED INSURED AND DEPENDENT RELATIVES FULL TERM PREMIUM CHARGES $768 $21 ~203 433 332 $40 WITH WORKERS COMP APPROVED BY RISK M~ BY~~' ~~K GATE. g---.5~/t ~/~ '. ~ I , .. TO' J.J. !,~ ___ ~. V r ~ FILING FEES TOTAL POLICY PREMIUM $25.00 $1,822.00 ATTACHMENT IDENTIFIED BY FORM NUMBER 1198 (08-93) 6865 (06-95) 1602 (08-83) 1652 (06-95) 2029 (05-94) 2068 (06-95) DRIVERS PAGE LOSS PAYEE PAGE 2 3 , COVERED VEH PAGE 3 PUC-N OTH-N Any loss under parlt I I is payable as interest may appear to named insured and above loss payee: prolJ.. Premium BU~t: Fin. Resp. Fil~3 146 96i~9whX~:XX 8.0 CA I CS 11 ease No: R,Q79~ %Factor Used: Counters i gned: cc · € ~ ~ADDITIONAL INTEREST COpy 1 11 3 (5 - 88) PLEASE READ YOUR POLICY POLICY NUMBERCA 0-41-'9-~'iQ-1 This declarations Page/Amended Declaration page with the policy jacket identified by the form and edition elate indlcatea cor1i~ttes the above numbered policy. 1194 Previous policy no. Form 1050 Ed. DECLARA T IONS NAMED INSURED COASTAL ELECTRIC INC 127 INDUSTRIAL RD 3 BIG PINE KEY FL 33043 PAGE 2 OF 3 A G E N T Policy period 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED I NSURED AS STATED HERE I N FROM JUL 11, 1996 TO JUL 11, 1997 FL 33043 progre.oi/e companier ISAKSEN INS INC PO BOX 431923 BIG PINE KEY CA-27492 PROGRESSIVE AMERICAN INS. CO. P.O. BOX 94739, CLEVELAND, OHIO 44101 1-800-444-4487 The insurance afforded is only with respect to such and so many of the following coverages as are indicated with respect to each described vehicle. The limit of the company's liability against each such coverage shall be as stated herein, subject to all the terms of this policy having reference thereto. SCHEDULE OF DR IVERS DVR NO DRIVER NAME 01-01 ROBERT 02-02 MELANIE R NORMAND NORMAND LICENSE # N655770572660 N655556597640 VIOL/ACC SR22 STA DOB ABC D MSC REQ TUS 07/26/57 0 0 0 0 00 N M 07/24/59 0 0 0 0 00 N M Any loss under parlt I I is payable as interest may appear to named insured and above loss payee: ProQ.. Premium Bu~At: Fin. Resp. Fil~3 146 961~9hX)(:XX 8.0 CA I CS 11 ease No: R.Q79, %Factor Used: Counters i gned: By Authorized Representative 111 3 (5-88) CVFL00101287Lll13.A2 PLEASE READ YOUR POLICY POLICY NUMBERCA 0-41-'9-~t:;Q-1 This declar.iltions Page/Amended Declaration page with the policy jacket identified by the form and edition date indlcatea corflrs'!{tes the abo~e numbe~ed policy. 1194 -- Previous policy no. Form 1050 Ed. DeCLARA T IONS NAMED INSURED COASTAL ELECTRIC INC 127 INDUSTRIAL RD 3 BIG PINE KEY FL 33043 PAGE 3 OF 3 FL 33043 progreDi/ecompanier A G E N T ISAKSEN INS INC PO BOX 431923 BIG PINE KEY Policy period 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED I NSURED AS STATED HERE I N FROM JUL 11, 1996 TO JUL 11, 1997 CA-27492 PROGRESSIVE AMERICAN INS. CO. P.O. BOX 94739, CLEVELAND, OHIO 44101 1-800-444-4487 The insurance afforded is only with respect to such and so many of the following coverages as are indicated with respect to each described vehicle. The limit of the company's liability against each such coverage shall be as stated herein, subject to all the terms of this policy having reference thereto. SCHEDULE OF COVERED VEH I CLES VEH NO 1-01 DR TRADE NO YR NAME 95 FORD BODY TYPE FLATBED SERIAL NO 1FDLE47F4SEA18693 DVR VEH TER RAD DSC DSC SCH CLS NO ZIP IUS COD PCT 5 C03 96 33043 100 781 40 LIABILITY PREMIUM BY VEHICLE VEH NO BI/PD $768 MED PAY $21 UM/UIM $332 PIP $40 PHYSICAL DAMAGE PREMIUM BY VEHICLE VEH COMP OR FT/CAC NO TYPE OED 1 COMP $500 PREM $203 COLLISION OED PREM ON-HOOK LIMIT OED PREM VEH TOTAL $1,797 $500 $433 I I I c8 Any loss under Part 46 is palable as interest may aJWear to named insured and above loss payee: 0f1r9i Premium Budget: Fin. Resp. Fil&J 1 9bflJ;l9v~~:><X o. 0 CA I CS 11 CCase No: RIR %Factor Used: Counters i gned: By Authorized Representative 111 3 (5-88) CVFL00101287Lll13.A3 . . progreDl/e companle.r ADDITIONAL INSURED The person or organization named below is a person insured with respect to such liability coverage as is afforded by the policy but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this agreement will be excess insurance over any other valid and collectible insurance. NAME OF PERSON OR ORGANIZATION: MOMROE CO 5100 COLLEGE RD KEY WEST FL 33040 All other parts of this policy remain unchanged. This endorsement changes Policy No.: 0 - 4129359 - 1 Issued to (Name of Insured): COASTAL ELECTRIC INC Endorsement Effective: 07/11/96 Expiration: 07/11/97 Form No. 1 198 (8-93) CVFL0624940043L1198011 DATE (ll1IIDD1YY) 08/01/96 THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMAnON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A General Agents Insurance CO. COMPANY B CERTIFICATE OF LIABILITY INSURANCE PRODUCER Isaksen Insurance Inc 30233 Overseas Highway P.O. Box 431923 Big Pine Key, (305) 872-0097 INSURED FL 33043- Coastal Electric Rt 1 Box 834 Suite B COMPANY c Big Pine Key FL 33043- COMPANY (305) 872-4568 0 COVERAGES THIS IS TO CERTIFY THAT THE POUCIES 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONomONS OF SUCH POUCIES UMlTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS CANCELLATION SHOULD ANY OF tHE ABOVE DESCAI8ED POLICIES BE CAIICELLED BEFORE 11tE EXPIRA110N DATE lHEREOF, THE ISSUING COMPANY WILL EllDEAVOR TO MAIL ...lL. DAYS WRI1TEIt 1I011CE 10 THE CERnFlCATE HOLDER tIAIIED TO THE LEFT, BUT FAlWRE TO MAIL SUCH NOncE SHALL IMPOSE NO OBUGA11ON OR UABlUlY OF ANY KIND UPOtI 1HE COMPANY, ITS A8Efn'S OR REPRESENTATIVES. ~ flEPRESEllTATIVE .{lL&Ol Q ~tfJL~L1t~ co LTR POLICY EFFEC11VE POLICY EXPIRA110II DATE (IIMJDDJVY) DATE (ll1IJDDJYY) TYPE OF INSURAIICE POLICY NUMBER GENERAL UABlUlY VO L COMMERCIAL GENERAL UABlUTY TBD CLAIMS MADE X OCCUR OWNER'S & CONTRACTOR'S PACT 07/31/96 07/31/97 AUTOIIOBILE UA8IU1Y ANY AUTO ALL OWNED AUTOS N SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS / / / / B..ece LV eo .H,.i~d{ & Loss f) AT 1: (-9-7(, -................ .. -."'------- -..---"'-....... -~. ....._~...."'" --......... ......-... '-- '" il-JITI,\i ~___ ~.lA -----L!!'.!'[...._ _.__.~,-._.._.. '_._"'.. ~,_ ._,..._. ....'.. -. ___.,.....~_~ . GARAGE UA8IU1Y ANY AUTO / I APPROVED BY R\SK MA}'~G[MFNT / I BY ~ ~~ O/e.I(;IC~k. Dfi.1E ?-/~?~ - / / \'{~l',1ER: NlA /' yrS ---- / / EXCESS UABlUTY UMBRELLA FORM OTHER THAN UMBAEUA FORM WORKERS COIIPENSATION AND EIIPLOYERS' UABlUTY 1l-fE PROPRIETORI INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL OTHER I I I / I I / I DE8CfIP1IOIII Of OPERAnortSJLOCATIOIISNEHICLES/SPECIA ITEIIS Traffic Signal Maintenance Certificate Holder is also an additional insured CERTIFICATE HOLDER Monroe County Attn: Risk Management 5100 College Road Key West FL 33040 (!C: UMITS GENERAL AGGREGATE $1000000 PRODUCTS COMPIOP AGG S 1000000 PERSONAL & ADV INJURY S 1000000 EACH OCCURRENCE $1000000 FIRE DAMAGE (Any one fire) $ 50000 MED EX? (Anyone person) $ 5000 COMBINED SINGLE UMIT $ BOOIL Y INJURY (per person) $ BODILY INJURY (per accident) $ PROPERlY DAMAGE $ AUTO ONLY EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ AOOREGA TE $ $ we STATU OTH TORY UMIlS ER EL EACH ACCIDENT $ EL DISEASE POLICY UMIT $ EL DISEASE EA EMPLOYEE $