Certificates of Insurance
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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 POUCES BELOW.
COMPANIES AFFORDING COVERAGE
PRODUCER
FRANK H FURMAN INC FOR
INTERNATIONAL RENTAL INS INC
POBOX 5090
SAN CLEMENTE
CA 92672
COMPANY
A
ST PAUL FIRE & MARINE INS
COAST LINE MARKING INC
COMPANY
B
INSURED
COMPANY
PO BOX 1745 C
JUPITER FL 33468 COMPANY
I D
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THIS IS TO CERnFY 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,
EXCWSIONS AND CONDmONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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TYPE OF "URANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRA110N
DATE (MIIIDDIYY) DAft (IIIIJDDIYY)
........
~
AUTQllOIILE UAIIIIJTY
~
1l ANY AUTO
ALL OWNED AUTOS
-
SCHEDULED AUTOS
-
X HIRED AUTOS
X NON'()WNED AUTOS
-
CK05504076
8/01/95
8/01/98
GENEAALAGGREGATE 82, 000, 000
P~D~.COMP~P~G.2,000,000
PERSONAL & ADV INJURY 81 , 0 0 0 , 0 0 0
EACH OCCURRENCE 81, 000, 000
FIRE DAMAGE (Any one") 8 1 0 0 , 0 0 0
MED EXP (Any one peIIOft)' 5 , 0 0 0
1,000,000
COMBINED SINGLE UMIT .
~
GENEIUL w.E:UTY CK 05504 07 6
~
X COMMERCIAL GENERAL UABIUTY
ppn CLAIMS MADE 00 OCCUR
OWNER'S & CONTRACTOR'S PROT
-
8/01/95
8/01/98
~
BODL Y INJURY
(Per person)
.
-
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BODILY INJURY
(Per accident)
.
PROPERTY DAMAGE
.
DCE88 UAIILITY
RUMBRELLA FOAM
OTHER THAN UMBRELLA FOAM
WORKERS COIIPEH8A11ON AND
EMPLOYERS' UAIILITY
nfE P~PRIETOAI R
PAR1NERSIEXECunvE
OFFICERS ARE: =-
011IER
APPROVED BY ~~SK N~GfMtNT
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DA1E - , - /" I I
WAIVER: NtA J-C"- YES - -
AUTO ONLY. EA ACCIDENT .
OntER ntAN AUTO ONLY:
EACH ACCIDENT .
AGGREGATE .
EACH OCCURRENCE .
AGGREGATE .
I
I STATUTORY UMITS
EACH ACCIDENT .
DISEASE. POLICY UMIT .
DISEASE EACH EMPLOYEE .
H><.>-
GARAGE UAIILITY
-
ANY AUTO
~
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DE8CRPI1ON OP OPDA'I'IONM.OCA1IOtIINEHICLE8ICIAL I1EII8
ATTN: DESIREE FAX: (305) 295-4321
MONROE COUNTY IS ADDITIONAL INSURED ON THE GENERAL LIABILITY ONLY
AND ONLY IN REGARDS TO THE INSURED'S OPERATIONS.
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SHOULD MY OF lIE ABOVE DESCRBED POLICES BE ~.....n BEFORE 1HE
EXPIRATION DATE 11EREOF, THE ISSUING COMPANY WU ENDEAVOR TO MAL
.l!l- DAYS WRITTEII NOTICE TO TIE CERTFlCAlE HOLDER NAIlED TO 1ItE LEFT,
BUT FALURE TO MAL SUCH NOTICE SHALL "POSE NO 0IILIGA1IOII OR uua.rrv
OF MY KIND UPON nE C~ANY, ITS. AGEN'1'8 OR. :nvE8.
AUTHORIZED REPRESENrA11VE ~:7/'-'CC7 t-~~
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5100 COLLEGE ROAD
KEY WEST, FL 33040
MONROE COUNTY
THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERfIFlCATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POUCES BELOW.
COMPANIES AFFORDING COVERAGE
PRODUCER
FRANK H F'URMAN INC
FRANK H FURMAN #266268604016
POBOX 1927
POMPANO BEACH
fL 33061
COMPANY
A
EMPLOYERS SELF INSURERS FUND
INSURED
COAST LINE MARKING INC
COMPANY
B
COMPANY
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 CONDmONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I
CO "
LTR ,
PO BOX 1745
JUPITER
COMPANY
C
FL 33468
TYPE OF INSURANCE
POUCY NUMBER
POUCY EFFEcnYE POUCY ~XPIRAnON
DATE (MMJDDIYY) DATE (IIIIJDDIYY)
LIMITS
~~NERAL UABILITY
: COMMERCIAL GENERAL LIABILITY
= =.J CLAIMS MADE D OCCUR
OWNER'S & CONTRACTOR"S PROT
-
-
GENERAL AGGREGATE S
PRODUCTS COMP/OP AGG S
PERSONAL. & AnY INJURY S
EACH OCCURRENCE S
FIRE DAMAGE (Any one fi..) S
MED EXP (Any one person) S
AUTOMOBILE UABILITY
_ ANY AUTO
~__ AU. OWNED AUTOS
~___ SCHEDULED AUTOS
lH__- J HIRED AUTOS
H NON-OWNED AUTOS
I
COMBINED SINGLE LIMIT
S
DATE
APP~~S~~NAGEMENT
BY ~-'- }~j'A^___
t {!If ~ 7 0
V
N/A ./ y~S
BODILY INJURY
(Per person)
S
BODILY INJURY
(Per accident)
S
W', !VEI
PROPERTY DAMAGE
S
~AGE UABIUTY
183017276
I
!
1/01i97
AUTO ONLY EA ACCIDENT S
OlliER lliAN AUTO ONLY:
EACH ACCIDENT S
AGGREGATE S
EACH OCCURRENCE S
AGGREGATE S
S
ANY AUTO
I
i
I
I
I
~
EXCESS UABLITY
RUMBREllA FORM
I OlliER THAN UMBRELLA FORM
A. I WORKERS COMPENSAnON AND
I EMPLOYERS' UABIUTY I
I lliE PROPRIETORl FJ-~. INCL i
" PARTNERs/EXECUTIVE
OFFICERS ARE: I EXCL I
I OTHER
I
1 / 0 1 i 98 X 1 STATUTORY LIMITS
EACH ACCIDENT S
DISEASE POLICY LIMIT .
DISEASE EACH EMPLOYEE S
500,000
500,000
500,000
i h, I it -7
o Cfi"
DESCRpnON OF OPEAAnONSILOCAnONSNEHlCLESlSPECIAL ITEMS
ATTN: DESIREE FAX: (305) 295-4321
MONROE COUNTY IS ADDITIONAL INSURED ON THE GENERAL LIABILITY ONLY
AND ONLY IN REGARDS TO THE INSURED'S OPERATIONS.
MONROE COUNTY
SHOULD ANY OF THE ABOVE DESCRIBED POUCES BE CANCELLED BEFORE THE
EXPlAAnON DATE ntEREOF, THE ISSUING COMPANY WI.L EJmEAVOR TO MAL
~ DAYS WRITTEN NOTICE TO THE CERTFlCATE HOLDER NAIlED TO TIE LEFT,
BUT FAILURE TO MAL SUCH NonCE SHALL IMPOSE NO OBUQAnoN OR UA8ILITY
OF ANY KINO UPON THE COMPANY, ITS AGENTS OR REPRESENTAnvES.
AUTHORIZED REPRESENTAnvE
5100 COLLEGE ROAD
KEY WEST, FL 33040
I
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