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Certificate of Insurance Aon Risk ServiCI:!s of Florida P.O. Box 019012 Miami, FL 33101..9012 A CORVbii::til?iil...jSll-it:i);s.er.ul iA.S..,.....Ulliuil..i.i:S..tsAN....\..jSe)irr)r.....r))<..,................... DATE (MM/DDfYY) ™ .......U~~Fl~.....~....~mi~..~'0......~.....m...............~....~,i......!.!9;!9!!.m).....~.5i.).ri<.........,....<.......... 3/02/99 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE PRODUCER 305-372-9950 INSURED COMPANY A NATIONAL UNION FIRE INS CO Conununity Asphalt Corp. 14005 NW 186th Street Hialeah, FL 33018 COMPANY B INSURANCE CO. STATE OF PA. COMPANY C LEXINGTON INS. CO. 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 REOUIREMENT, 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/DDfYY) DATE (MM/DDfYYI LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY 9330124 CLAIMS MADE ~J OCCUR SIR: $25000 EACH OCC. OWNER'S & CONTRACTOR'S PROT $100000 AGG. AFTER X Employee Benft. WHICH $10000 SIR APL 1000000/1000000 AUTOMOBILE LIABILITY A X ANY AUTO 8260098 ALL OWNED AUTOS SCHEDULED AUTOS COMPo & COLLISION X HIRED AUTOS X NON-OWNED AUTOS DEDUCTIBLE: $1,000 X Physical Dan~ 7/01/98 7/01/99 GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Anyone fire) MED EXP (Anyone person) 2000000 1000000 1000000 1000000 100000 10000 7/01/98 7/01/99 COMBINED SINGLE LIMIT 1000000 BODILY INJURY (Per person) BODILY INJURY (Per accident) coY PROPERTY DAMAGE GARAGE LIABILITY ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION ANI> EMPLOYERS' LIABILITY W~'\lFR: AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGA TE $ EACH OCCURRENCE AGGREGATE B 7081929 7/01/98 7/01/99 OTH- ER THE PROPRIETOR/ X PARTNERS/EXECUTIVE DFFICERS ARE: OTHER INCL EXCL EL DISEASE - POLICY LIMIT EL DISEASE - EA EMPLOYEE 1000000 1000000 1000000 C Contractors Equipment FloatE~r 8520742 7/01/98 7/01/99 Limit:$8,344,793 Ded:$5,000except. $25,000 Wind DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Re: Marathon Airpc.rt Resurfacing Taxiway and Hangar Access FAA AlP Proj:No 3-12-004-1 FDOT WF'I Project No. 6826793 PFC Application No.4 CAC#3810. The Monroe Board of Ce,unt Commissioners, its em 10 ees and officials are included as Additional p~nf@At~HQ~Q~~+~t:~~ppm@IIP9\lii9~~i'~#~!pj;Nq$1Q(TiQNI9r~#!9~"P.f!:~ipIU:: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Monroe County Board of County Commissioners 5100 College Road Key West, Fl 33040 O^TE 3 ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY F ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. INITIAL AUTH ZEDREPRESENT~ ~ #7:-- 012917000 .... .. ..-..........-......-.........................-...... .......-.._-...............................-.....'.............'.......................................,.. I$cISHifIElhiA(' ........~4(}i:JR~M .~~9'F~~<.. PRODUCER ..........:..,.......-:.-..-...........-:....,..'.....;.........-.;.....'.....:.....'..,...-:,..'..,..'..,..'..,..'-.-..........--.............-.....,..'.....'......... .....~iiINBEiji(Ui..<>.......................... :......~...............<.....:../.............../............................................. 7/17/98 HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NL AND CONFERS NO RIGHTS UPON THE CERTIFICATE OL ER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR L T THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE Aon Risk Services of Florida P.O.Box 019012 Miami, FL 33101-9012 305-372-9950 INSURED Community Asphalt Corp. 14005 NW 186th Street Hia1euh, FL 33018 DATE (MM/DD/YYI INSURANCE CO. STATE OF PA. INS CO COMPANY C LEXINGTON INS. CO. 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 OFANY 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 INSURANC[ GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ~J OCCUR OWNER'S & CONTRACTOR'S PROT X Employee Benft. 1000000/1000000 ~OMOBILE LIABILITY A I X I ANY AUTO ~---I ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X ' NON-OWNED AUTOS 'I ~ Physical DCUll,~ GARAGE LIABILITY ANY AUTO B EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION ANI) EMPLOYERS' LIABILITY THE PROPRIETORI PARTNERS/EXECUTIVE OFFICERS ARE: OTHER rxllNCL [b C Contractors Equipment F1oatE!r POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DDIYY) DATE IMM/DDIYYI LIMITS GENERAL AGGREGATE PRODUCTS - COM PlOP AGG $ PERSONAL & ADV INJURY EACH OCCURRENCE 2000000 1000000 1000000 1000000 100000 10000 9330124 SIR: $25000 EACH OCC. $100000 AGG. AFTER WHICH $10000 SIR APL XCD and Blanket Cant 7/01/98 7/01/99 FIRE DAMAGE (Anyone fire) MED EXP (Anyone person) COMBINED SINGLE LIMIT 1000000 BODILY INJURY (Per person) BODILY INJURY ,I (Per accident) I $ actual inc uded PROPERTY DAMAGE AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY. EACH ACCIDENT $ AGGREGA TE $ EACH OCCURRENCE AGGREGATE OTH- ER 1000000 EL DISEASE - POLICY LIMIT 1000000 EL DISEASE. EA EMPLO~~_~.l:9il 0 0 q 9 Limit:$8,344,793 Ded:$5,OOOexcept. $25,000 Wind DESCRIPTION OF OPERATIONS/LOCATI'ONSNEHICLES/SPECIAL ITEMS Reference: Marathon Airport Resurfacing Taxiway and Hanger Access FAA AlP Proj: No: 3-12-004 13 FDOT WPI Project No: 6826792 & 6826793 PFC Application No: 4 CAC#3810. The Monroe County Board of County Commissioners ,its employees and officials will be included as "ADDITIONAL 8260098 7 /01/98 ! 7/01/99 COMPo & COLLISION DEDUCTIBLE: $1,000 7081929 7/01/98 7/01/99 8520742 7/01/98 7/01/99 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. ;~::.'ft!~~;~~~.?-~:.~9f.1C.fi:~t':~!-.!~p.9SE N.D. OBLI~~,T.'ON OR LIABILITY . ',-OF' . A IND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. AUTHORI D PRESENTATIVE ORS Greiner, Inc. 5805 N.W. 11th Street,Ste#340 Miami, Florida 33126-2063 ....~............. ... . .. . ............. '.., . . .....,.....,. . n. '. ......,...... ... .............. ... " ............. ".. .. ........... .... ..... ....-...... . :-:-:-:-:.:-:-:-:-:.:.:.:.......:-:-:-:.....-.. 07/16/98 15:36 u ......... AON I4J 0005/0009 MED3 $5,000,0001$10,000.000 Agg. IF Installation Floater Max. Value of Equip. Insta1Ied VLP1 Hazardous $300,000 (Requires MCS-90) VLP2 Cargo $500,000 (Requires MC5-90) VlP3 Transporter $1,000.000 (Requires M~90) au Bailee Liability Max. value of property HKL1 Hangarkeepers' Liability $300,000 HKl2 $500,000 HKLS $1,000,000 AIR1 Aircraft Liability $25,000,000 AIR2 $1,000,000 AIR3 $1,000,000 AE01 Architects' Errors & Omissions $25O,OOOIoccurrencel$500,OOO Agg. AE02 $SOO,OOOIoecurrencel$1.000,OOO Agg. AE03 $1 ,OOO,OOOloccurrencel$3,ooo,ooo Agg. INSURANCE AGENT'S STATEMENT I have reviewed the above requirements with the bidder named below. The following deductibles apply to the corresponding policy: POLICY: 9330124 (SIR: $25,000. ea. occ., $100,000. agg. after which $10,000. SIR 8520742 ($5,000. deductible except $25,000. on windstorm perils) applies) OeOUCTIBLES: Uability ~)olicies are x Occurrence aaim9B ~ " ,1-~ .g ~ . Signature Juan E. Beltran Aon Risk Services, Inc. of Florida Insurance Agency BIQDERl'S STATEMENT I understand the insurance that will be mandatory if awarded the contract and will comply in full with SIll the requirements. Bidder Signature 111-94