Certificates of Insurance
At~t.II~.~
CEATIFICA TE OF INSURANCE
DATE (MM/DD/YY)
()Ui'..i(,L..f)
lyre:: 1'"1 i:~j I..: (J J",~
l~~: (:i ::::; E; C) c:: I (:, or E: ~::; ~l
I )-'.Ie:: /I
13 O?/:t(?/'(?~.:.'
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
()() :~),:;. .~.;.
f' CJ EHJ >< :-.:; ()" :--';()
F> C ;'-.; (:'; ('-1 c:: cn.. (:',
1':'1
~~:; :~':: ~.:.:I(\.::; ...011 :.:; ()
COMPANY
A
;:;.: I ~::;C:{)F;F"
t '-':',-StlJ-- -:;..r':~ c:-(~. --(::(:){n p.;-:).n >..,
C::F~ T !ylF:: J:-:-:tJ::::;"fr:F: T ]-..j['
COMPANY
B
A~RlS-1<'Nf;"-'~HHNT
BY- ~.~
DATE 1-;17 -7S
\',I,:'/ER: N/^ /' YES
INSURED .! C.
r.' ""1 r:.:("(::-::" :L:.-- .:. ....
1<1::"( I..I..I[:::;T
I....
"I..
:.":";:::";().":.!. t .... :1. :~?(.:.:';:::~
COMPANY
C
COMPANY
o
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
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MMIDDIYY) DATE (MMIDD/YY)
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
,
i CLAIMS MADE OCCUR
OWNER'S & CONT PROT
GENERAL AGGREGATE $
PRODUCTS-COM PlOP AGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
_____ ..______._~~D EXP (Any o~perso_'2L_.._~___.______ _____
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
(cOMBINED SINGLE LIMIT $
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
i
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i
I
I
i
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l-t-
, EXCESS LIABILITY
PROPERTY DAMAGE
i UMBRELLA FORM
I
, I OTHER THAN UMBRELLA FORM
! WORKERS COMPENSATION AND
, EMPLOYERS' LIABILITY
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $
AGGREGATE $
$
. GARAGE LIABILITY
j ANY AUTO
STATUTORY LIMITS
EACH ACCIDENT
$ :I. <> (>
$
$
~.....
(~1 i THE PROPRIETOR/ ' INCL
; PARTNERS/EXECUTIVE
, OFFICERS ARE: EXCL
OTHER
lt~583
02/15/95 02/15/96
DISEASE - POLICY LIMIT
DISEASE - EACH EMPLOYEE
~I (){)
I..'
I ()()
1.-:.
I
I
I DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES/SPECIAL ITEMS
Received
Risk Mgmr. & Loss Control
DATE.. 9-2~-q5
;z;d
'--------1
INITfAI
CERTIFICATE HOLDER
CANCELLATION
MONROE CTY BRD OF CONN.
c::,....C: PUF:I...JC i)..I::Jh:i<~::; :OJ\.I.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXp'I~.~TION 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
COMPANY, ITS AGENTS OR REPRESENTATIVES.
I<F"{ I..r.JF~::;T
r" L. ~.:) :~.:; () l.!. ()
:..:":: ~.:.):J~:':: :::; F:CJC):3E:~-l[~I... -f I-~L. \/1) II
I
ACORD 25-S (3f93)
'-~D:tKE~9', COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC 00 00 alA
Orig~nal Printing
Issued May 1, 1988
INFORMATION PAGE
RISK ID FEIN 59-2842301
standard
Insurer: Commerce Mutual Insurance Company,
an assessable mutual
NCCI Carrier Code No. 25836
1 . The Insured: CRIME BUSTER INC.
DBA NATIONAL SECURITY ALARM CO.
1121 MARGARET ST.
KEY WEST, FL 33040
Mailing Address:
P.O. BOX 1298
KEY WEST, FL 33040
Partnership ~ Corporation
APPP(WrO BY RI"~' ',1' '\11,r.t~'ENl
BY. cg{~CP2<ee.<A- g~
~.:~, __2~o~ Z~__ 0
Indi vidual
other workplaces not shown above:
2. The policy period is from 2/15/94 to 2/15/95 at the iRsu~d'~~ir~~--
address. The Anniversary Rating Date is 2/15/94.
3.
A.
Workers' Compensation Insurance: Part One of the policy applies to the Workers'
Compensation Law of the states listed here: FLORIDA
B. Employers Liability Insurance: Part Two of the policy applies to work in each
state listed in Item 3.A. The limits of our liability under Part Two are:
Bodily Injury by Accident $
Bodily Injury by Disease $
Bodily Injury by Disease $
100,000 each accident
500,000 policy limit
100,000 each employee
C. Other states Insurance: Part Three of the policy applies to the states, if any,
listed here: NONE.
D.
This policy includes these endorsements and schedules: WC 00 04 14
WC 00 03 08 WC 89 06 00 A
WC 09 04 02
4.
The premium for this policy will
Classifications, Rates and Rating Plans.
verification and change by audit.
be determined by our Manuals of Rules,
All information required below is subject to
Classifications
Code
No.
Premium Basis
Total Estimated
Annual Remuneration
Rate Per
$100 of
Remuneration
Estimated
Annual
Premium
SEE ATTACHED
Total Estimated Annual Premium $
Countersigned by:
;P~;7~
DONALD MCMAHON & ASSOCIATES, INC., PENSACOLA, FL
PAR March 21, 1994
Minimum Premium $407
Copyright 1987 National Council on Compensatlon Insurance.
RYDER
infopage.mrg
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.. .ta:t;;;;i;:'I:'I:::::.::ai:li;i;;;i\:liii::i.i(US:.}in\iiUlia:::::)::::,',',;::=:: ISSUE DATE (MMIDDIYY)
~~~~.~~~~~:n!:=!::'!:'."::::':!!i'!.!!~;:::'~:rn:n~:Sl:~O"~~,!!ij:5!:<.:::::::::::::::i::".:::::::::::::::::::.
PRODUCER
eenan Insurance Agency, Inc.
Canal street, Suite D
09/05/95
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.
ey West
(305) 294-1271
FL 33041
COMPANY D
LETTER
DATE
I
I
I
--J
ew Smyrna Beach,
(904) 424-0945
Fl
32170
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER Frontier Insurance Com an
COMPANY B
LETTER
rimebuster, Inc.,
.0. Box 1298 1121 Margaret st
COMPANY C
LETTER
BY-
I
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E
,"I'VER:
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/DDIYY) DATE (MM/DDIYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMSMADE[]]OCCUR. GLS-C011390-01
OWNER'S & CONTRACTOR'S PROTo
errors & omis.
GENERAL AGGREGATE $1 ,000,000
PRODUCTS-COMP/OP AGG. $ I n c 1 ud ed
1 1 / 3 0 / 9 4 1 1 / 3 0 / 9 5 PERSONAL & ADV. INJURY $ 5 0 0 , 0 0 0
EACH OCCURRENCE $ 5 0 0 , 0 0 0
FIRE DAMAGE (Anyone fire) $ 5 0 , 0 0 0
MED.EXPENSE(Anyoneperson) $ 5 000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
/
/
/
/
COMBINED SINGLE $
LIMIT
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
EACH OCCURRENCE
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
Recel 'cd
'J .. M ! ,~ ]
,"~Ir ,~ '-':'~r.
I <,'. gmt. & .A.'>C' 1..,,)( tro
/
/
DISEASE--POLlCY LIMIT
DISEASE--EACH EMPLOYEE
:~-'~ ,,'\7' r
/
/
/
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
/
/
/
/
4#9RPg$*$.]t.::
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL-----1] 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.
iir""'~~""'''''~a. · _ 0. ~~ ;
. . . ~ ,
.:.:..:.:.....:::::::::\\:::.>.>:..:h!:::!!:'!,!?,:!:::?!,::. .:!!!:!:ji499Rt.H;9RpgMnQN@~9()'
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:;:..:.::...........1
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DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
ertificate holder is included as an additional insured with respects to the
perations of the named insured only, subject to the terms and conditions of
he insureds contracts.
CeiibFICATE:adtOER.:::' .. :::i::i:::i:i:i::\\\i:: ........ :::::::::.:.::::::!:!::.!:::!::':,:uNpgMi.ijIQN??::'::":'::::::i::::::::':.::::::::. ::: ::..... ..............::.:.:::::::::::::::::::::::::::::::::::::::::..
onroe County Board Of
ounty Commissioners
3583 S. Roosevelt Blvd.
ey West, FL 33040-4399
POLICY NUMBER: GLS-C01l390-01
COMMERCIAL GENERAL LIABILITY
CG 20 10 10 93
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
3583 S. ROOSEVELT BLVD.
KEY WEST, FL 33040-4399
(If no entry appears above, information required to complete this endorsement will be shown in the Declara-
tions 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 in-
sured.
CG 20101093
Copyright, Insurance Services Qffice, Inc., 1992
o
@) INTEGON@
Bankers and Shippers Insurance Company
3060 South Church Street · PO Box 2510
Burlington, North Carolina 27215
Received
Risk Mgmt. & Loss C~ntrol
9-/q-q~-
DATE ~
/-
CERTIFICATE OF INSURANCE
INITIAL
THIS CERTIFICATE OF INSURANCE DOES NOT
AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED.
Certificate Holder:
BOARD OF COMMISIONERS
3583 S RSVL T BLVD
KEYVVEST, FL 33040
APPROVED BY Ri:.;,' ,
Insured:
CRIMEBUSTER INC.
PO BOX 1298
VVEST, FL 33040
BY-
Use this number to present inquiries or
obtain information about coverage and to
provide assistance in resolving complaints
800-323-6848
D~TE
-- 7'-5
\"ldVER:
N/A
YES
Policy Number:
Policy Eff Date:
Policy Exp Date:
CFL 0949829
08/07/95
08/07/96
Insurance is provided insured as indicated below.
Type of Insurance
Limits of Liability
Bodily Injury Property Damage
Auto Liability: $50,000 each person
Scheduled Autos $100,000 each occurrence $25,000 each occurrence
Auto Physical Damage:
Scheduled Autos
Collision Nil Lesser of ACV or
Stated Amount
Subject to $ _
Deduction from Each Loss
Comp Nil Lesser of ACV or
Stated Amount
Subject to $
Deduction from Each Loss
Specified Perils Nil Lesser of ACV or
Stated Amount
Subject to $
Deduction from Each Loss
Other:
BASIC PIP NO DEDUTIBLE
Agent: 003163
ISLAND INSURANCE AGENCY INC.
3229 FLAGLER AVE #112
KEY VVEST, FL 33040
Auth9rized Represent~ . e;
?z --.-- .
('
~., -z;.-,Z: fr ___-/?
issue date 8/24/95
CV38 06/91
(Insured Copy)
ACORD.
CERTIFICATE OF LIABliLITY INSURANOE
'_______________. 8LJ5lSJ2 _ ... _ ..
. 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 TERTHE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
DATE (MM!ODIYYi
PROo.uCl R
ISLAND INSURANCE AGENCY/INC.
3229 FLAGLER AVE #112
KEY WEST/FL. 33040
COMPANY
A BANKERS AND SHIPPERS INS CO.
INSURED
COMPANY
B
, CRIMEBUSTER/INC.
PO BOX 1298
KEY WEST/FL. 33040
COMPANY
C
COMPANY
o
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/DDIVY) DATE (MM/DDIVY)
LIMITS
A
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERA TIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPER
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (Private Pass)
ALL OWNED AUTOS
(Other than Private Passenger)
HIRED AUTOS
NON.OWNED AUTOS
GARAGE LIABILITY
XX SEE SCHEDULE
BODILY INJURY OCC
BODIL Y INJURY AGG
$
$
r:'
PROPERTY DAMAGE OCC $
,._--_._-~~-_.._----.--
PROPERTY DAMAGE AGG $
BI & PO COMBINED OCC $
BI & PO COMBINED AGG $
PERSONAL INJURY AGG $
l:dSr<
c,'}':') . 'ji"
.t.L.:::S. '/
~~-0?/
. ) ", ~ i.'
L\!r~'i .'\ :.
I BODILY INJURY
! (Per person)
CFL0949829-04
8/7/95
8/7/96
BODILY INJURY
(Per accident)
$ 50,000
iLOO / 000
PROPERTY DAMAGE
$ 50,000
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
BODILY INJURY &
PROPERTY DAMAGE
COMBINED
EACH OCCURRENCE $
AGGREGATE $
$
WC STATU- OTH. ,
. IQBvJ"I,MITS_ _ .~_.
EL EACH ACCIDENT $
EL DISEASE. POLICY LIMIT
EL DISEASE. EA EMPLOYEE $
- I
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;
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
1983 FORD VAN VIN:IFTDFI4Y4DHA52800
1987 CHEVY P/U VIN: IGCHR33K9HS125733
! 1985 FORD VAN VIN: IFTDE14Y4FHB76763
i
1986 CHEVY VAN VIN:IGCCMI5EXGB208364
1984 FORD VAN VIN: IFMEEIIFOEHB73652
cANceLLAtiON' .
CERTIFICATI: HOL[)S~
MONROE COUNTY BOARD OF COUNTY COMMISIONERS
C/O PUBLIC WORKS DIVISION
. 3583 S. RSVLT BLVD
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
10 DAYS WRITTE
OR REPRESENTATIVES,
ACORD 25.N (1/95)
-- ... ..__._-~.-.--
~' , .,411Ae<>8~:)CORPOFtATfON 1988 i
.
',!'
I NTEGON.
INSURANCE -
nANI<Ens AND SHIPPERS INSlJRANCF: COMPANY
Monroe County Public Works
3583 s Roosevelt Blvd
Key West. F133040
Attn: Cindy
Re: CrimebleJier Inc. Bankers and Shippers policy numPer CFL 0949829
Cindy:
In reference to our phone conversation today on Crimcbuste Inc. this is to comfirm thatl
per our guidelines, Bankers and Shippers will not list a government entity as an additonal
interest. If you have any further question~ please feel free to call me.
-
Sincerely, , i
G\\~I\A"hv~ 'i
Mark y arbo;l~~ -
500 W Fifth Street. PO Box 3199. Winston-Salem, NC 27102-3199. Tel (910) 770-2000
r-- .
CORRESPONDENCE INSTRUCTIONS
FROM J.-?/ A /4c'5 DATE
#~IlI#tr .coc" A.-r-y &.ttJ.1(J) &>.- ~A.-""1 ~,.", 1$ /- A,.. 4S7tS
TO C;p ;PC/dLlc ~ell.K5 /}/V{$/o/'ll. .
;fA-/\, '2 q;- -3'72
FOR THE PURPOSE INDICATED BY THE CHECK MARK
~E NOTE AND FILE
o PLEASE NOTE AND RETURN TO ME
o PLEASE NOTE AND SEE ME ABOUT THIS
o PLEASE ANSWER, SEND COpy TO ME
o PLEASE TAKJ;: CHARGE OF THIS
o TO BE SIGNED
o FOR YOUR INFORMATION
o YOUR COMMENTS, PLEASE
o PLEASE Pf1EPARE REPLY FOR MY SIGNATURE 0 RUSH-IMMEDIATE ACTION DESIRED
REMARKS:
o~
/Ii:- .s- 74uc~ 1 L I.1'Tct'
4/2~ /J r:.- tPNL 5'CJ2..t/l C ~
1/ C-H I cL e-9 TrllJr /V/f t 19 tr
[)o / Me, T/rI c ~u I'v Cotult. A-C r
. tu Dfl/( J.
NATIONAL SECURITY ALAR" CO.
CRI"EIUSTER INC. .
NASA
PROl1iC1EO BY
~
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~
~
~1lE-'tB'
W~LERT-
m1ZlI!
SPECIALISTS IN HI. TECH SECURITY SYSTEMS. COMMERClA1../RESIOENTIAL
MONROE COUNTY'S ONL Y 24 HR. CENTRAl MONITORING $fA TION
1121 Margaret St. . P.O. Box 1291. Kay W..t, FL 33040
(305) 294-1~71 . (800) 828.2335 . FAX (305) 298-1081
l!= -, '-, L L,~
. ................. ....................... ........... .....................
................................. .....................
............................. ............................. .....................
....................... ...................... .. .....................
.................. ......................... .....................
.....................
...... At~.tlll.~ .1:....:..IIIII.I~.IIII..:.'IlIi.:.I,.IIII.I'III!!:::...:.....:::.:::::::::::::::::;:::;..:
ISSUE DATE (MM/DD/YY)
eenan Insurance
33 N. Causeway,
.0. Box 1967
ew Smyrna Beach,
(904) 424-0945
Agency,
Suite B
Inc.
12/04/95
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.
PRODUCER
Fl
32170
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER Frontier Insurance Com an
ey West
( 305) 294-1 271
FL 33041
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
E
Receiv r:
Risk Mgrnr &Lo~,s c:cincru:
-- ---
INSURED
rimebuster, Inc.,
.0. Box 1298
Ole.!
INITIAL
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/DD/YY)
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMSMADE[K]OCCUR. GLS-C011390-02
OWNER'S & CONTRACTOR'S PROTo
errors & omis.
GENERAL AGGREGATE $1 , 000, 000
PRODUCTS.COMP/OP AGG. $ I n c 1 uded
11/30/95 11/30/96 PERSONAL&ADV.INJURY $ 500,000
EACH OCCURRENCE $ 5 0 0 , 0 0 0
FIRE DAMAGE (Anyone fire) $ 5 0 , 0 0 0
MED.EXPENSE(Anyoneperson) $ 5 000
AUTOMOBILE LIABILITY COMBINED SINGLE
-l ANY AUTO LIMIT $
ALL OWNED AUTOS flY tJ/!..!& BODILY INJURY
G~ K-- (Per person) $
SCHEDULED AUTOS
HIRED AUTOS -L / / / BODILY INJURY
(Per accident) $
NON-OWNED AUTOS /
.. I' ~ vr'(
GARAGE LIABILITY
PROPERTY DAMAGE $
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM / / / /
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION / / / /
EACH ACCIDENT $
AND
DISEASE--POLlCY LIMIT $
EMPLOYERS' LIABILITY
DISEASE--EACH EMPLOYEE $
I OTHER
I
i / / / /
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
ertificate holder is included as an additional insured with respect to the
perations of the named insured only, subject to the terms and conditions of
he insureds contracts.
..,.................................. .............. .... .. ...... ............ ........... ... .
Gg~tml*A!~.a~ijl.i.mq'\:'?.:..........:.:.:.:.:.:.:: . ...........:.::..:.9jNq~iji.l.ATj&N\. ................:: .::':'.':':::":':':':':':.::::::::::..:..::}:::\\\\/:':
.:.:.:.:.:.:.;.:.:.:.:.:.:.:.:-:.:.:.;.:-:.:-:.:-:.:.:.:.:.:.:.:.:.:-:.:.:.:.:.:........
onroe County Board Of
ommissioners
ttn.: Risk Management
5100 College Rd.
ey West
FL 33040
Ag9ftP~$~$e.\\.mg;BimimM.{
.:. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
} EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
..:...:. MAIL-1.Q DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
I LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
.:,:...: LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
II,"rno",~o~~ ~
...................::::.....................................................................................................:...::i:Ag9i.!1.Pi<<.BpgRAnQNdjij)
....... ACORQM ..........I.lllillllll...II....I'I:I.'III.I..'IIII.111III..:.......:..........:......
.........,...............,........................-.......,..........
....-.-. .. .................-.--...-.................
............................................
it DATE (MMlDDIYY)
................ .................
.... .......................
..........................'......
.......................................
....................... -.......
""""""""""""""",'""","\",:,,:,/>::,: 8 15 95
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
ISLAND INSURANCE AGENCY,INC.
3229 FLAGLER AVE #112
I KEY WEST,FL. 33040
i
!INSURED COMPANY
I B ~f'lrpr:r'
~I:~Ui;:/INC. COMCANY ~ '\/i;M W/~~
I KEY WEST, FL. 33040 BV__ -L:=~//~___, ~ !
i COMDANY GA.T[ 7 - ,;J.c; r '7 0 (.) Ie (C
~ . C/A-'b
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,
i EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I
I CO
LTR
!
I
COMPANY
A
BANKERS AND SHIPPERS INS CO.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE . POLICY EXPIRATION
DATE (MMlDDIYY) i DATE (MMlDDIYY)
LIMITS
I
I
IA
I
I
I
I
I
I
COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPER
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (Private Pass)
ALL OWNED AUTOS
(Other than Private Passenger)
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
XX SEE SCHEDULE
r~
BODILY INJURY AGG
PROPERTY DAMAGE OCC
PROPERTY DAMAGE AGG
BI & PO COMBINED OCC
BI & PO COMBINED AGG
PERSONAL INJURY AGG
$
$
$
$
$
$
$
GENERAL LIABILITY
BODILY INJURY OCC
Iusk >:[.;/:'._/" _ _.-/
;JATE ____..D____<;---?S {j S
lXL';;'. ___'0 ~~.~;?
"t;-.c...
CFL0949829-04
BODILY INJURY $ 50/000
(Per person)
8/7/95 8/7/96 BODILY INJURY $100,000
(Per accident)
PROPERTY DAMAGE $ 50/000
---------
BODILY INJURY &
PROPERTY DAMAGE $
COMBINED
EACH OCCURRENCE
AGGREGATE
WC STATU-
_.IQ8,(klMJIS
EL EACH ACCIDENT $ I
EL DISEASE - POLICY LIMIT $
I
EL DISEASE - EA EMPLOYEE $ I
1
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETORI
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
DESCRIPTION OF OPERATIONSlLOCATIONSlVEHICLESI8PECIAL ITEMS
1983 FORD VAN VIN:IFTDFI4Y4DHA52800
11987 CHEVY P/U VIN: IGCHR33K9HS125733
1985 FORD VAN VIN: IFTDE14Y4FHB76763
,
1986 CHEVY VAN VIN:IGCCMI5EXGB208364
1984 FORD VAN VIN: IFMEEIIFOEHB73652
MONROE COUNTY BOARD OF COUNTY COMMISIONERS
C/O PUBLIC WORKS DIVISION
3583 S. RSVLT BLVD
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
10 DAYS WRITTE TICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILUR 0 MAIL SUCH TICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF AN COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZ R