Certificates of Insurance
A.~.tl'lt.. CERTIFICATE OF INSURANCE
DATE (MM/DD/YYI
PRODUCER
ROGER BOUCHARD INSURANCE
101 Stan.:rest Dr ~ PO Box 6090
CLe:MWATER~ FL 34618
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
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INSUREi:l
COMPANY
A
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DL POl" tel" 'Cons tl- uc t i 011 I nc
1100 Gillespie Avenue
Sarasota. FL 34236
COMPANY
B
Au toQ~ners I nsural'lCe_Cl}(n~anY
COMPANY
C
: I
! 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.
COMPANY
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POLICY EFFECTIVE i POLICY EXPIRATIO".
DATE (MM/DD/YV)! DATE (MM/DD/YV) ,
TYPE OF INSURANCE
POLICY NUMBER
LIMITS
1/09/98
1/09/99
$
$
$
j $
FIRE DA_M_AG!_(~n~oll=-fir=-)j $
MED EXP (Anyone person) __$
GENERAL AGGREGATE
- ---- - ~._"~--- -.........-
PRODUCTS-COMP/OP AGG
---..---- --------
PERSONAL & ADV INJURY
EACH OCCURRENCE
,
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.t Q!)OOOQJ
t~ifij
'-50001
1000000 I
GENERAL LIABILITY
i X i COMMERCIAL GENERAL L1ABILI~ 20506438
l] CLAIMS MAD(~~' OCCUR
OWNER'S & CO NT PROT
'------,._--,----~---,--_.__._~-
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AUTOMOBILE LIABILITY
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iX
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
'20200555
1/09/98
1/09/99
COMBINED SINGLE LIMIT
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
-
1
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PROPERTY DAMAGE
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT $
-.-----...... ----i
1
--._- j
1/09/99
EACH OCCURRENCE
AGGREGATE
OTHER THAN AUTO ONLY:
EACH ACCIDENT L $
$
$
$
$
AGGREGATE
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~-_: E~CESS LIABILITY ------.---- --------- -----.----.---------
i B fX i UMBRELLA FORM 71280681 1/09/99
i : 'OTHER THAN UMBRELLA FORM
r----- . ------.,-------------..----~-----.
_ - WORKERS COMPENSATION AND _ ~, ~,.. ............._
i EMPLOYERS' LIABILITY
CANCELLATION
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCelLED BEFORE THE I
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STATUTORY LIMITS
EACH ACCIDENT $
DISEASE - POLICY LIMIT $
DISEASE - EACH EMPLOYEE i $
_-______.______..L___
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
',\TE
dd/asst
MONROE COUNTY BD OF
COMMISSIONERS
5100 COLLEGE ROAD
KEY WEST. FL 33040
I
ACORD 25-S 13/931
COUNTY
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30DAYS 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.
~~z~ RE~'1SENTATI~ // /J I
~v-I'" E ~~ 695232000 I
. oACORD CORPORATION 1993 I
_._.'-'-_.~
CERT3S_1