Certificates of Insurance
PROOUCER THIS CERnFlCATE IS ISSUED AS A MAlTER OF INFORMAnON
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
COIIPOIIA.,. II.SIC .A"AO..."., HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P. o. 80J( 7.8 ALTE TH A FRED BY I EL W.
COMPANIES AFFORDING COVERAGE
..Ibourn.
FI. 32802.07.8
COMPANY
A
Assuranc. Co. of AmerIca
INSURED
80b HIlson & Compan~, 'no
f0480 a.lf. f.7tll "errac.
.'aml, FL 33f 57
COMPANY
B
COMPANY
C
COMPANY
D
:~1Wffi1W&m:l@f:Mlmf:i:mlMM&t't.nintll1tti,t.l1tMmWM~~lMf:M~f:1Mm@tmdlWiMMl1nUtMllililtillHMMMMMWfrY@fmUiWf:WilfiliUtW@f.@11
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,
EXCLU IONS AND CONDITIONS OF SUCH UCIES. UMITS HOWN MAY HAVE BEEN REDUCED BY PAID lAIM.
co
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MMlDDIYY) DATE (MMlDDIYY)
10/01/98 10/01/99
Lvrs
LNITS
GENERAL AGGREGAlE $ 2 000 000
PRODUCTS - COMP/OP AGG $ 2 000 000
PERSONAl & ADV INJURY $ 1 000 000
EACH OCCURRENCE $ 1 000 000
FIRE DAMAGE (An one fire) $ 300,000
MED EX? (Anyone rson) $ 10 000
COMBINED SINGLE LIMIT $ 1,000,000
BODILY IDJRY $
(Per person)
BODILY ItUJRY $
(Per accident)
A GENERAl LIABILITY
X COMMERCIAl GENERAl LIABILITY
CLAIMS MADE [!] OCCUR
OWNER'S & CONlRACTOR'S PROT
ECA20609203
A AUTOMOBLE LIABILITY
X ANY AUTO
AlL OWNED AUTOS
SCHEDUlED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS
EC88717624
10/01/98 10/01/99
\i
PROPERTY DAMAGE $
GARAGE LIABILITY
ANY AUTO
{' --...------
\,t.!' .. '.: 0 t .
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGAlE
EACH OCCURRENCE
AGGREGAlE
EXCESSLIABLITY
UMBRElLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
INITIAL
a EACH ACCIDENT $
EL DISEASE - POLICY LIMIT $
EL DISEASE - EA EMPLOYEE $
THE PROPRIETOR!
PARTNERSaECUTIVE
OFFICERS ARE:
OTHER
INCl
EXCL
DATE
DESCRIPTION Of: OPERATIONSA.OCATIONSNEHICLE8JSI:'ECIAl ITEMS
Issued: 01/20/99 Certificate Holder is named as an Additional Insured withrespect to General Liability and Auto Liability.
Additional Insured applies only to operations performed by the insured.
Re-Issued: 02/04/99 Re-issued: 02/05/99
SHOULD ~Y OF THE ABOVE DESCRIBED POLICIES BE CANCELlED BEFOfE THE
EXPIRATION DAlE THEREOF, THE ISSUING COMPANY WIll ENDEAVOR TO MAL
~ DAYS WRITlEN NOTICE TO THE CERTIFICAlE HOlDER NAMED TO THE lEFT,
BUT FAILURE TO MAIl SUCH NOTICE IMPOSE N O8lIGATI lABILITY
OF ANY KIND UPON THE COMPAN I ENTS ~ 'A
AUTHORIZED REPRESENTATIVE
Cindy Brown
.onroe County
If 00 CoUe.. lIoad
Key We.t
FL
33040
FLORIDA ROOFING. SHEET METAL & AIR CONDITIONING CONTRACTORS ASSOCIATION. INC.
P.O. BOX 4907. WINTER PARK, FL 32793. (407) 671-FRSA
1-800-767-3772 . FAX (407) 671-2520
ISSUED TO:
CERTIFICATE OF INSURANCE
Monroe County Construction
Management
5100 College Rd.
Key West FL 33040
Bob Hilson & Company, Inc.
10460 SW 187 Terrace
Miami FL 33157
ATTN:To Whom it may concern
JAN 2 2 1999
-A.. .~-. ~-- <. .,
.~:~.
being subject to the provisions of the Florida Workers' Compensation Act, has secured the payment of
compensation by insuring their risk with the FLORIDA ROOFING, SHEET METAL & AIR CONDITIONING
CONTRACTORS ASSOCIATION SELF INSURERS FUND.
This is to certify that Bob Hi l son & Company, I nc.
10460 SW 187 Terrace
Miami FL 33157
COVERAGE NUMBER: 870-008328
EFFECTIVE DATE: 01/01/99
LIMITS
Workers' Compensation Statutory - State of Florida
EXPIRATION DATE:
01/01/00
Employers' Liability
$100,000 - Each Accident
$100,000 - Disease, Each Employee
$500,000 - Disease, Policy Limit
REMARKS: Non-cancelable without 30 days prior written notice.
" t.J (\. "rnr p \/ ~ 7' ~V1 !.:~.",.. ~ <- " ""ff t ^ G r= M' Po J.~
VY\." .' U/k) .. . ·
L' Y --L-1-J
l1- \ 19
W~lVER: ill,,':, ./ , ~
~cc CWI~~-
This certificate is not a policy and of itself does not afford any insurance. Nothing contained in this certificate '()~
shall be constructed as extending coverage not afforded by the policy(ies) shown above or as affording
insurance to any insured not named above.
Additional location insured: 300 Atlantic Drive
Key Largo, FL 33037
Qualifiers: Mark A. Zehnal-CCC041344,CBC 038910,
Robert B. HiLson - CC C017513, GonzaLo C. Arostegui - CG C0139~TE
Bradley R. Farinelli-CCC057397, Tibor Torok-CCC057388
DA TE:
01/')0/99
By: ~~?2~
Tom e, Administrator -
FRSA-SIF
DATE
By: ~~
Debbie Kemmerer - SI Accounts Representative
FRSA-SIF
INITIAL