Certificates of InsuranceDATE (MM/DD/YY)
AGWOR10. CERTIFICATE OF INSURANCE ISSUEII/28/94
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
ISLAND INSURANCE AGENCY, INC. NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
3229 FLAGLER AVENUE UNIT # 11 2 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
KEY WEST FL 33040 COMPANIES AFFORDING COVERAGE
CODE
SUB -CODE
INSURED LLOYD PRICE
PRICE & DAVIS LAWN MAINTENANCE
1107 KEY PLAZA SUITE #214
KEY WEST FL 33040
COVERAGES
COMPANY LETTER A IIE/BRITAMCO UNDERWRITERS, INC.
LETTER
ANY B FLORIDA WORKERS COMPENSATION JUA
LIBERTY MUTUAL INS. CO.
COMPANY `.
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
APPROVED BY RISK MANAGEMENT
BY1
nATC_
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN i TO !gFAR INSURED TMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR O H� 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 TYPE OF INSURANCE
LTR
A GENERAL LIABILITY
x COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR.
OWNER'S & CONTRACTOR'S PROT.
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
OTHER THAN UMBRELLA FORM
POLICY NUMBER
DAC80007FA5393
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DD/YY)
11/07/94 11/07/95
Received
Risk Mgmt. & Loss Con tro)
DATE.
MT'.A_L
ALL LIMITS IN THOUSANDS
GENERAL AGGREGATE $500 , OO(
PROD UCTS-COMP/OPS AGGREGATE $500 , OO(
PERSONAL & ADVERTISING INJURY $500 , OO(
EACH OCCURRENCE $500 , OO(
FIRE DAMAGE (Any one tire) $ —0—
MEDICAL EXPENSE (Any one person) $ —O—
COMBINED
SINGLE $
LIMIT
BODILY
INJURY
$
(Per person)
BODILY
INJURY
$
(Per accident)
PROPERTY
$
DAMAGE
EACH AGGREGATE
OCCURRENCE
B WORKER'S COMPENSATION 09-80195-94325— 11/16/94 11/16/95 STATUTORY
003144 100,000 (EACH ACCIDENT)
AND 500,000 (DISEASE —POLICY LIMIT)
EMPLOYERS' LIABILITY
100,000 (DISEASE —EACH EMPLO`
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS ****ADDITIONAL INSURED
,LANDSCAPING & GARDENING, MONRO COUNTY BOARD OF COUNTY
2798 OVERSEAS HIGHWAY
MARATHON FL 33050
CERTIFICATE HOLDER CANCELLATION
MONROE COUNTY REGIONAL SERVICE CENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
BUILDING DEPT. SUITE #300 EXPIRy6N DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
2798 OVERSEAS HIGHWAY MAIL DAYS WRI TO THE CERTIFICATE HOLDER NAMED TO THE
MARATHON FL 33050 L U NOTICE SHALL IMPOSE NO OBLIGATION OR
LI TY H OMPANY, ITS AGENTS OR REPRESENTATIVES.
COMMISSIONERS
TIM E-: TOMITA
ACORD 25-S (3/88) 1 'ACORD CORP^RAT ; c a
F
DATE (M
A0411UP, INSURANCE BINDER 1MIDD/YY)
1/29/94
THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM.
PRODUCER PHONE COMPANY BINDER#
FL AUTO JOINT UNDERWRITING 01916-94
EFFECTIVE EXPIRATION
INSURANCE WORLD OF KEY WEST
DATE TIME DATE TIME
X 1008 WHITE ST. AM 12:01AM.
KEY WEST, FL 33040 11/29/94 12:01 PM 11/29/95 NOON
THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY
CODE: SUB CODE- PER EXPIRING POLICY #:
AGENCY DESCRIPTION OF OPERATIONSNEHICLES/PROPERTY (Including Location)
CUSTOMER ID:
INSURED
�1989 CHEV.PK I.D." IGCGR33KOKJ121191
LLOYD PRICE
704 CHAPMAN LANE
KEY WEST , FL 33040 APPanWI) RV PMK MmorFMFNT
;COVERAGES
TYPE OF INSURANCE
PROPERTY CAUSES OF LOSS
BASIC BROAD I SPEC
GENERAL LIABILITY
_ COMMERCIAL GENERAL LIABILITY
CLAIMS MADE1-1 OCCUR
--f—OWNER'S & CONTRACTOR'S PROT
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
AUTO PHYSICAL DAMAGE DEDUCTIBLE
COLLISION:
OTHER THAN COL:
GARAGE LIABILITY
1 ANY AUTO
RY_
COVERAGE/FORMS
DATE
WAIVFP: IV/A _YES
IETRO DATE FOR CLAIMS MAD[
Received
Risk£
DATE - //-a9 -�
N-I iA.l, A a.
ALL VEHICLES I SCHEDULED VEHICLES
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE:
WORKER'S COMPENSATION
AND
EMPLOYER'S LIABILITY
SPECIAL
CONDITIONS:
OTHER
COVERAGES
NAME & ADDRESS
LIMITS
AMOUNTDUCTIBLE
COINS %
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
PERSONAL & ADV INJURY
$
EACH OCCURRENCE
$
FIRE DAMAGE (Any one fire) Is
MED EXP (Any one person)
$
COMBINED SINGLE LIMIT
$
BODILY INJURY (Per person)
$ () 0l�Q� 0
BODILY INJURY (Per accident)
$ 1 00 000
PROPERTY DAMAGE
$ 25,000
MEDICAL PAYMENTS
$
PERSONAL INJURY PROT
$ 101000
UNINSURED MOTORIST
$
ACTUAL CASH VALUE
STATED AMOUNT
$
OTHER
AUTO ONLY - EA ACCIDENT
$
OTHER THAN AUTO ONLY:
EACH ACCIDENT
$
AGGREGATE
$
EACH OCCURRENCE
$
AGGREGATE
$
SELF -INSURED RETENTION
$
STATUTORY LIMITS
EACH ACCIDENT
$
DISEASE - POLICY LIMIT
$
DISEASE - EACH EMPLOYEE
$
1V10. COIUNTY REGIONAL SERV. CENTER MORTGAGEE X ADDITIONAL INSURED
BLDG . DEPT STE 300 Loss PAYEE
LOAN #
2798 OVERSEAS HWY
MARATHON , FL 33050 AUTHORIZED REBi ESENTATIVE
ACORD 75-S (3/93) NOTE: IMPORTANT STATE INFORMATION ON REVERS