FY1995 09/21/1994BRANCH OFFICE
3117 OVERSEAS HIGHWAY
MARATHON, FLORIDA 33050
TEL. (305) 289-6027
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CLERK OF THE CIRCUIT COURT
MONROE COUNTY
500 WHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
October 5, 1994
BRANCH OFFICE
88820 OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-7145
Mayor Samuel J. Feiner, Chairman
Monroe County Tourist Development Council
3406 North Roosevelt Boulevard
Key West, FL 33040
Dear Mayor Feiner:
At the September 21, 1994 meeting, the Monroe County
Board of County Commissioners granted approval and authorized
execution of the following documents:
An Agreement between Monroe County and Stuart Newman
Associates, Inc., for a period of 36 months, commencing on
October 1, 1994 and terminating September 30, 1997, to provide
public relations coverage to Monroe County.
A Funding Agreement between Monroe County armed the Red Barn
Actors Studio, Inc., covering the
November 16, 1994 through June 18, 1995, in an amount not to
exceed $20,500.00, Fiscal Year 1995, Two Penny, under the
Cultural Umbrella.
A Funding Agreement between Monroe County and the Lower Keys
Chamber of Commerce covering the Island Art Fair from December
10, 1994, in an amount not to exceed $2,300.00, Fiscal Year 1995,
Two Penny, under the Cultural Umbrella.
A Funding Agreement between Monroe County and Florida Keys
Community College/Tennessee Williams Fine Arts Center covering
the Tennessee Williams Fine Arts Center's 1994-95 season from
November 26, 1994 through April, 1995 in an amount not to exceed
$18,400.00, Fiscal Year 1995, Two Penny, under the Cultural
Umbrella.
A Funding Agreement between Monroe County and Key West
Players, Inc., covering the Waterfront Playhouse, November 1994
through May 1995, in an amount not to exceed $19,425.00, Fiscal
Year 1995, Two Penny, under the Cultural Umbrella.
FUNDING AGREEMENT F!LE1)
THIS AGREEMENT is made and entered into by and�tietween`"the" Board of
County Commissioners of Monroe County, Florida, (hereinafter referred to as the
"BOCC") and the Red Barn Actors Studio, Inc. (hereinftef. refetTed to as "Event
�. err
Sponsor");
WHEREAS, the umbrella organization under contract to the BOCC has
recommended to the Monroe County Tourist Development Council (hereinafter
"TDC"), which has endorsed the recommendation, that certain monies be allocated
for promotion of an event;
THEREFORE, in consideration of the mutual promises contained herein, the
parties agree as follows:
1. BOCC shall pay to Event Sponsor a sum not to exceed twenty
thousand, five hundred dollars ($20,500.00) for promotion and related expenditures,
as described in the event budget, attached hereto as Exhibit A, in producing the Red
Barn Theatre Festival, on November 16, 1994 through June 18, 1995. Payment
will be made only after submiission by Event Sponsor of invoices and support
documentation acceptable to the Finance Department of the Clerk of the Circuit Court.
The advertising and promotion budget for County funding may be altered as to the
individual line items, or components, within 10% of the amount stated for that item or
component, without increasing the total dollar amount and without requiring a written
amendment to this agreement.
2. Event Sponsor shall provide promotion and related services as
described in the Sponsor's application for funding, Exhibit B, attached hereto.
3. Event Sponsor shall reimburse BOCC for any amount of funds expended
by BOCC in connection with an event which does not occur as a result of any act or
omission by Event Sponsor.
4. Event Sponsor covenants and agrees to indemnify and hold harmless
Monroe County Board of County Commissioners from any and all claims for bodily
injury (including death), personal injury, and property damage (including property
owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of the services
provided, event sponsored, or other activities and funding associated with this
agreement.
5. Event Sponsor shall maintain records pursuant to generally accepted
accounting principles for three (3) years after the event and shall permit BOCC and its
agents and employees access to said records at reasonable times.
1
6. BOCC may terminate this agreement without cause upon providing
written notice to Event Sponsor no less than sixty (60) days prior to the event and may
terminate for breach upon providing to Event Sponsor notice at least seven (7) days
prior to the effective date.
7. Event sponsor is an independent contractor and shall disclose any
potential conflicts of interest as defined by Florida Statutes, Chapter 112 and Monroe
County Code, Article XXI.
8. Event Sponsor warrants that helshe/it has not employed retained or
otherwise had act on his/its behalf any former COUNTY office or employee in
violation of Section 2 or Ordinance No. 10-1990 or any COUNTY officer or employee
in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of the
provision the COUNTY may, at its discretion terminate this contract without liability
and may also, at its discretion, deduct from the contract or purchase price, or
otherwise recover, the full amount of any fee, commission, percentage, gift, or
consideration paid to the former or present COUNTY officer or employee.
IN WITNESS WHEREOF, each party has caused this Agreement to be
executed by its duly authorized representative, the day of 1994.
14
(SEAL)
Attest: Danny L. Kolhage, Clerk
(CORPORATE SEAL)
Attest:
By YLt�
Secretary
m
Witness
Approved as rm and legal sufficiency:
Date: 9
Board of issi t�9em oners
of Monr fie un 000
Mayor/Chairman
Red Barn Actor Studio,
Pres
C
2
EXHIBIT "A"
RED BARN THEATRE
1994-95 ADVERTISING BUDGET
Print Ads: 11,500
Posters & Flyers; 1,700
Brochures: (printing, design, distribution) 4,500
Photography:
950
Direct Mail: 400
Radio: 1,450
TOTAL: $ 20,500
EXHIBIT "B"
APPLICATION FOR FUNDING FROM THE
MONROE COUNTY TOURIST DEVELOPMENT COUNCIL
CULTURAL UMBRELLA
EVENT: RED BARN THEATRE 1994-95 SEASON
LOCATION: 319 DUVAL STREET (REAR)
KEY WEST, FLORIDA 33041
DATE OF EVENT: 35 weeks from November, 1994— June, 1995
Preseason show: November 16 - 19
1 st Show:
December 14 - January 15
2nd Show:
January 25 - February 26
3rd Show:
March 8 - April 2
4th Show:
April 12 - May 7
5th show:
May 17 -June 18
6th Show:
to run Mondays & Tuesdays from January - April
Discussion has taken place with Parvan and our Fine Arts Council about the
possibility of touring a show up the Keys.
All mainstage shows have matinees. Approximately 230 performances are
scheduled.
Shows under consideration are:
An original children's show -(written by Bruce Peterson)
Patsy Cline Musical
The Rain Maker
Jeffrey
Falsetto's
ESTIMATED ATTENDANCE: 20,000
EVENT DESCRIPTION: Live professional theatre. Final season selection is pending
contracts royalty agreements and will be announced by
October 1, 1994.
IMPACT OF EVENT ON TOURISM: -
Over the past year group sales from out -of -district have jumped to an all time high.
The following is a list of all the travel agents who have booked groups at the Barn and
came to Key West specifically to see our shows and spend the night.
_ Personalized Tours - Stuart
Groups International - Miami
Fran Weiss - Tamarac
Travels with Honey - Tamarac
Alice's Travel World - Boynton Beach
Discover Travel - Central Florida
Big Pine Travel - services Central Florida
Wills Travel - services Central Florida
Iry Green - Fort Lauderdale
Cruises Unlimited - Fort Lauderdale
Sample Tours - Coral Springs
Paradise Tours - Fort Lauderdale
Sunway Tours - services Central Florida
Davis Tours - Miami
Big Pine Fishing Lodge - Big Pine Key
Travel Commercial - Sarasota
Air & Sea Travel - Miami
Our mailing list is now 40% out of district and through surveys we know 65% of our
audience are tourists.
NAME OF SPONSORING ORGANIZATION: 1ED Bkf-'L'.UACTOI','�-STUDIO.IIJC.
ADDRESS: 319 Duval Street (rear). Post Office Box 707. Key West, FL
PHONE:
The Red Barn Theatre incorporated in 1981 and received the 501(3)(C) status in 1984.
The Barn has consistently produced six to eight shows each year, nine months out of
the year, five to six nights each week for fouteen years. Outreach programs were
developed such as matinees, discounts late night/off night offerings, classes for
children and adults, and new works play readings free to the public, which offer
accessible theatre to the 20,000 patrons that come through the Red Barn doors each
year.
HISTORY OF EVENT:
Several landmarks occurred this 1993-94 season:
1. The Barn won national acclaim when the New York based publishing house Tams-
Witmark featured the Barn's production of Nunsense II in their brochure as the first
regional production. This brochure was mailed to every theatre in the country.
2. Co-op ads which included all 3 theatres in town (The Waterfront Playhouse and
TWFAC) ran in several tourist brochures and a cultural map. Networking meetings with
all 3 theatres were continued this season to discuss national as well as local audience
development, and The Key West Theatre Festival among other topics.
3. Award winning playwright Nicholas Patricia from Chicago gave the Barn
management a workshop on how to produce new play readings. The Barn
successfully began its New Play Readings Workshop with the play Morning Dew With
Trellis by Richard Browner on May 22, 1994. A series of these readings are planned in
94-95 as part of an all encompassing outreach program free to the public.
4. The controversial play Oleonno by David Mamet had a successful Monday &
Tuesday night run at the Barn establishing theatre seven nights a week for five months.
5. The Barn enjoyed sell -out houses this year through March. April and May have
been slow, but we continue to offer nightly entertainment. Networking with guest
houses, hotels and tour groups implement strategic audience development.
6. A children's show written by local playwright Bruce Peterson specifically for the
Barn will run on weekend matinees to capture the local and tourist family market.
7. 93-94 proved to be our biggest subscription year with $12,000 in subscription sales.
One fourth of these subscriptions are out of state.
AMOUNT REQUESTED: $37,200.00
Applications must be signed by president and treasurer of the
organization and signatures must be notarized.
(Corporate Seal) '- t �
Pr ident
n[ 0 /I(`-)/q(4
Date
I LD-G -Cuz
Tr asurer
Date
The above mentioned organization holds Monroe County and the TDC
harmless for any liability arising from the funded event/activity.
Approved as to form and legal sufficiency
Signed before me this day CSC D f i I,�/c�, -i
Date
I '
Nothry Public
CINDY SUNSHINE HOEFFER
MY COWASSION / OC35238D EXPIRES
Much 20, 1998
BONDED TW 7M FAW INSURANCE. INC.
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
FLORIDA STATUTES. ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL AUTHORIZED TO ADMINISTER OATHS..
1. This sworn statement is submitted to
by
whose business address is
?, I q Do V ccl 14 ?
and (if applicable) its Federal Employer Identification Number (FEIN) is
(If the entity has no FEIN, include the Social Security Number of the individual signing this
sworn statement: .)
2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a
violation of any state or federal law by a person with respect to and directly related to the transaction of
business with any public entity or with an agency or political subdivision of any other state or of the United
States, including, but not limited to, any bid or contract for goods or services to be provided to any public
entity or an agency or political subdivision of any other state or of the United States and involving antitrust,
fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.
3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes, means
a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any
federal or state trial court of record relating to charges brought by indictment or information after July 1,
1989, as a result of a jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere.
4. I understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes, means:
1. A predecessor or successor of a person convicted of a public entity crime; or
2. An entity under the control of any natural person who is active in the management of the entity and
who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors,
executives, partners, shareholders, employees, members, and agents who are active in the management of
an affiliate. The ownership by one person of shares constituting a controlling interest in another person,
or a pooling of equipment or income among persons when not for fair market value under an arm's length
agreement, shall be a prima facie case that one person controls another person. A person who knowingly
enters into a joint venture with a person who has been convicted of a public entity crime in Florida during
the preceding 36 months shall be considered an affiliate.
5. I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural
person or entity organized under the laws of any state or of the United States with the legal power to enter
into a binding contract and which bids or applies to bid on contracts for the provision of goods or services
let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The
term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and
agents who are active in management of an entity.
6. Based on information and belief; the statement which I have marked below is true in relation to the entity
submitting this sworn statement. [indicate which statement applies.]
VNeither the entity submitting this sworn statement, nor any of its officers, directors, executives,
partners, shareholders, employees, members, or agents who are active in the management of the entity, nor
any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July
1, 1989.
The entity submitting this sworn statement, or one or more of its officers, directors, executives,
partners, shareholders, employees, members, or agents who are active in the management of the entity, or
an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July
1, 1989.
The entity submitting this sworn statement, or one or more of its officers, directors, executives,
partners, shareholders, employees, members, or agents who are active in the management of the entity, or
an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July
1, 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida,
Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that
it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor
list. [attach a copy of the final order]
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE
PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND,
THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED•
I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING
INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA
STABS FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAIINF�'S�TffiS FORM.
[signa
Sworn to and subscribed before me this PZ day of
Personally known _ 99��
OR Produced identification �`G X L 16
(Type of identification)
;�+"••s, MARTHA STROBIL
:*• COMMiSSiGN ! CC 248585
EXPIRES: December 28,1W
"A „�°�'• Bonded Th►u Mutery pI&MC t
Form PUR 7068 (Rev. 06/11/92)
Notary Public • State of�'�'t�'q
Mission expiresm7e
5, 1
(Printed typed or stamped
commissioned name of notary public)
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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVEPOLICY EXPIRATION LIMITS
TR' DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY
GENERAL AGGREGATE
$ 1, 0 000, 000
A X COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OP AGG.
$ INCL.
CLAIMS MADE X OCCUR. CPS 011241
10-5-93 10-5-94
PERSONAL & ADV. INJURY
A(1
$ 110001000 _
OWNER'S & CONTRACTOR'S PROT.
EACH OCCURRENCE
$ 11VW,DOD
FIRE DAMAGE (Any one fire)
$ 50, DOD
MED. EXPENSE (Any one person) $ 5,000
AUTOMOBILE LIABILITY
" COMBINED SINGLE
ANY AUTO
LIMIT
$
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per person)
$
HIRED AUTOS
: BODILY INJURY
NON -OWNED AUTOS
(Per accident)
$
GARAGE LIABILITY
PROPERTY DAMAGE
$
EXCESS LIABILITY
EACH OCCURRENCE
$
UMBRELLA FORM
AGGREGATE
$
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
STATUTORY LIMITS
EACH ACCIDENT
$
AND
DISEASE —POLICY LIMIT
$
EMPLOYERS' LIABILITY
DISEASE —EACH EMPLOYEE
$
OTHER
Received
%sk Nlgmt. & Loss Control
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
MONROE COUNTY TOURIST DEVELOPMENT
3406 N. ROOSEVELT BLVD.
SUITE 201
KEY WEST, FLMIDA 33040
IINriTAL __ b� c✓%r,�
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUIN COMPANY WILL ENDEAVOR TO
MAIL10__ DAYS WRITTEN NO T E ERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO ICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KI E MPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRES
DAVID W. FREEMAN P00194
J�.
SCOTTSDALE INSURANCE COMPANY °
ENDORSEMENT
NO. 3
ATTACHED TO AND
ENDORSEMENT EFFECTIVE
FORMING A PART OF
(STANDARD TIME)
INSURED
AGENCY AND CODE
POLICY NUMBER
Mo. DAY YR. 12:01 NOON
A.M.
Red Barn Actors Studio,
Gresham & Associates
CPS 011241
10
1.1
93
X
Inc.
090012
In consideration of an Additional Premium of $1,968.00, it is hereby understood and
agreed that Limits of Liability per CLS-SD-1 Commercial General Liability Coverage Part
Supplemental Declarations is amended to $1,000,000 in lieu of $300,000.
Previous Annual Premium for General Liability:
Revised Annual Premium for General Liability:
Pro Rata Additional Premium for General Liability (.984):
All other terms and conditions remain unchanged.
Surplus Lines Agent: DEBBIE J. OMNIELL
Agent-s Address: Palm Beach Gardens, FL
License No. 410-%-3468
Producing Agent: The Porter Allen Company
City: Key *st
This Insurance is issued pursuant to the
Florida Surplus Lines Law.
File # 888-92 Qtr. 4th
Premium $1; %& 00
Admin. Fee -0-
Tax $98.40
"
Agent-s Sigpature a'�) Vv 1
$1,500.00
$2,000.00
$1,968.00
REPRESENTATIVE .
UTS-3g (3-92)
11-2-93/kla
DATE
17. SCOTTSDALE fNSURPNCECOMPANY°
ENDORSEMENT
NO. 4
ATTACHED TO AND
ENDORSEMENT EFFECTIVE
FORMING A PART OF
(STANDARD TIME)
INSURED
AGENCY AND CODE
POLICY NUMBER
MO. DAY YR. 12:01 NOON
A.M.
Red Barn Actors Studio,
Gresham & Associates
CPS 011241
10
11
93
X
Inc.
090012
In consideration of an Additional Premium of $100.00, it is hereby understood and
agreed that CG-2011 Additional Insured is added and made to apply.
All other terms and conditions remain unchanged.
Surplus Lines Agent IEBBIE J. QRNILL
Agent's Address: Palm Beach Gardens, FL
License No. 410--%-3468
Producing Agent: The Porter Allen Company
City: Rey lest
This Insurance is issued pursuant to the
Florida Surplus Lines Law -
File # 888-92 Qtr. 4th
Premium $100.00
Adman. Fee -�D-
Tax $5.00
�1
Agent" s Signature
AUTHORIZED REPRESENTATIVE
UTS-3g (3-92)
11-2-93/kla
DATE
I
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -MANAGERS OR LESSORS OF
PREMISES ENDORSEMENT 4A
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
1. Designation of Premises (Part Leased to You): See Below
2. Name of Person or Organization (Additional Insured): See Below
3. Additional Premium: See Below
(If no entry appears above, the information required to complete this endorsement will be shown in the Declara-
tions as applicable to this endorsement.)
WHO IS INSURED (Section II) is amended to include as This insurance does not apply to:
an insured the person or organization shown in the 1. Any "occurrence" which takes place after you
resact liabilc arising bawcease to be a tenant in that premises.
-a�tbe ownership. maintenance or use�f that p_ artnfr
thg prhedule 2. Structural alterations, new construction or dem-
and subject to the following additional exclusions: olition operations performed by or on behalf of
the person or organization shown in the Sched-
ule.
DESIGNATION OF PREMISES
Location 1
319 Duval Street
Key West, Florida 33040
Location 2
812 Southard Street
Key West, Florida 33040
ADDITIONAL INSURED
1. Monroe County Tourist Development
3406 N. Roosevelt Blvd.
Suite 201
Key West, Florida 33040
2. Monroe County
Attn: Risk Management
College Road
Stock Island, Key West, Florida
33040
CG 20 11 1185 Copyright, Insurance Services Office, Inc., 1984 0
THE REAL F'LLORI1DA
THE F RI KEYS
&KEYWEST,,-..
KE-Y LARGO ISLAMCJRPfJA. MAf "I''' - E311. Pi'.1= K1-... • $. Wk ',1
December 30, 1993
Mr. Danny Kolhage
Clerk of the Circuit Court
500 Whitehead Street
Key West, Florida 33040
Dear Mr. Kolhage:
The Monroe County Board of County Commissioners approved an Agreement with
the Red Barn Actors Studio, Inc. covering the Red Barn '94.
Enclosed please find the original Certificate of Insurance approved by Risk
Management.
if you should have any questions regarding the above, please do not hesitate to call.
Sincerely
Carol A. Fisher
Administrative Assistant
:caf
Enclosures
Acknowledge Receipt: _6 Date: / ' 3 - C
3406 N.RoosEVEET BL.D Slut-_- �21)1, f'O_ Bc;x 0t,(_, Kr_; VV=.-1_ F(_. '�(.)41 US.A_ t:W)5) 1.9E-1552. • FAX:13O51296-0788
AMID.
ISSUE DATE (MM/DD/YY)
12-28-93
THE PORTER ALLEN COMPANY, INC.
513 SOUTHARD ST.
KEY WEST, FL. 33040
INSURED
RED BARN ACTORS STUDIO, INC.
P.O. BOX 707
KEY WEST, FL. 33040
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
COMPANIES AFFORDING COVERAGE
COMPAN
LETTER Y
A
SCOTTSDALE INSURANCE
COMPAN Y
B
D Of Ww A"Iffawl1w
LETTER
_...., ........
COMPANY
`.
LETTER
_.
COMPANY
D
LETTER
COMPANY
LETTER
E
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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION 'I LIMITS
TR : DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY
GENERAL AGGREGATE
$1 10 O 0 O O O �..
A X COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OP AGG.
_
$ INCL .
CLAIMS MADE X OCCUR.
CPS 011241
10-5-93 10-5-94
PERSONAL & ADV. INJURY
$1,000,000.
OWNER'S & CONTRACTOR'S PROT.
EACH OCCURRENCE
$1 , 0100 , O O O_.
FIRE DAMAGE (Any one fire)
_
$ 5.0 , O O 0.
MED. EXPENSE (Any one person); $ EXCLUDED
AUTOMOBILE LIABILITY
COMBINED SINGLE
$
ANY AUTO
LIMIT
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
HIRED AUTOS
BODILY INJURY
$
NON -OWNED AUTOS
(Per accident)
Received
GARAGE LIABILITY
Risk M
t- ss Comm
PROPERTY DAMAGE
$
EXCESS LIABILITY
DATE_
EACH OCCURRENCE
$
UMBRELLA FORM
AGGREGATE
$
INITIAL
OTHER THAN UMBRELLA FORM
STATUTORY LIMITS
WORKER'S COMPENSATION
EACH ACCIDENT
$
AND
_... .....
.. .,_. _.
DISEASE —POLICY LIMIT
$
EMPLOYERS' LIABILITY
DISEASE —EACH EMPLOYEE
$
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
MONROE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
ATTENTION: RISK MANAGEMENT EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
COLLEGE ROAD MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
STOCK ISLAND, KEY WEST FL. 33040 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTA-UVd R NZ
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
6
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -MANAGERS OR LESSORS OF
PREMISES ENDORSEMENT 4A
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
1. Designation of Premises (Part Leased to You): See Below
2. Name of Person or Organization (Additional Insured): See Below
3. Additional Premium: See Below
(If no entry appears above, the information required to complete this endorsement will be shown in the Declara-
tions as applicable to this endorsement.)
WHO IS INSURED (Section II) is amended to include as This insurance does not apply to:
an insured the person or organization shown in the 1. Any "occurrence" which takes place afte► you
Schedule but only with respect to liability arising out cease to be a tenant in that premises.
of the ownership, maintenance or use of thRt part of
the premises leased to you and shown in the Schedule 2. Structural alterations, new construction or dem-
and subject to the following additional exclusions: olition operations performed by or on behalf of
the person or organization shown in the'Sched-
ule.
DESIGNATION OF PREMISES ADDITIONAL INSURED
Location 1
319 Duval Street
Key West, Florida 33040
Location 2
812 Southard Street
Key West, Florida 33040
1. Monroe County Tourist Development
3406 N. Roosevelt Blvd.
Suite 201
Key West, Florida 33040
2. Monroe County
Attn: Risk Management
College Road
Stock Island, Key West, Florida
33040
Copyright. Insurance Services Office. Inc.. 1984
CG20111185