FY1994 10/20/1993AGREEMENT
This Agreement is made as of the 20th day of October ,
1993, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY,
-17 -n
FLORIDA, hereinafter "Board" and FLORIDA KEYS CHILDVN"S SfiLTLR,
hereinafter "CHILDREN'S SHELTER." o r
CD
WHEREAS, it is provided in the Children's She 4er's Aftici`e',s
of Incorporation that the purpose of the Children's $helgr
.ice
provides early intervention and prevention programs' for youth"In
crisis and their families and help in the form of an emergency
shelter residential facility for abused, neglected and runaway
children; and
WHEREAS, the Board recognizes a public purpose in
reimbursing the Children's Shelter for employee salaries and
operating expenses in lieu of providing the public support which
would otherwise be necessary for children in crisis and their
families; now, therefore
IN CONSIDERATION of the mutual promises and covenants
contained herein, it is agreed as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of
the Children's Shelter substantially and satisfactorily
performing and carrying out the duties and obligations of the
Board as to providing shelter, and early intervention and
prevention programs for youth's and their families living in
Monroe County, Florida, shall pay to the Children's Shelter the
sum of Twenty One Thousand Dollars ($21,000) for fiscal year
1993-94.
2. TERM. This Agreement shall commence October 1, 1993,
and terminate September 30, 1994, unless earlier terminated
pursuant to other provisions herein.
3. PAYMENT. Payment will be paid monthly as hereinafter
set forth. On or before the 15th of each month, the Children's
Shelter shall submit to the Board its request for reimbursement.
Evidence of payment shall be in the form of cancelled checks
submitted by the Children's Shelter to the Board. After the
Clerk of the Board examines and approves the monthly request for
reimburse- ment, the Board shall reimburse the Children's
Shelter. However, the total of said monthly payments in the
aggregate sum shall not exceed the total amount of Twenty One
Thousand ($21,000) during the term of this agreement.
4. SCOPE OF SERVICES. The Children's Shelter, for the
consideration named, covenants and agrees with the Board to
substantially and satisfactorily perform and carry out the duties
of the Board in providing shelter, and early intervention and
prevention programs for youth's and their families living in
Monroe County, Florida.
5. RECORDS. The Children's Shelter shall maintain
appropriate records to insure a proper accounting of all funds
and expenditures, and shall provide a clear financial audit trail
to allow for full accountability of funds received from said
Board. Access to these records shall be provided during
weekdays, 8 a.m, to 5 p.m., upon request of the Board, the State
of Florida, or authorized agents and representatives of the Board
or State.
2
The Children's Shelter shall be responsible for repayment of
any and all audit exceptions which are identified by the Auditor
General of the State of Florida, the Clerk of Court for Monroe
County, an independent auditor, or their agents and
representatives. In the event of an audit exception, the current
fiscal year contract amount or subsequent fiscal year contract
amounts shall be offset by the amount of the audit exception. In
the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the Children's
Shelter shall be billed by the Board for the amount of the audit
exception and the Children's Shelter shall promptly repay any
audit exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The Children's
Shelter 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
services rendered under this agreement by the Children's Shelter
or any of its agents, employees, officers, subcontractors, in any
tier, occasioned by the negligence or other wrongful act or
omission of the Children's Shelter or its subcontractors in any
tier, their employees or agents. In the event the completion of
services is delayed or suspended as a result of Children's
Shelter's failure to purchase or maintain required insurance, the
Children's Shelter shall indemnify the Board from any and all
3
increased expenses resulting from such delay. The first Ten
Dollars ($10.00) of remuneration paid to the Children's Shelter
is for the indemnification provided above. The extent of
liability is in no way limited to, reduced, or lessened by the
insurance requirements contained elsewhere within this agreement.
7. INDEPENDENT CONTRACTOR. At all times and for all
purposes hereunder, the Children's Shelter is an independent
contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the
Children's Shelter or any of its employees, contractors, servants
or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services
pursuant to this agreement, the Children's Shelter shall abide by
all statutes, ordinances, rules and regulations pertaining to or
regulating the provisions of, such services, including those now
in effect and hereinafter adopted. Any violation of said
statutes, ordinances, rules or regulations shall constitute a
material breach of this agreement and shall entitle the Board to
terminate this contract immediately upon delivery of written
notice of termination to the Children's Shelter.
9. PROFESSIONAL RESPONSIBILITY AND LICENSING. The
Children's Shelter shall assure that all professionals have
current and appropriate professional licenses and professional
liability insurance coverage. Funding by the Board is contingent
upon retention of appropriate local, state and/or federal
certification and/or licensure of the Children's Shelter's
program and staff.
I
10. INSURANCE. The Children's Shelter shall obtain, prior
to the commencement of work governed by this agreement, at
Children's Shelter's own expense, that insurance specified in the
insurance schedules attached hereto and incorporated herein by
reference. The Children's Shelter will also insure that all
subcontractors, in any tier, have obtained the insurance as
specified in the attached schedules. The Children's Shelter will
not be reimbursed for any work commenced prior to coverage with
required insurance. The Children's Shelter will not be
reimbursed for any services governed by this contract until
satisfactory evidence of the required insurance has been
furnished to the Board via either Monroe County's certificate of
insurance or a certified copy of the actual insurance policy.
Delays in the commencement of work, resulting from the failure of
Children's Shelter to provide satisfactory evidence of the
required insurance, shall not extend deadlines specified in this
agreement. The Children's Shelter and any subcontractors shall
maintain the required insurance throughout the entire term of
this agreement. Failure to comply with this provision may result
in the immediate termination of reimbursement.
The Board, at its sole option, has the right to request a
certified copy of any or all insurance policies required by this
agreement. If a certificate of insurance is provided, the
County -prepared form must be used. "Accord Forms" are not
acceptable.
All insurance policies must specify that they are not
subject to cancellation, non -renewal, material change, or
5
reduction in coverage unless a minimum of thirty (30) days prior
notification is given to the Board by the insurer. The standard
language of "endeavor to provide notification" is insufficient.
The acceptance and/or approval of the Children's Shelter's
insurance shall not be construed as relieving the Children's
Shelter from any liability or obligation assumed under this
agreement or imposed by law.
Monroe County, Monroe County Board of County Commissioners,
its employees and officials shall be included as "additional
insureds" on all policies, except for worker's compensation.
Any deviations from these general insurance requirements
must be requested in writing on the County -prepared form entitled
"Request for Waiver or Modification of Insurance Requirements"
and approved by Monroe County's Risk Manager.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifica-
tions of the services and/or reimbursement of services shall be
amended by an agreement amendment, which must be approved in
writing by the Board.
12. NO ASSIGNMENT. The Children's Shelter shall not assign
this agreement except in writing and with the prior written
approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This
agreement shall be incorporated by reference into any assignment
and any assignee shall comply with all of the provisions herein.
Unless expressly provided for therein, such approval shall in no
manner or event be deemed to impose any obligation upon the Board
1.1
in addition to the total agreed upon reimbursement amount for the
services of the Children's Shelter.
13. NON-DISCRIMINATION. The Children's Shelter shall not
discriminate against any person on the basis of race, creed,
color, national origin, sex or sexual orientation, age, physical
handicap, or any other characteristic or aspect which is not
job -related in its recruiting, hiring, promoting, terminating or
any other area affecting employment under this agreement. At all
times, the Children's Shelter shall comply with all applicable
laws and regulations with regard to employing the most qualified
person(s) for positions under this agreement. The Children's
Shelter shall not discriminate against any person on the basis of
race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any other
characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATORY. The signatory for the Children's
Shelter, below, certifies and warrants that:
(a) The Children's Shelter's name in this agreement is the
full name as designated in its corporate charter, if a
corporation, or the full name under which the Children's Shelter
is authorized to do business in the State of Florida;
(b) He or she is empowered to act and contract for the
Children's Shelter; and
(c) This agreement has been approved by the Board of
Directors of the Children's Shelter, if the Children's Shelter is
a corporation.
7
15. NOTICE. Any notice required or permitted under this
agreement shall be in writing and hand -delivered or mailed,
postage pre -paid, by certified mail, return receipt requested, to
the other party as follows:
For Board: Monroe County Attorney
310 Fleming St., Rm. 29
Key West, Florida 33040
For Children's
Shelter: Dale Wolgast
Executive Director
Florida Keys Children's Shelter
73 High Point Road
Tavernier, Florida 33070
16. CONSENT TO JURISDICTION. This agreement shall be
construed by and governed under the laws of the State of Florida
and venue for any action arising under this agreement shall be in
Monroe County, Florida.
17. NON -WAIVER. Any waiver of any breach of covenants
herein contained to be kept and performed by the Children's
Shelter shall not be deemed or considered as a continuing waiver
and shall not operate to bar or prevent the Board from declaring
a forfeiture for any succeeding breach, either of the same
conditions or covenants or otherwise.
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or
cannot be continued at a level sufficient to allow for continued
reimbursement of expenditures for services specified herein, this
agreement may be terminated immediately at the option of the
Board by written notice of termination delivered to the
Children's Shelter. The Board shall not be obligated to pay for
any services or goods provided by the Children's Shelter after
the Children's Shelter has received written notice of
termination, unless otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or
personal, purchased with funds provided under this agreement,
shall become the property of Monroe County and shall be accounted
for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the
entire agreement of the parties hereto with respect to the
subject matter hereof and supersedes any and all prior agreements
with respect to such subject matter between the Children's
Shelter and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these
presents to be executed as of the day and year first written
above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
By
eputy r
BOARD OF COUNTY COMMISSIONERS
OF MONR COUNTY, FLORIDA
y
Mayo—r7Chairman
FLORIDA KEYS CHILDREN'S
SHELTER
-44Lz-
ecut erector
APPR0 S0 AS TO Fr 74
AN GAL SUFFiC! '
2
April 22. 199.1
lsr Printing
WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
FLORIDA KEYS CHILDRENS SHELTER
Prior to the commencement of work governed by this contract the Contractor- shall obtain
Workers' Compensation Insurance with limits sufficient to respond to the applicable state statutes.
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than:
$500,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$500,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract.
Coverage shall be provided by a company or companies authorized to transact business in the
state of Florida and the company or companies must maintain a minimum rating of A -VI, as
assigned by the A.M. Best Company.
If the Contractor has been approved by the Florida's Department of Labor, as an authorized self -
insurer, the County shall recognize and lionor the Contractor's status. The Contractor may be
required to submit a Letter of Authorization issued by the Department of Labor and a Certificate
of Insurance, providing details on the Contractor's Excess Insurance Program.
If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required.
In addition, the Contractor may be required to submit updated financial statements from the fund
upon request from the County.
Administrative InAwdion WC2
114709.1
82
April 22. 1993
Is[ Printing
GENERAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
1314,"l'WEEN
MONROE COUNTY, FLORIDA
AND
FLORIDA KEYS CHILDRENS SHELTER
Prior to the commencement of work governed by this contract, the Contractor shall obtain
- General Liability Insurance. Coverage shall be maintained throughout the life of the contract and
include, as a minimum:
• Premises Operations
• Products and Completed Operations
• Blanket Contractual Liability
• Personal Iniury Liability
• Expanded Definition of Property Damage
The minimum limits acceptable shall be:
$1,000,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$ 500,000 per Person
$ 1,000,000 per Occurrence
$ 100,0001'roperty Damage
An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its
provisions should include coverage for claims filed on or afler the effective date of this contract.
In addition, the period for which claims may be reported should extend for a niinimum of twelve
(12) months following the acceptance of work by the County.
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
Adminislralive Imtniclion GL3
a47p9.1
56
April 22, 1993
1st IYiNing
VEHICLE L1AIIIIXI'Y
INSURANCE REQUIREMENT'S
FOR
CON'I'RACT
BE"f WEEN
MONROE COUNTY, FLORIDA
AND
FLORIDA KEYS CHILDRENS SHELTER
Recognizing that the work governed by this contract requires the use of vehicles, the Contractor,
prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be
maintained throughout the life of the contract and include, as a minimum, liability coverage for.
• Owned, Non -Owned, and I fired Vehicles
The minimum limits acceptable shall be:
$100,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$ 50,000 per Person
$100,000 per Occurrence
$ 25,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
Administrative Irutniction V L 1 1
Nd709.1 75
April 22. 1993
1st Printing
PROFESSIONAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BE'IVEEN
MONROE COUNTY, FLORIDA
AND
FLORIDA KEYS CHILDRENS SHELTER
Recognizing that the work governed by this contract involves the furnishing of advice or services
of a professional nature, the Contractor shall purchase and maintain, throughout the life of the
contract, Professional Liability Insurance which will respond to damages resulting from any claim
arising out of tile- performance of professional services or any error or omission of the Contractor
arising out of work governed by this contract.
The minimum limits of liability shall be:
$1,000,000 per Occurrence/$2,000,000 Aggregate
Administrative Irdniction PRO3
94709.1 74
PRODUCER
r
INSURED '
CERTIFICATE OF INSURANCE
j- 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
I POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY '1
LETTER A .... ... ��
COMPANY E3
LETTER
COMPANY G. I j'+++Ittt� / ��• f �f '
LETTER
COMPANY
p
LETTER
COMPANY('n / P
LETTER E
I` I•. , ; I', I 1.. !: !"� i'.I ':; L: 1.1
ISSUE DATE (MM/DD/YY)
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.
i
CO TYPE OF INSURANCE POLICY NUMBER
LTR
GENERAL LIABILITY
I •I
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
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL AGGREGATE $
PRODUCTS-COMP/OP AGG. $
PERSONAL & ADV. INJURY $
EACH OCCURRENCE $ .i „ it (1 (; „ CI
FIRE DAMAGE (Any one lire) $ c., i•, „ ; `, j`, /•;
MED. EXPENSE (Any one person) $ c,
APPROVED BY RISK MANAGEMENT LCOIMBINED SINGLE $
DATE
WAIVER N/A �S
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
CERTIFICATE HOLDER
FI I..! !J i. N t:; L) i': !:: L;'
,
r I I.:. .... I... I ,
I
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
EACH OCCURRENCE $ I
AGGREGATE $
i
STATUTORY LIMITS
EACH ACCIDENT $
DISEASE —POLICY LIMIT $
DISEASE —EACH EMPLOYEE $
CANCELLATI..O.N _
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION 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 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE -
ACORD 25-S (7/90)
OACORD CORPORATION 1990
INSURED '
CERTIFICATE OF INSURANCE
j- 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
I POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY '1
LETTER A .... ... ��
COMPANY E3
LETTER
COMPANY G. I j'+++Ittt� / ��• f �f '
LETTER
COMPANY
p
LETTER
COMPANY('n / P
LETTER E
I` I•. , ; I', I 1.. !: !"� i'.I ':; L: 1.1
ISSUE DATE (MM/DD/YY)
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.
i
CO TYPE OF INSURANCE POLICY NUMBER
LTR
GENERAL LIABILITY
I •I
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
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL AGGREGATE $
PRODUCTS-COMP/OP AGG. $
PERSONAL & ADV. INJURY $
EACH OCCURRENCE $ .i „ it (1 (; „ CI
FIRE DAMAGE (Any one lire) $ c., i•, „ ; `, j`, /•;
MED. EXPENSE (Any one person) $ c,
APPROVED BY RISK MANAGEMENT LCOIMBINED SINGLE $
DATE
WAIVER N/A �S
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
CERTIFICATE HOLDER
FI I..! !J i. N t:; L) i': !:: L;'
,
r I I.:. .... I... I ,
I
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
EACH OCCURRENCE $ I
AGGREGATE $
i
STATUTORY LIMITS
EACH ACCIDENT $
DISEASE —POLICY LIMIT $
DISEASE —EACH EMPLOYEE $
CANCELLATI..O.N _
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION 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 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE -
ACORD 25-S (7/90)
OACORD CORPORATION 1990
COUNTY)' ID :305-2'92-4401 JRI''1 26' 93 16: 01 PI0 .01'9 PM
•
Ccrtilicatc of Ilasur;ltlCc
NIONROE COUNTY'
a- Irttrr'M IWAklrs shown Irt rhlr ecrilllnte, t1.Ir r�triliute d Inw.�.cr k t+r.t.e .. u.. -Jf- . 6.Wd .hares 1+1-�. 'TMt• ..r<lrcare .i.........,...e• a....l ..
r.e .o....r. rr..a.� bf a.. P.1.0- sed bO.- mfm .. •ho- Mtwv....r.-
L.aMrATJ1E AFFORDING r nV RACON
rx.+- ir7tt AWrM!C OT MLuhr[r
FLORIDA KEYS CIITLDRENS SHELTER, INC .
73 HIGH POINT ROAD I�' NATIONAT., INDEMNITY COMPANY OF
�, TI-IF. SOUTH
TAVERNIER, FL 33070C..,yr.r,<.
'"LAND AnnY,ss ny u;rrrcr_
RAY HAMPSON £r ASSOCIATES
102481 OVERSEAS HIGHWAY.Z� !�� --
KEY LARGO, FL 33037 ramp.�yr..�rli r.irt :,
7i+is is to crr►i(d' That the insurJnCC policies listed txlnu :Ssvc hcrtt ifxUC(! to at, insured nn.t are enGcsntd at this time- It :s U'f;rc c.i that c+nsr of +hctie
la>licics t+�U Irc tintrhttl nr chand;crl vAthout providing 45 Jays written noocc of sur-h caf,c01ation of chanl•c to monroc County, Cl'd'tu
fr+
�d•IncR rocr=rr oA� ror.r-cr nArr. Atx u,tns trtrtmusArnK
co trt'trtr»R ter INfV7NNce
1 r�--
- General Ap) re�tte ?
General [iabiliry
1'rodu[tsCamp/O1iS i
Q Cnmmercial Gcncrrl liability q EMENI
❑ Claims J.Iadc Q occufmcc RISK MAN Aggrrpntc
APPROVED �
�/ 1'rrx+mal Y AdvcRisinp 1
❑ Owner's do ContracWln Pfgtctzive
R� I rrll Z injury
G V L'nch nccurrencc 3
❑ \_C_U_ CuvcnF.- DATE
❑ Idrowl form r(nfrtrty Paotauc !A �----Y S r I ) F <�•n bye r...l 1
WAIVER: � `f 1 I
❑ Inacix-micnt Cuntt•Y4rY / Mrvlit.rt Ef ftcncU f
O n1jinket Contractual _ _•___._„� _
_ mxlity injury
Aummot+ilt t1a1>ility
(nach Person) t
❑ Any .Auto
A Q Alt 0-11clAutos 74AP119642 2/04/93 11/24/93 (d--rchArcitlrm) S
❑ Scheduled Au,U1 Prntymy IYamaxr 1
ISOdily Injury and Properry t 300 ,
Ty Ilirid Autos r
DamaRt CombinM _
Medical..Paymerits
XX Nont)wncd Autos _� —_--- -
IJodity lniary And !
P.nccsa liability
❑ Umbrella rornl Property dlamage
❑ O+her than Umbrella Fonts Combined
Q Claims Made '
- --- - - Wn:kcrs' Comfx•nutinn Gatutory
Worker' Cornpm,,ition and
limltloyco' liability - 1�rr,plgrrs' Liability
Commenu: %annroc Cot.nty, 17oryd2, and J-loirr,.,c taunty Itoatd of C:nmur r'nrlln+lssiuncr� are namctl m, Addirion.rl ilmolvds with mpm to the
Gence.l tiabifity, Vrl.rtle liabaitY. and P.xecss lhhitity I'nikicd. - EXCLUDING F_MPLOYF.F..Sv
2/22/93
tt~ AAA�.rcw%A + AAA- nalr Itstled: �
monroe County
A,+atc�riztd Representathe: Roger T.Gob1
5100 college Road
Ad,Jrrss: P O Box 2909 Jacksonvil e r 322 3
Kcr VCSt, FL 330404399 Telephoner_ 9 0 4- 3 S 4- 7 711
OCT 26 "93 09�10 U �!
U |
OCT
.-- '— —' -- n ;.
*
ORE-
THIS CER E Is ISSUED AS A MATTER OF INFORMAMON ONLY AND
PRODUC&A
3070
COMPAN
COMPANY
Oompmy
THIS iSTO CVA'nFYIMAT THE POLICIES OF INSURAN(
INDICATED, NOTWITHSTANDING ANY REQUIREMENT,
E
'E
T -D BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THO POLICY PERIOD
C � CONDITION OF �NY CONTRACT OR OTHER COCAJMENT WITH RESPECT TO WHICH THIS
CERTIFICATE!MAY BE ISSUEff OR MAY PERTAIN, THE
110u,
ANCE AFFORDED �Y THE POLICIES DESCRIBED HEREIN IS, SUBJECT TO'ALL THE TERMS,
EXCLUSIONSiND CONDITIONS OF SUCH POLICIES. L
MITS:G
HOWN MAY HAVE:BEEN REDUCED BY PAID CLAIVIS.
TYPE ?F INSURANCE POLICY s
im"
POLICY PMTIVB POLICY EXPIRATION! LIMITS
CLA"S MADE OCCUR.
PERSONAL & ADV. INJU S
OWNER'S CONTRACTOR'S PROT.
EACH OCCURRENCE s
FIRE DAMAGE (Any env fire) I;
ANY AUTq
LIMIT
ALL O.WNEP AUTOS
GCHFOUL40 AUTOS
(Par person)
HIRED AUIOB
AGGREGATE
AM
FLORIDA OPERAT113NS ONLY
SHouLD A�Y OF THE ABOVE DESCRIBED POLICIES BE CANCE�LED SEFOF.IE THE
MAIL DAYS WRITTEN NOTICE TO TH9 CgfMFICA*re HOLDOR NAMED TO THE
LEFT, BU`I? FAILURE TO MAIL SUCH NOTICE SHALL,IMPOSE NO OBLIGATION
LIABILITY OF ANY KIND UPON THE MMPANY, ;TS AGENTS OR REPRFsENTATives,