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Certificates of Insurance
M Rosa l ip i rnnnnl l m Deputy ci "k DATE 1 .18�JRR SUBJECT Corrected endorsement - additional in sured Attached please find original corrected additional insured endorsement regarding Florida Health Services - Professional Liability Insurance which should be attached to the original contract with same and Monroe County In Home Services for CCE and CCDA programs. This was resolution # 418-1987.... Approved by the Board of County Commissioners 'on November 3, 1987. Thank you for your usual cooperation. BY Gwen Rodriguez, Project Director Monroe County In Home Services TOPS IPFORM1232 una ar u.s.a GENERAL AMENDMENT ENDORSEMENT NO: 7 THE POLICY TO WHICH THIS ENDORSEMENT IS ATTACHED IS HEREBY AMENDED AS FOLLOWS: In consideration of an additional premium of $500.00, it is understood and agreed that the following entity is added as an additional Naned Insured: plus Tax $15.00 Board of County Commissioners Monroe County, Florida SURPLUS LINES AGENT, EDWARD J. WOICHICK LIC. # 009-30.8590.05 4763 S. CONWAY RD., SUITE B •RLANDO, FL 32812 PROD. AGT.-Braun & Brown CITY THE INSURANCE IS ISSUED PURSUANT TO THE FLORIDA SURPLUS LINES LAW. PERSONS JISURED By SURPLUS LINES CARRIERS DO NOT HAVE THE PROTECTION OF THE FL3RIDA INSURANCE Gd •RANTY ACT TO THE EXTENT 01 ANV RIGHT OF RECOVERY FOR THE OBLIGATION OF N.N INSOLVENT IN'.:CENSED INSURER. FILE j.-87 file 1st qt. 1988 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. ANNUALPREMIUM I DUE AT ENDORSEMENT EFFECTIVE DATE INSTALLMENT PREMIUM PAYMENTS Date Due Prior Installments $ $ ENDORSEMENT TOTAL PREMIUM Is Additional Premium I Return Premium Attached to and forming part of Policy No. 80-1093088 Issued to Florida Health Nursing Service, Inc. Effective 11/2/87 I REVISED INSTALLMENTS I Cl INTERSTATE FIRE & CASUALTY COMPANY ❑ CHICAGO INSURANCE COMPANY ❑ INTERSTATE INDEMNITY COMPANY t . A r By IIG-9-35 (1182) INSURED MEMORANDUM TO Rosalie Connolly, Deputy Clerk Monroe County G4e% Rodriguez, Project Director Monroe County In Home Services DATE October 6, 1988 SUBJECT Certificate of Insurance - Florida Health Nursing Services, Inc. Attached please find certificate of insurance to be attached to Resolution No. 271-1988 between Monroe County Board of County Commissioners and Florida Health Nursing Services, Inc. Thank you for your continued cooperation. GR/gs DATE (MM/DD/YY) 9-19-88 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Gordon B . hilli s & Co . NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, p EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 8116 Maitland, Fl 32751-2116 COMPANIES AFFORDING COVERAGE ETTERNY A Scottsdale Insurance Company COMPANY INSURED LETTER s Florida Health Nursing Services, Inc. COMPANY 1510 Venera Avenue LETTER C Coral Gables, Fl 33146 COMPANY p LETTER COMPANY E LETTER THIS IS TO CERTIFY THAT 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 CONDI- TIONS OF SUCH POLICIES. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDNY) POLICY EXPIRATION DATE (MWDD/YY) LIABILITY LIMITS IN THOUSANDS EACH OCCURRENCE AGGREGATE GENERAL LIABILITY BODILY A X COMPREHENSIVE FORM GLS 200764 8-19-88 8-19-89 INJURY $ $ PROPERTY X PREMISES/OPERATIONS UNDERGROUND DAMAGE $ $ EXPLOSION & COLLAPSE HAZARD X PRODUCTS/COMPLETED OPERATIONS CONTRACTUAL BI & COMBINED $ 1f 000 $ 1 000 f X INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY $ X Broad Form CGL AUTOMOBILE LIABILITY BODILY ANY AUTO INJURY (PER PERSON) $ ALL OWNED AUTOS (PRIV. PASS.) BODILY ALL OWNED AUTOS (OTHER THAN INJURY (PER ACCIDENT) $ PASS. PRIV.HIRED PROPERTY AUTOS NON -OWNED AUTOS DAMAGE $ GARAGE LIABILITY BI&PD COMBINED $ EXCESS LIABILITY UMBRELLA FORM BI & PD COMBINED $ $ OTHER THAN UMBRELLA FORM STATUTORY WORKERS' COMPENSATION $ (EACH ACCIDENT) AND $ (DISEASE -POLICY LIMIT) EMPLOYERS' LIABILITY $ (DISEASE -EACH EMPLOYEE) One Million Dollars JOTHER A Professional Liability GLS 200764 8-19-88 8-19-89 each claim/aggregate Insurance DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Monroe County Board Of County Commiss e11WOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX - Monroe County In Home Services PIRATIQNI DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL l UU DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 1315 Whitehead S t . LEFT, BUT FAILURE TO114JIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Key West, Fl 33040 OF ANY KIND UPON COMPANY, ITS AGENTS OR P SENTATIVES. it AUTHORIZED REPRESEN IVE Attn: Ms. Gwen Rodriguez, Project Di for 7 0— SCOTTSDALE INSURANCE COMPANY ENDORSEMENT NO. _____ --------------- WORMING-------------------------------------------------------------|ATTACHED TO AND |ENDOR%EMENT EFFECTIVE| | A PART OF } (STANDARD TIME) | \ [ POLICY NUMBER |MO DAY YR 12:Oiam i INSURED i AGENCY AND CODE | /------------------ |--------------------- |------------------- |------------------ | � GL% 280764 /8 | 19 | 88 | X /Florida Health |GORDON B. PHILLIP%| } | \ I I | Q CO. 090006 [ |------------------ !||---- |-------- |------------------- \------------------ | ADDITIONAL INSURED In consideration of the premium charged on this policy, it is agreed and understood that the following is added as an additional insured: Monroe County Board of County Commissioners Monroe County In Home Services 130 Whitehead %t. Key West, Fl 33040 The inclusion of this additional interest shall not operate to extend the limits of liability afforded by this policy. All other terms and conditions remain unchanged. DATE: September 19' 1988 UT%-3(6-82) any ---- outnorz xepresene " ISSUE DATE (MM/DD/YY) CERTIFICATE OF INSURANCE PRODUCER 9/21/89 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Brown & Brown, Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, P.O. Drawer 1712 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Daytona Beach, FL 321.15 COMPANIES AFFORDING COVERAGE CODE COMPANY A LETTER COMPANY B INSURED LETTER Florida Health Nursing Services, Inc. 1510 Venera Avenue Coral Gables, FL 33146 SUB -CODE COMPANY c LETTER COMPANY D LETTER COMPANY E LETTER Scottsdale Insurance Company Wausau Insurance Company 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE (MM/DD/YY) DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY GENERAL AGGREGATE $ 1,000, A X COMMERCIAL GENERAL LIABILITY TO Be Determined 8/19/89 8/19/90 PRODUCTS-COMP/OPSAGGREGATE S CLAIMS MADE X OCCUR. PERSONAL 3 ADVERTISING INJURY $ OWNER'S 6 CONTRACTOR'S PROT. EACH OCCURRENCE $ 1,000, FIRE DAMAGE (Any one fire) $ 50, MEDICAL EXPENSE (Any one person) $ 1 f AUTOMOBILE LIABILITY COMBINED ANY AUTO SINGLE E LIMIT ALL OWNED AUTOS BODILY SCHEDULED AUTOS INJURY $ (Per person) HIRED AUTOS BODILY NON -OWNED AUTOS INJURY $ (Per accident) GARAGE LIABILITY PROPERTY $ DAMAGE EXCESS LIABILITY EACH AGGREGATE OCCURRENCE i S OTHER THAN UMBRELLA FORM B WORKER'S COMPENSATION 1410-00-093033 STATUTORY TUTO 5/04/89 5/04/90 AND100, s (EACH ACCIDENT) EMPLOYERS' LIABILITY _ _ 100, (DISEASE —POLICY LIMIT) S 500, (DISEASE —EACH EMPLOYE OTHER IDESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPEaAL ITEMS *Sexual & Physical Abuse Limits $25,000 each person $50,000 aggregate CERTIFICATE HOLDER /Hold Harmless Clause inclugWELLATION for; SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Board of County Commissioners Monroe County EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO Florida MAIL 45- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILLTY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHOR D REPR �SENTATIY�,� ACORD 25-S (3/88) IVACORD CORPORATION 1 888 SCOTTSDALE INSURANCE COMPANY Y ENDORSEMENT N C] . ------------------------------------------------------------------------------- 1ATTACHED TO AND 1ENDORSEMENT EFFECTIVE1 I (FORMING A FART OF I (STANDARD TIME) I I IPOLICY NUMBER TO DAY YR 12:01 1 INSURED I AGENCY AND CODE I I------------------ I--------------------- 1---------- t I GLS 200764 1081 19 1 90 1 X (Florida Health ISOUTHERN UNDER- i I I I I I lNursing Service,Inc1WRITERS,INC.0900061 ------------------ r--f----f---- i--------1-------------------- 1-------------------- 1 GENERAL LIABILITY ENDORSEMENT It is agreed that the following provision(s) appi to the above policy: (Only those Provisions indicated by an 'X' in the appropriate brackets apply.) A. ( ) CLASSIFICATION LIMITATION It is hereby understood and agreed that coverage as provided by this policy applies only to these operation_ as described under the 'Description O Hazards' section of the coverage parts attached to this policy. K (X) MINIMUM EARNED PREMIUM If this policy is cancelled at., the request of the INSURED, the total retained by the Company shall not be less than 25% of the premium oi- $629.00, whichever is greater, C. ix) PUNITIVE OR EXEMPLARY DAMAGE EXCLUSION It is understood and agreed that this policy does not apply to a claim or or indemnification for punitive or exemplary damages. If a suit shall have been brought against the INSURED for claim falling within the coverage provided under- the policy, seeking both compensatory and punitive or exemplary damages, them the Company will afford a defense to such action; however, the Company shall not have an obligation to pay for any costs, interest, or damages attributable to punitive or exemplary damages. ------------------------------------ DATE: 08: 3v/90 Authorized Representative pd GLS-30 1-86) H 3 M Q y "•� r y♦' !�� a= NCDN O a d (D r- ■ m p oo .•. a O -� s �E =o_-• 19 ME in A • (D 7 C G A o A A p O Q • C p A CD a N O c w -. O co trwf 7 j R) 7 DG w 00 O /D O. l9 Orw O7 O .•. � D) C C w F O O CL O q a�C N• a S. o o > 3 Ca W_ -• 3 n �vCL. ; m G 0 3 o w r O06 A n oo� H' N S Z 7 q O ? CD nd=r a �3a sc=O Qoa = r iO oo�, arm a a 3s V I sm v M M Q ~_ Zma C n� P� o 9oNo Co D 1 M N lD w C 7 O C m M p N n T� O Z y e C o � c s: Z o w &< CL o CD0.a z o N L 0 0 Cj CL. e d n, 9 , y CD 3� A. O eD v . d ; Er Q A r O m co 0 CD 06oCD Co -.0 N O_ y m CO A C.N � = fD N O. CL r- 7 CD _ V d ri� OrVa ' c C D N � W m00 _ p N — O Cr 5.00 (D O a y. a O d Cr (D ` S S .� O 67 O _.._ N d - 0 O G cOi , m C O = 0- .o � CD a o, ,..0�. 3 � O A d 3 3 A Q 033 n3, C -0 3 7 0 (D 0, A a c c, 3 s N 0) g C_ in D GO cn O CD P.-m ca --�0 co- (n f7 c Q. r—r -� phj O -. y ccn O (aD (AD _ S co m y 0 7 7 X y C Q 0-0 � .< (D ' -:C r y O a O C (n �- H 0 0 a O ;-z- co O :3 v Z O . (D .� rn 0 -+. O (n O 1 Q. 3 N .0 o, 3 D O a C i (4 — 0) (D C to O D (D co (D N ° 0 3 a o D (n OCD � y S Cr m 0 CD 3 rY ? O O y � a o CD G (D H D) a�� cm 0. CD O 3 H y i T D D1 Or K D c, m Z D 0 0 K D 0 m D D aOZ T 0 O m 0 Zp D-O D N Z m O m m D Z O m � T T D � a Z m O O Z z N C D 0 D C) m Z n D z 0 C) O 0 m A 1_--] r 1 Al ZZ 00 a The Cochenour Agency, Inc. P.O. Box 290066 • Port Orange, Florida 32129 (904) 788-6790 • FLA Watts 800-962-2053 September 6, 1990 Florida Health Nursing Service, Inc. 715 Palermo Avenue Coral Gables, Florida, 33134 Attn: Jobyna L. Okell RE: Professional Liability Policy #GLS200764 Policy term 8/19/90 to 8/19/91 Dear Ms. Okell, Enclosed you will find a RENEWAL CERTIFICATE for the above referenced which should be attached with your policy. We have requested the company to correct your mailing address and will forward the endorsement to you when it is issued. We encourage you to review the policy to be sure the coverage is what you desired. If you have any questions about the renewal coverage let us know immediately. Thank you for allowing us to continue this important coverage. Sincerely, Stella Santoro Customer Service Renewal Certifica GLS 200764 Policy Number SCOTTSDALE INSURANCE COMPANY 8370 East Via De Ventura Scottsdale, Arizona 85258 A STOCK COMPANY ITEM 1. NAMED INSURED AND MAILING ADDRESS Florida Health Nursing Services,Inc. 1510 Venera Ave. Coral Gables,Dade Co.,FL 33146 AGENT NAME AND ADDRESS Southern Underwriters, Inc. P.O. Box 948116 Maitland, FL 32794-8116 Agent No. 090006 ITEM 2._-POLICY PERIOD 1 year From: 8-19-90 To: 8-19-91 A.M., Standard Time at the addres as stat In consideration of the renewal premium stated, the above numbered policy is renewed for the period specified, subject to the terms and conditions thereof, except as otherwise specified herein. ANNUAL PREMIUM TAX POLICY FEE INSPECTION FEE $1,794.00 $90.95 $25.00 NO CHANGES FROM PREVIOUS TERM. TOTAL PAID $1,909.95 JXJ CHANGES ON ENDORSEMENT BELOW ARE APPLICABLE WITH ABOVE INCEPTION DATE. Florida Surplus Lines File Tax No.:B156-88 Q3-90 Revised Form L6395a is attached to and made a part of this policy. Revised Form GLS-3 is attached hereto and made a part of this policy. Forms UTS-131 and L9235 are attached hereto and made a part of this policy. BETTY A. SPENCE - SURPLUS LINES AGENT i 448483193 PRODUCING AGENT: JnFn R. Cochenour-Pt. Orange THIS INSURANCE IS ISSUED PURSUANT TO THE FLORIDA SURPLUS LINES LAW. PERSONS INSURED BY SURPLUS LINES CARRIERS DO NOT HAVE THE PROTECTION OF THE FLORIDA INSURANCE GUARANTY ACT TO THE EXTENT OF ANY RIGHT OF RECOVERY FOR THE OBLIGATION OF AN INSOLVANT UNLICENSED INSURER. BS/pd Q&J, UTS-1 (6-82) uthoriz d Represen tive COVERAbE PART l 6395a (Ed. 1.73) COMPREHENSIVE GENERAL LIABILITY INSURANCE For attachment to Policy No. GLS 200764 to complete said policy. ADDITIONAL DECLARATIONS Location of all premises owned by, rented to or controlled by the named Insured (ENyeR •,,.,„ IF SANE LOCATION AS ADDRESS SHOWN IN ITS. I Of DECLARATIONS) Interest of named insured in such premises ICNECR .FLOW) Owner ❑ General Lessee Tenant Other Part occupied by named insured ,ENTER .FLOW) The following discloses all hazards insured hereunder known to exist at the effective date of this policy, unless otherwise stated herein. REVISED 8-19-90 SCHEDULE The insurance afforded is only with respect to such of the following Coverages as are indicated by specific premium charge or charges. The limit of the company's liability against each such Coverage shall be as stated herein, subject to all the terms of this policy having reference thereto. Coverages Limits of Liability Advance Premiums each occurrence aggregate A —Bodily Injury Liability $ Per Form $1203 $ 494.00 B—Property Damage Liability $ Per Form $1,203 $ Included Form numbers of endorsements attached at issue $ Included Per Declarations Page I Total Advance Premium $ 494.00 General Liability Hazards Description of Hazards Cod Premium Bases Rates Advance Premiums B.I. P.D. Bodily Injury Property Damage Premises - Operations MINIMUM & DEPOSIT i Home Health Care Services - including Completed Operations. 11111 Incl. Incl. Full Ea ned Additional Insured Endorsement UTS-35 .10 Incl. 130 Incl. Fullyp Ea ned Additional Insured Endorsement UTS-3 .10 Incl. 130.00 INcl. Broad Form Comprehensive General Liability Insurance UTS-71 99990 .15 Incl. 234.00 Incl. (a) Area (Sq. Ft.) (a) Per 100 Sq. Ft. of Area (b) Frontage (b) Per Linear Foot (c) Remuneration (c) Per 100 of Remuneration (d) Receipts (d) Per 100 of Receipts (e) Units (e) Per Unit (f) Admissions (f) Per 100 Admissions Escalators (Number at Premises) Number Insured Per Landing Excluded I Independent Contractors i cost Per$100 of cost i Not covered Completed Operations (a) Receipts (a) Per $1,000 of Receipts i Included in Premises -Operations Products (b) Sales (b) Per $1,000 of Sales Total Advance B.I. and P.D. Premiums 494.00 Is Included When used as a premium basis: 1. "admissions" means the total number of persons, other than employees of the named insured, admitted to the event insured or to events conducted on the premises whether on paid admission tickets, complimentary tickets or passes; 2. "cost" means the total cost to the named insured with respect to operations performed for the named insured during the policy period by independent contractors of all work let or sublet in connection with each specific project, including the cost of all labor, materials and equipment furnished, used or delivered for use in the execution of such work, whether furnished by the owner, contractor or subcontractor, including all fees, allowances, bonuses or commissions made, paid or due; 3. "receipts" means the gross amount of money charged by the named insured for such operations by the named insured or by others during the policy period as are rated on a receipts basis other than receipts from telecasting, broadcasting or motion pictures, and includes taxes, other than taxes which the named Insured collects as a separate item and remits directly to a governmental division; 4. "remuneration" means the entire remuneration earned during the policy period by proprietors and by all employees of the named insured, other than chauffeurs (except operators of mobile equipment) and aircraft pilots and co-pilots, subject to any overtime earnings or limitation of remuneration rule applicable in accordance with the manuals in use by the company; 5. "sales" means the gross amount of money charged by the named insured or by others trading under his name for all goods and products sold or distributed during the policy period and charged during the policy period for installation, servicing or repair, and includes taxes, other than taxes which the named insured and such others collect as a separate item and remit directly to a governmental division. (over) COVERAGE A —BODILY INJURY LIABILITY COVERAGE B—PROPERTY DAMAGE LIABILITY The company will pay on behalf of the insured all sums which the insured shall become legally obligated to pay as damages because of A. bodily injury or B. property damage to which this insurance applies, caused by an occurrence, and the company shall have the right and duty to defend any suit against the insured seeking damages on account of such bodily injury or property damage, even if any of the allegations of the suit are groundless, false or fraudulent, and may make such investigation and settlement of any claim or suit as it deems expedient, but the company shall not be obligated to pay any claim or judgment or to defend any suit after the applicable limit of the company's liability has been exhausted by payment of judgments or settlements. Exclusions This insurance does not apply: (a) to liability assumed by the insured under any contract or agreement except an incidental contract: but this exclusion does not apply to a warranty of fitness or quality of the named insured's products or a warranty that work performed by or on behalf of the named insured will be done in a workmanlike manner; (b) to bodily injury or property damage arising out of the ownership, maintenance, operation, use, loading or unloading of (1) any automobile or aircraft owned or operated by or rented or loaned to any insured, or (2) any other automobile or aircraft operated by any person in the course of his employment by any insured; but this exclusion does not apply to the parking of an automobile on premises owned by, rented to or controlled by the named insured or the ways imme- diately adjoining, if such automobile is not owned by or rented or loaned to any insured; (c) to bodily injury or property damage arising out of (1) the ownership, main- tenance, operation, use, loading or unloading of any mobile equipment while being used in any prearranged or organized racing, speed or demolition contest or in any stunting activity or in practice or preparation for any such contest or activity or (2) the operation or use of any snowmobile or trailer designed for use therewith; (d) to bodily injury or property damage arising out of and in the course of the transportation of mobile equipment by an automobile owned or operated by or rented or loaned to any insured; (e) to bodily injury or property damage arising out of the ownership, maintenance, operation, use, loading or unloading of (1) any watercraft owned or operated by or rented or loaned to any insured, or (2) any other watercraft operated by any person in the course of his em- ployment by any insured; but this exclusion does not apply to watercraft while ashore on premises owned by, rented to or controlled by the named insured; If) to bodily injury or property damage arising out of the discharge, dispersal, release or escape of smoke, vapors, soot, fumes, acids, alkalis, toxic chemicals, liquids or gases, waste materials or other irritants, contaminants or pollutants into or upon land, the atmosphere or any water course or body of water; but this exclusion does not apply if such discharge, dispersal, release or escape is sudden and accidental; (g) to bodily injury or property damage due to war, whether or not declared, civil war, insurrection, rebellion or revolution or to any act or condition incident to any of the foregoing, with respect to (1) liability assumed by the insured under an incidental contract, or (2) expenses for first aid under the Supplementary Payments provision; (h) to bodily injury or property damage for which the insured or his indemnitee may be held liable (1) as a person or organization engaged in the business of manufacturing, distributing, selling or serving alcoholic beverages, or (2) if not so engaged, as an owner or lessor of premises used for such purposes, if such liability is imposed (i) by, or because of the violation of, any statute, ordinance or regulation pertaining to the sale, gift, distribution or use of any alcoholic beverage, or (iD by reason of the selling, serving or giving of any alcoholic beverage to a minor or to a person under the influence of alcohol or which causes or contributes to the intoxication of any person; but part (ii) of this exclusion does not apply with respect to liability of the insured or his indemnitee as an owner or lessor described in (2) above; (i) to any obligation for which the insured or any carrier as his insurer may be held liable under any workmen's compensation, unemployment compensa- tion or disability benefits law, or under any similar law; (j) to bodily injury to any employee of the insured arising out of and in the course of his employment by the insured or to any obligation of the insured to indemnify another because of damages arising out of such injury; but this exclusion does not apply to liability assumed by the insured under an incidental contract; (k) to property damage to (1) property owned or occupied by or rented to the insured, (2) property used by the insured, or (3) property in the care, custody or control of the insured or as to which the insured is for any purpose exercising physical control; but parts (2) and (3) of this exclusion do not apply with respect to liability under a written sidetrack agreement and part (3) of this exclusion does not apply with respect to property damage (other than to elevators) arising out of the use of an elevator at premises owned by, rented to or controlled by the named insured; (U to property damage to premises alienated by the named insured arising out of such premises or any part thereof; (m)to loss of use of tangible property which has not been physically injured or destroyed resulting from (1) a delay in or lack of performance by or on behalf of the named insured of any contract or agreement, or (2) the failure of the named insured's products or work performed by or on behalf of the named insured to meet the level of performance, quality, fitness or durability warranted or represented by the named insured; but this exclusion does not apply to loss of use of other tangible property resulting from the sudden and accidental physical injury to or destruction of the named insured's products or work performed by or on behalf of the named insured after such products or work have been put to use by any person or organization other than an insured; (n) to property damage to the named insured's products arising out of such products or any part of such products; (o) to property damage to work performed by or on behalf of the named insured arising out of the work or any portion thereof, or out of materials, parts or equipment furnished in connection therewith; (pto damages claimed for the withdrawal, inspection, repair, replacement, or loss -of use of the named insured's products or work completed by or for the named insured or of any property of which such products or work form a part, if such products, work or property are withdrawn from the market or from use because of any known or suspected defect or deficiency therein; (q) to property damage included within: (1) the explosion hazard in connection with operations identified in this policy by a classification code number which includes the symbol "x", (2) the collapse hazard in connection with operations identified in this policy by a classification code number which includes the symbol "c", (3) the underground property damage hazard in connection with operations identified in this policy by a classification code number which includes the symbol "u". It. PERSONS INSURED Each of the following is an insured under this insurance to the extent Set forth below: (a) if the named insured is designated in the declarations as an individual, the person so designated but only with respect to the conduct of a business of which he is the sole proprietor, and the spouse of the named insured with respect to the conduct of such b business; (b) if the named insured is designated in the declarations as a partnership or joint venture, the partnership or joint venture so designated and any partner or member thereof but only with respect to his liability as such; (c) if the named insured is designated in the declarations as other than an in- dividual, partnership or joint venture, the organization so designated and any executive officer, director or stockholder thereof while acting within the scope of his duties as such; (d) any person (other than an employee of the named insured) or organization while acting as real estate manager for the named insured; and (e) with respect to the operation, for the purpose of locomotion upon a public highway, of mobile equipment registered under any motor vehicle registration law, (i) an employee of the named insured while operating any such equipment in the course of his employment, and (i i) any other person while operating with the permission of the named insured any such equipment registered in the name of the named insured and any person or organization legally responsible for such operation, but only if there is no other valid and collectible insurance available, either on a primary or excess basis, to such person or organization; provided that no person or,organization shall be an insured under this para- graph (e) with respect to: (1) bodily injury to any fellow employee of such person injured in the course of his employment, or (2) property damage to property owned by, rented to, in charge of or occupied by the named insured or the employer of any person described in sub- paragraph (ii). This insurance does not apply to bodily injury or property damage arising out of the conduct of any partnership or joint venture of which the insured is a partner or member and which is not designated in this policy as a named insured. III. LIMITS OF LIABILITY Regardless of the number of (1) insureds under this policy, (2) persons or organi- zations who sustain bodily injury or property damage, or (3) claims made or suits brought on account of bodily injury or property damage, the company's liability is limited as follows: Coverage A —The total liability of the company for all damages, including damages for care and loss of services, because of bodily injury sustained by one or more persons as the result of any one occurrence shall not exceed the limit of bodily injury liability stated in the schedule as applicable to "each occurrence': Subject to the above provision respecting "each occurrence", the total liability of the company for all damages because of (1) all bodily injury included within the completed operations hazard and (2) all bodily injury included within the products hazard shall not exceed the limit of bodily injury liability stated in the schedule as "aggregate". Coverage B—The total liability of the company for all damages because of all property damage sustained by one or more persons or organizations as the result of any one occurrence shall not exceed the limit of property damage liability stated in the schedule as applicable to "each occurrence". Subject to the above provision respecting "each occurrence", the total liability of the company for all damages because of all property damage to which this coverage applies and described in any of the numbered subparagraphs below shall not exceed the limit of property damage liability stated in the schedule as "aggregate": (1) all property damage arising out of premises or operations rated on a re- muneration basis or contractor's equipment rated on a receipts basis, including property damage for which liability is assumed under any in- cidental contract relating to such premises or operations, but excluding property damage included in subparagraph (2) below; (2) all property damage arising out of and occurring in the course of operations performed for the named insured by independent contractors and general supervision thereof by the named insured, including any such property damage for which liability is assumed under any incidental contract relating to such operations, but this subparagraph (2) does not include property damage arising out of maintenance or repairs at premises owned by or rented to the named insured or structural alterations at such premises which do not involve changing the size of or moving buildings or other structures; (3) all property damage included within the products hazard and all property damage included within the completed operations hazard. Such aggregate limit shall apply separately to the property damage described in subparagraphs (1), (2) and (3) above, and under subparagraphs (1) and (2), separately with respect to each project away from premises owned by or rented to the named insured. Coverages A and B—For the purpose of determining the limit of the company's liability, all bodily injury and property damage arising out of continuous or re- peated exposure to substantially the same general conditions shall be considered as arising out of one occurrence. IV. POLICY TERRITORY This insurance applies only to bodily injury or property damage which occurs within the policy territory. AUTHENTIC �y CERTIFICA 1 C' OF INSURANCE ISSUE DATE (MM/DD/YY) 8/19/92 PRODUCER Broker: Southern Underwriters Inc. 2700 Westhall Lane, Suite 210 Maitland, F1. 32751-7299 Agent: The Cochenour Agency Inc. PO Box 290066 Port Orange, Fl. 32129 INSURED Florida Health Nursing Services Inc. 1500 West Sample Rd., Suite 1189. Pompano Beach, Fl. 33065 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 LETTER A Scottsdale Insurance Company COMPANY B LETTER COMPANY `. LETTER COMPANY D LETTER ATTN: Erica Fichter, bookkeeping dept. COMPANY LETTER E 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS ' GENERAL LIABILITY GENERAL AGGREGATE S 1,000,000. COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. S 1, 000, 000. CLAIMS MADE OCCUR. PERSONAL & ADV. INJURY $ -- OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $ 1,000,000. A Ccinprehensive Form Renewal of x 08-19-92 08-19-93 FIRE DAMAGE (Any one fire) $ -- GLS 410938 MED. EXPENSE (Any one person) S -- AUTOMOBILE LIABILITY Note: Canprehensive Form includes: COMBINED SINGLE ANY AUTO Premises Operations/Completed Operations/ LIMIT $ ALL OWNED AUTOS Broad Form CGL. Limits are BI/PD Combined BODILY INJURY SCHEDULED AUTOS Occurrence; BI/PD Combined Aggregate. (Per person) $ HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) $ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS EACH ACCIDENT S AND DISEASE —POLICY LIMIT S EMPLOYERS' LIABILITY DISEASE —EACH EMPLOYEE S OTHER A Professional Liability Renewal of $1,000,000. Each Claim/ Gls 410938 08-19-92 08-19-93 $1,000,000. Aggregate. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS - Insured's Physical Locations: 92140 Overseas Hwy. Suite 11, Tavernier, Florida and 1111 12th St., Suite 211 1/2 Key West, Florida. CERTIFICATE HOLDER CANCELLATION Monroe County Board of County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Ccnnissioners, Monroe County InHome ServicesEXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO attn; project director MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 1315 Whitehead Street LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Key West, Florida, 33040 LIABILITY OFAt Y KIND UPON THE COMPANY, I�AGENTS OR REPRESENTATIVES. AUTHORIZZEQ`RERRESENTATIVy. ACORD 25-S (7190) 1 ©ACORD CORPORATION 1990 FUT193CERTIFICATEOF INSURANCE ISSUE DATE (MMIDD/YY) 8-23-91 PRODUCER Broker THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Southern Underwriters, Inc. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 2700 Westhall Lane, Suite 210 POLICIES BELOW. COMPANIES AFFORDING COVERAGE Maitland, FL 32751-7299 Agent COMPANY LETTER A Scottsdale Insurance Company The Cochenour Agency, Inc. P. 0. Box 290066 COMPANY B LETTER Port Orange, FL 32129 INSURED Florida Health Nursing Services, 1510 Venera Avenue Inc COMPANY LETTER C COMPANY LETTER D Coral Gables, FL 33146 COMPANY E LETTER • ' 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. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY BODILY INJURY OCC. $ X COMPREHENSIVE FORM GLS 410938 8-19-91 8-19-92 BODILY INJURY AGG. $ PREMISES/OPERATIONS X PROPERTY DAMAGE OCC. $ UNDERGROUND EXPLOSION & COLLAPSE HAZARD PROPERTY DAMAGE AGG. $ BI & PD COMBINED OCC. $1 000 PRODUCTS/COMPLETED OPER. CONTRACTUAL BI & PD COMBINED AGG. $1 000 INDEPENDENT CONTRACTORS X PERSONAL INJURY AGG. $ BROAD FORM PROPERTY DAMAGE PERSONAL INJURY A11TtW(YelLYL I I ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS ( Priv. Pass. ) ALL OWNED AUTOS ( Other Than Priv. Pass. BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS ReceivedPROPERTY DAMAGE $ GARAGE LIABILITY RiS 1 � T IVIgIYI & Lo CQntwl BODILY INJURY & PROPERTY DAMAGE COMBINED $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM INITIAL G EGATE $ OTHER THAN UMBRELLA FORM S WORKER'S COMPENSATION C STATUTORY LIMITS EACH ACCIDENT $ AND DISEASE —POLICY LIMIT $ EMPLOYERS' LIABILITY DISEASE —EACH EMPLOYEE $ A OTHER Professional Liabilit GLS 410938 8-19-91 8-19-92 000 A ,re ate Eac Claim/ gg g DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners Monroe County In Home Services SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 1315 Whitehead Street LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Key West, FL 33040 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. ATTN: Project Director ALIT R DREPRESENT TIVE •-. 90 ••. CORPORATION 19901 * „ BURNS & WILCOX, LTD. C E R T I F I C A T E O F I N S U R A N C E ISSUE DATE : 08/19/93 PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS COCHENOUR AGENCY, INC. /f I NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, P.O. BOX 290066 AVj�(i 4? 3 #01 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PORT ORANGE, FL 32129 I cc. --- ---------------------------- ----I COMPANIES AFFORDING COVERAGE APPMM Nr 00 MANACPAW COMPANY LETTER A SCOTTSDALE INSURANCE COMPANY INSURED I COMPANY LETTER B q 1 )FLORIDA HEALTH NURSING SERVICE I COMPANY LETTER C nn C/O ERICA FICHTER I COMPANY LETTER D DATE 1500 W SAMPLE ROAD, #1189 I COMPANY LETTER E �+ POMPANO BEACH, FL 33064 I WA11 t N/A COVERAGES THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT WITHSTANDING 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. LTR TYPE OF INSURANCE POLICY NUMBER EFF. DATE EXP. DATE LIMITS IGENERAL LIABILITY I I GENERAL AGGREGATE $ 1,000,000 A JIM COMMERCIAL GENERAL LIABILITY I CLS086233 08/19/93 08/19/94 I PRODUCTS-COMP/OP AGG. $ 1,000,000 I [ I CLAIMS MADE [Xl OCCURRENCE I I PERSONAL & ADV. INJURY $ 1,000,000 I[ I OWNER'S & CONTRACTOR'S PROT. I I EACH OCCURRENCE $ 1,000,000 I[Xl Professional Liab I ( FIRE DAMAGE $ 50,000 I[ 1 (1,000,000/1,000,000) I I MED. EXPENSE $ 0 --------------------------------------------------------------------------------------------------------------------------------- AUTOMOBILE LIABILITY I I I[ I ANY AUTO I I COMBINED SINGLE LIMIT $ 0 I[ ] ALL OWNED AUTOS I ReceivedI I[ 1 SCHEDULED AUTOS I Risk IVIgmt.&lr-v7ssControl I BODILY INJURY (PER PERSON) $ 0 I [ I HIRED AUTOS �ATE G — ! r� I[ I NON -OWNED AUTOS ��jQ Dl� I BODILY INJURY (PER ACCIDENT)$ 0 I [ I GARAGE LIABILITY "TIAL �jF�CJ I[ I I I PROPERTY DAMAGE $ 0 --------------------------------------------------------------------------------------------------------------------------------- IEXCESS LIABILITY I I EACH OCCURRENCE $ 0 I[ I UMBRELLA FORM I I AGGREGATE $ 0 I[ I OTHER THAN UMBRELLA FORM I I --------------------------------------------------------------------------------------------------------------------------------- IWORKER'S COMPENSATION I I [ I STATUTORY LIMITS I AND I I EACH ACCIDENT $ 0 IEMPLOYERIS LIABILITY I I DISEASE -POLICY LIMIT $ 0 I I I DISEASE -EACH EMPLOYEE $ 0 --------------------------------------------------------------------------------------------------------------------------------- IOTHER I I I I I --------------------------------------------------------------------------------------------------------------------------------- DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS NURSING SERVICE CERTIFICATE HOLDER I CANCELLATION MONROE COUNTY BOARD CTY COMM I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE MONROE CTY IN HOME SERVICES I THEREUF, THE iSSUING COMPANY WILL ENDEAVOR TO HAIL 10 DAYS WRITTEN NOTICE TO THE 1315 WHITEHEAD STREET I CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE KEY WEST, FL 33040 I NO OBLIGATION OR LIABILTIY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. --------------------------------------------------------------------------------------------------------------------------------- W W 1.0_ AUTHORIZED REPRESENTATIVE