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Certificates of InsurancePEDRO-2 OP ID: NR 14 `6* O �" CERTIFICATE OF LIABILITY INSURANCE DATE(M 10/06/1YYY) 6/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu) of such endorsement(s). PRODUCER BUTLER, BUCKLEY, DEE'iS INC. 305-262-0086 6161 BLUE LAGOON DR., STE 420 FL Bode MIAMWilliam William S. Bodenhamer CONTACT NAME; WILLIAM BODENHAMER alcNr o E:t :786 2161764 ntc No): 305 2620086 ADDRESS: BBODENHAMER@BBDINS.COM INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FCCI Commercial Insurance Co INSURED PEDRO FALCON ELECTRICAL CONTRACTORS, INC. INSURER B : 31160 AVE C INSURER C : INSURER D : BIG PINE KEY, FL 33043-4516 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION Nl1MRFR- 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 4_1 OCCUR X GL 0008236 3 03/13/11 03/13/12 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 X POLICY F7 PRO LOC $ AUTOMOBILE LIABILITY j COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO + '`�(' - ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS �l BODILY INJURY (Per accident)$ PROPERTY DAMAGE Per accident)$ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 A EXCESS LIAB CLAIMS -MADE UMB0005173 5 03/13/11 03/13/12 AGGREGATE $ 4,000,000 DED I X I RETENTION $ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? NI (Mandatory In NH) N / A 001-WC10A-65512 11/02/10 11/02/11 X M!C OTH- TORY LIMITSSTATU- ER E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYE6 $ 500,00 If yes, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT I $ 500,00 A INSTALLATION FLTR CM0004409-3 03113/11 03/13/12 RENTAL *SEE NOTES ,EQUIPMENT JOBSITE: BLANKET *SEE NOTE LEASED *SEE NOTES DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES [Attach ACORD 101 Additional Remarks Schedule, if more space is required) *30 DAYS NOTICE OF CANCELLATION EXCEPT NON PAYMENT OF PREMIUM 10 DAYS/ MONROE COUNTY BOARD OF COUNTY COMMISSIONERS IS NAMED ADDITIONAL INSURED. PROJECT: FIRE STATION#17 CONCH KEY, DEMOLITION, RENOVATION & CONSTRUCTION (:ANU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MONROE COUNTY BOARD OF COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN COMMISSIONERS %MONROE COUNTY ACCORDANCE WITH THE POLICY PROVISIONS. FACILITIES DEVELOPMENT AUTHORIZED REPRESENTATIVE 1100 SIMONITON ST, ROOM 2-216 KEY WEST, FL 33040 © 1938-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Alikk. '� CERTIFICATE OF L.IABIL.ITY INSURANCE °ia0612" o 1' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holler is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statmwnt on this certificate does not confer rights to the certificate hotter in lieu of such endorsement(s). PRODUCER Ellie Mills State Farm Insurance Agency 20330 Old Cutler Road Cutlet Bay FL 33189 AMt Janioe Rowton P e,Rl 305-238-WMi ,.R4j � 5 M&. 08 IL :'anice.rowton,i b tatefarm.00rn INSURE AFFORDING COVERAGE NAIL A _ INSURER A :State Farm Mutual Automobile ITISuranDe Company 17e INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key FL 33043 INSU_RERB� _'_,,,,,_.,..,_.� INSURER C ; INSURER a: INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. SR TYPE OF INSURANCE LILY NUMBERPOUCY UMrTS GENERAL ULAWLITYEIE] COMMERCIAL GENERAL LIABILITY CLAIMSMIADE 1:1 OCCUR EACH OCCURRENCE S y p i O.aManj $ MEDEXP(Anyonspown) S PERSONAL & ADV INJURY $ GENERALAGGREGATE S GEML AGGREGATE UMIT APPLIES PER: POLICY PRO LOC PRODUCTS • COMPIOP AGO $ S A AtrTOMoetLEuasltm ANY AUTO ALL OWNED SCHEDULED AUTOS x' AUTOS NON -OWNED HIREDAUTOS _ AUTOS Y 0838673-D26-59P 113 7113-E10-69P 645 9389-D09-59S 5611826-E07-69Q I0HI6=11 10MISM11 10IO6f2011 110iMM11 0412612012 05M012012 01109R012 05W12012 NEDSINGLELIMIT dent s 1,000,000 BODILY INJURY (Per persm)y S BODILY INJURY (PeraodOOMl S PROPERTY DAMAGE peracern dd $ S UMBRELLA LIAR EXCESS LIAR OCCUR CLA{MS•MADE EACHOCCURRENCE S AGGREGATE $ DED RETENTIONS S WORKERS C0W%NSATtDN AND EMPLOYER$' LIANUrTY ANY PROPRIETOMIPARTNERIEXECUTIVE YIN N OFFICEIMEMSER EXCLUDED? a 1Maud0tWyInNH) M yes, daaM6e under IONS bdM N l A❑ + f ti l - �. yry `1 1 ( I WC ORYSTATU H- E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY ItMIT •'� 5 T F19 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Altectr ACORD 101, AddMonal Romeft SOW* te, If male space Is required) Project Fire Station S17 Conch Key. Demaiition, Renovation & Constnldion Monroe County Bayard of County Commision8rs SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN c!o Monroe County Facilities Development I ACCORDANCE WITH THE POLICY PROVISIONS. 11©Q Simonton Street, Room 2-216 ALItNoratJ:a �SENTATIWVEKey West FL 3304t1�wra� 01988-2010 AQ ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001486 132849.6 11-15-2010 '4 'O`® CERTIFICATE GAF LIABILITY INSURANCE °10 si�o11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies rosy require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement[sy PROO1aa' Ellie Mills State Farm Insurance Agency 20330 Old Cutler Road Cutler Bay FL 33189 Q NAeIE: Janice a n PHONE-osin. 30U Fa"'rc ADDRESS: anice.rowton.ib statefann.com INSUREPIS� AFFORDING COVERAGE NA1C 0 INSURER A :State Fol Automobile I Co INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Pine Key FL 33043 INSURERS: INSURER C : INSURER D : _ DWRER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF IN5URANCE POLICY NUMBER MMI LIMITS GENERALLIABIUTY COMMERCIAL GENERAL LIABILITY CLAJMS444DE F—I OCCUR EACHOCCURRENCE S $ MED EXP (Any one person) S �~ PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ GENLAGGREGATE LIMIT APPUESPER: POLICY PRO-jEcT LOC PRODUCTS-COMPIDPAGG S $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS H REDAUTOS K AUTOS ED Y 898 3933-AOBB 10M612011 Q1/08RD12 n s 1,000,000 BODILY INJURY (Per Pao san) $ BODILY INJURY (Per acddent) $ x per dent E S $ UMBRELLA LIAB EXCESS LWB OCCUR CLAIMS MADE r' EACH OCCURRENCE $ AGGREGATE $ DED I RETENTIONS $ VIORXERSCOMPERSATION AND EMPLOYERS' UABILnY ANY P$tOPA1ETOWPARTNER/EXECUTIVE YIN OFFICE&EMBER EXCLUDI:D7 D (Mtirrdatory to NN) M yes, dBto'16e under N I A E.L EACH ACCIDENT S El. DISEASE - EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS ILOCARONS I VEHICLES (Attach ACORD 10t. Addtft" Ranoft S—iM Ir moreapece Is regdred) Project: Fire Station #17 Conch Key, Demolition, Renovation 8 Construction Monroe County Board of County Commisioners cto Monroe County Facilities Development 1100 Simonton Street, Room 2-216 Key West FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 0 1988201014CORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001486 132849.6 11-15-2010 `<>R ©' CERTIFICATE OF LIABILITY INSURANCE ° 10/0 0011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATNE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) roust be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PR°D� Ellie Mills State Faun Insurance Agency 20330 Old Cutler Road Cutler Bay FL 33189ADDRESS:IL ME Janioe Rowton 8 Fox F4MENE anice.rowlon.t t) statefaml.00m INSUR & AFFOROING COVERAGE NAIC 0 INSURER A: State Farm Mutual Automobile insurance Com any 2a INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key FL 33043 INSURERS: INSURER C : INS' RER 0 INSURER INSURER F : �iTaPld--T - s a7.. AFITI:,1:13 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. TYPEOFINSURANCE $1151111 POLICYNUMBER LIAWL r P LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR ❑ EACH OCCURRENCE S PREMISES Me 0=nM ) 4 MED EXP (Arty one Person) S Y� PERSONAL 3 AOV INJURY S ---._........._...........__..... GENERAL AGGREGATE ter... 2 GEWL AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS -PRODUCTS S S A AUTOM0131LE LIABILITY ANY AUTO ALL OWNED SCHEOULEO �(, AUTOS AUTOSNONONED HIRED AUTOSAUTOS Y 022 3871f03-59L DOS 4'7S9-CC9-590 DOT 7437-D26-59T 030 5488-829.69N 101OW2011 i0106ri011 IOM612011 10106t2011 12V812011 03M912012 04126*012 02128=12 81 enf INGLE LIMIT $ 1,000,000 BODILY INJURY (Pe` pwzw) $ BODILY kNJURY (Pet eoddent) 3 E A A ax ddeM S E UMBRELLAUAB EXCESS LIAR OCCUR CLAIMS -MADE ( I EACHOCCURRENCE $ AGGREGATE S DED RETENTIONS S WORKERS COMPEraSAAON AND EMPr.OYERV LIAORM Y t N ANY PROPRIErOR1PAR7NERIEXECUIIVE OFFICE/MEMBEREXCLUDED? {Mandatory In NH) d yes. desdtbe under IftA {{....._.......__.� 1 lJ ' VJC STATU- OTH- E.L.EEACHACCiDEN1` ! _ E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE. POLICY LIMIT s DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Atrdf arwt Remaft Schedule, R . wo Waee Is required) Project: Fire Station #17 Conch Key, Demolition, Renovation & Construction Monroe County Board of County Commisioners SHOULD ANY OF THE A13OVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN c/o Monroe County Facilities Development ACCORDANCE MATH THE POLICY PROVISIONS. 1100 Simonton Street, Room 2-216 Key w@$t FL 33Q4Q AUhWR4.ED BNTATNE r I 0198111-2010 CORD CORPORATION. All rights reserved. ACORD 25 (2010(05) The ACORD name and logo are registered marks of ACORD 1001486 132849.6 11-15-2010 _...... _. .. ...... - '4�!�'� EVIDENCE OF PROPERTY INSURANCE °"1 012011 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE OF PROPERTY INSURANCE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. AGO -ICY m.—V ..365-262-0086 COMPANY BUTLER. BUCKLEY, DEETS, INC. 6161 BLUE LAGOON DR STE 420 MIAMI, FL 33126-2048 . 305-262-01 14965925 INSURED PEDRO FALCON ELECTRICAL CONTRACTORS INC. 31160 AVENUE C, BIG PINE KEAY, FL 33043 LOCATIOIWDESCRIPTrON 10 S. Conch Avenue Conch Key, FL 33050 American Zurich Insurance Company LOAN NUMBER POLICY NUMBER BR70720372 N3FEC'nw DATE EIGIRATNOPN DATE 11/2Z2011 11/22/2012 OONnNUEDUVTR n TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: 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 EVIDENCE OF PROPERTY INSURANCE 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. L,UYEKAVE U1r JKM1kI1UN COVERAGE I PERILS I FORMS AMOUNT OF INSURANCE DEDUCTIBLE Builders Risk Coverage Form/ exetud%ng WiAdbtmm g Hait $5.000 Any One Building or Structure $1,116,000 All Covered Property at all Locations $1,116,000 wr��vW u1W MVII �l 1 MVIIWYVIp GANCENiLA I KAI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE ADDITIONAL INTEREST NAMED BELOW, BUT FAILURE TO MAIL SUCH NOTICE SHALL NNPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. NAME AID ADDRESS MORTGAGEE >< ADDITIONAL 1N.Sta2ED Monroe County BOCC I= P 1100 Simonton Street LOyI Key West, FL 33040 AUTHORIZED 1 / ( . C.C-' ACORD 27 (2006/07) .CORPORATION 1993-2006. All rights reserved. The ACORD name and logo are m of ACORD CSR: NR ACOREV DATE(MMIDD/YYYY) `....� EVIDENCE OF PROPERTY INSURANCE 11/23/2011 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PHONE A/C No Ext 305-262-0086 COMPANY BUTLER, BUCKLEY, DEE 15 INC. Citizens Property Ins Corp. Monr oun 6161 BLUE LAGOON DR., STE 420 6676 CORPORATE CENTER PARKWAY. oe C MIAMI, FL 33126 Jacksonville, FL 32216 �oc)Imes pevebPm®nt William S. Bodenhamer FAX I E-MAIL I NOV 2 8.Aii CODE: SUB CODE: AGENCY pEDRO-2 CUSTOMER IDS: INSURED PEDRO FALCON ELECTRICAL CONTRACTORS, INC. 31160 AVE C BIG PINE KEY, FL 33043-4516 LOCATIONIDESCRIPTION 10 S. CONCH AVENUE CONCH KEY, FL 33060 LOAN NUMBER TIME: RECEIVED POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 11/22/11 11/22/12 n TERM INATEDIFCHECKED THIS REPLACES PRIOR EVIDENCE DATED: BUILDERS RISK -WIND ONLY 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 EVIDENCE OF PROPERTY INSURANCE 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. rnVFRAt:F INVnI2UATInN COVERAGE I PERILS I FORMS AMOUNT OF INSURANCE DEDUCTIBLE BUILDING -WIND ONLY 1,000,000 35% WAIVED -1ST LOSS TABLE CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUUI I IVNAL INTEREST [NAME AND ADDRESS MORTGAGEE X ADDITIONAL INSURED LOSS PAYEE LOAN # MONROE COUNTY BOCC 1100 SIMONTON STRET KEY V,IEST. FL 33040 C c- AUTHORIZED REPRESENTATIVE AWKU Z7 (ZUUVIIZ) ©1993-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFUTE OF LIABILITY INSLOANCE 1 DATE (MM/DD1YY 03/09/20 2rr) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Ellie Mills State Farm Insurance Agency 20330 Old Cutler Road Cutler Bay FL 33189 LiINSURERS 4 CONTACT NAME: Janice Rowton A N xt : 305-238-8688 a/c No): 305-238-8608 E-MAIL ADDRESS: janice.rowton.i b statefarm.com AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 25178 INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key FL 33043 INSURER B : INSURER C : INSURERD: INSURER E : INSURER F : UUV1-KAhtS CFRTIFICCTF NI IMRFR• 0C11101f%1J KI"RAOCO. 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. INSR LTR I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYYI POLICY EXP (MM/DDffYYYI LIMITS GENERAL LIABILITY ❑ ❑ EACH OCCURRENCE $ PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR A GEMIN BYiRt$I , BY (y,J MED EXP (Any one person) $ PERSONAL & ADV INJURY $ DA W %;X GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO-- LOC $ A AUTOMOBILE LIABILITY Y 0223871-F03-59 03/09/2012 06/03/2012 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED X SCHEDULED NON -OWNED HIRED AUTOS AUTOS D09 4759-009-59 D07 7437-D26-59 030 5488-B29-59 03/09/2012 03/09/2012 03/09/2012 09/09/2012 10/26/2012 08/29/2012 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUREl 1-1 EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ Wr WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICE/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under N / A ❑ Facliffles LIAR MAR r),, :' ^ - WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ nF-,r.P1PT10N OF OPERATIONS beloW E.L. DISEASE - POLICY LIMIT $ 1:1 El RECEMD BY: DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project: Fire Station #17 Conch Key, Demolition, Renovation & Construction Monroe County Board of County Commissioners as Additional Insured The listed insurance policy(s) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County Commissioners. Monroe County Board of County Commissioners Monroe Cty Administraton Dept, Facilities Development 1100 Simonton Street, Room 2-216 Key West FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRI NTATIVE rM_ 01988-2010 ACOR'D CORPORATION_ All rights reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.6 11-15-2010 A`CQR►�® CERTIFICATE OF LIABILITY INSURANCE DATE (MM Y) 10/09/2012/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Ellie Mills State Farm Insurance Agency CONTACT NAME: Janice Rowton PNONE . 305-238-8688 ac No): 305-238-8608 20330 Old Cutler Road O Cutler Bay FL 33189 nooREss: 'an ice. rowton.i b statefarm.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 25178 INSURED Pedro Falcon Electrical Contractors, Inc. INSURERB: INSURERC: 31160 Avenue C INSURERD: Big Pine Key FL 33043 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM DIDYEFF /YYYY MM%DD YYXYY LIMITS GENERAL LIABILITY ❑ ❑ EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR AP DA EMM PREMISES Ea occurrence $ MED EXP (Any one person) $ W PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ 17 POLICY PR� LOC A AUTOMOBILE LIABILITY YI ❑ 645 9389 D09 59 10/09/2012 04/69/2013 EDa�IN DtSINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALL OWNED x SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Pe raccident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR �acllftll s DolVHIom 4nt EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ r IAll WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEIMEMBER EXCLUDED? (Mandatory in NH) N / A ❑ TIME. ____ RECENEQ 8 '. �r - WC STATU- I OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under r)FRrIPIPTION OF OPERATIONS below El El DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Project: Fire Station #17 Conch Key Demolition, Renovation & Construction Monroe County Board of County Commissioners as Additional Insured The listed insurance policy (s) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County Commissioners Monroe County Board of County Commissioners THEULD EXANY OFPIRATION DESCRIBED VTHE THEREOF, NOTICE POLICI ES WILL BE CBE CDELIVERED ELLED BEFORE Monroe Cty Administration Dept, Project Mgmt Dept ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street, Room 2-216 AUTHORIZED RE��PRESENTPTIVE Key West FL 3304(p ©1988-2010 AC CORPO ION. A ghts reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD P01486 132849.6 11-15-2010 C11 PEDRO-2 OP ID: NR '416.. , CERTIFICATE OF LIABILITY INSURANCE DAT11101DlYYYY) 11/01/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 305-262-0086 BUTLER, BUCKLEY, DEETS INC. 6161 BLUE LAGOON DR., STE 420 MIAMI, FL 33126 William S. Bodenhamer CONTACT NAME: WILLIAM BODENHAMER WC o >n :786 2161764 A/c No : 305 2620086 E-MAIL ggODENHAMER BBDINS.COM ADDRESS: INSURERS) AFFORDING COVERAGE NAIC t INSURER A: FCCI Commercial Insurance CO INSURED PEDRO FALCON ELECTRICAL CONTRACTORS, INC. INSURERS: 31160 AVE C INSURER C : INSURER D : BIG PINE KEY, FL 33043-4516 INSURER E : INSURER F : COVERAGES CFRTIFICATF NIIMRFR- DPVlc[ntu NIIMRMo. 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. INSR LTR TYPE OF INSURANCE ADDL MIS& SUOR WVQ POLICY NUMBER POLICY EFF (MMIDDNYYYI POLICY EXP IMMIDDIYYYYILIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 A00,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx] OCCUR X GL 0008235 4 AOMED 03/13/12 03/13/13 PREMISES Ea occurrence $ 100,00 EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY E 1,000,00 YQO\,If• r�4r GENERAL AGGREGATE E 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: O LOC POLICY X PRCT F PRODUCTS - COMP/OP AGG $ 2,000,00 �3 (\�^, �..00 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) t ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS RE GE�I�O e`� BODILY INJURY (Per accident) $ PROPERTYDAMAGE Paracddent _ $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,00 id AGGREGATE E 4,000,00 A EXCESS LIAB CLAIMS -MADE UMB00051736 03/13/12 03/13/13 DED I X I RETENTIONS 10,000 E A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N BE EXCLUDED9 0 NIA 001-WC11A-65512 11/02/12 11/02/13 WC STATU- TH- X I I PER E. L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE $ 500,00 (Mandatory in (MandatoryOFFICEPUMIn N) tt yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,00 A INSTALLATION FLTR CM0004409-4 03/13/12 03/13/13 RENTAL 'SEE NOTE EQUIPMENT JOBSITE BLANKET *SEE NOTE LEASED *SEE NOTE DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES Attach ACORD 101 Additional Remarks Schedule, If more ace Is required) 30 DAYS NOTICE OF CANCELLATION EXCEPT NON PAYMENT OF PREMIUM 10 DAVES/ MONROE COUNTY BOARD OF COUNTY COMMISSIONERS IS NAMED ADDITIONAL INSUR%PRV GEMENi PROJECT: FIRE STATION#17 CONCH KEY, DEMOLITION, RENOVATION & CONSTRUCTIOEV MONROE COUNTY BOARD OF COUNTY COMMISSIONERS %MONROE COUNTY FACILITIES DEVELOPMENT 1100 SIMONTON ST, ROOM 2-216 KEY WEST, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE me,: ACORD 25 (2010/06) 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACOR©® �- CERTI ATE OF LIABILITY IN ANCE DATE (MMDD/YYYY) 11/02/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Ellie Mills Inusrance Agency, Inc. CONTACT NAME: Janice ROwton PNNE• 305-238-8688 FAX No:305-2388-608 C 20330 Old Cutler Road O Cutler Bay, FL 33189 E -M AIL ADDRESS: 'anice.rowton.i b statefarm.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 25178 INSURED Pedro Falcon Electrical Contractors, Inc. INSURERB: INSURER C : 31160 Avenue C INSURER D : Big Pine Key, FL 33043 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 AFF CBMtI POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ��,N,,7RFr, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY RD BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER MM DIDPOLCY/YYYY EXP MM/D 1EFF YYYY LIMITS GENERAL LIABILITY ❑ ❑ NOVACH - OCCURRENCE $ PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY U Y CLAIMS -MADE ElOCCUR MED EXP (Any one person) $ RECEIVED By. ,, ;, PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ POLICYPRO LOC A AUTOMOBILE LIABILITY FYI ❑ D09 4759 C09 59 09/09/2012 03/09/2013 Ea accident) LE LIMIT $ 1,000,000 ANY AUTO 030 5488 B29 59 08/29/2012 02/28/2013 BODILY INJURY (Per person) $ BODILY INJURY (Per accident)AUTOS ALL OWNED SCHEDULED AUTOS$ PROPERTY DAMAGE Per accident $ HIRED AUTOSNON-OWNED AUTOS r UMBRELLA LIAR OCCUR �. EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ APPR V DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N D WA WC STATU- OTH- T RY LIMIT ER E.L. EACH ACCIDENT _ $ OFFICE/MEMBER EXCLUDED? (Mandatory In NH) N / A ❑ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project Name: Conch Key Fire Station Monroe County Board of County Commissioners as additional insurers The listed insurance policy (s) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County Commissioners CERTIFICATF wni nFR CANCELLATION Monroe Count Board of County Commissioners y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe Cty Administration Dept., Project Mgmt Dept ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street, Room 2-216 Key West, FL 33040 CC •• AUTHORIZED REPRESENTATIVE © 1988-2010 ACORDI90F2F ORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 F '4C40R "CERTI ATE OF LIABILITY IN RANCE DATE TE(MM/2012� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road Cutler Bay, FL 33189 S O NAME: CONTACT Janice Rowton . 305-238-8688 FAX No): 305-2388-608 E-MAIL AODREss: 'anice.rowton.i b statefarm.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 25178 INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key, FL 33043 INSURER B : INSURER C : INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 HA EDUCED BY PAID CLAIMS. TYPE OF INSURANCE ADDL SUBR nuf1le1�7R pOLI eV�lO LICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY ❑ 3, EACH OCCURRENCE $ PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7OCCUR a�y� \' Q 5 1-10 O tl MED EXP (Any one person) $ PERSONAL & ADV INJURY $ RECEN ED GENERAL AGGREGATE $ GENT AGGREGATE LIMIT PER: APPLIES PRODUCTS - COMP/OP AGG $ POLICY PRO LOC $ A AUTOMOBILE LIABILITY FYI El113 7113 E10 59 11/10/2012 05/10/2013 Ea accMBIdenl IN LE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL AUTOSAUTOS OWNED x SCHEDULED HIRED AUTOS NON -OWNED AUTOS 651 1826 E07 59 645 9389 D09 59 022 3871 F03 59 11/07/2012 10/09I2012 06103/2012 05/07/2013 04/09/201 12/03/2012 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR El EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DIED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N OFFICE/MEMBER EXCLUDED? N / A ❑ BY DA B -- WAI W WC STATU- OTH- T RY LIMITSER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory In NH) E.L. DISEASE - POLICY LIMIT S If yes, describe under nM'.R1PT1QtJ OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project Name: Conch Key Fire Station Monroe County Board of County Commissioners as additional insurers The listed insurance policy (s) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County Commissioners CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners Monroe Cty Administration Dept., Project Mgmt Dept 1100 Simonton Street, Room 2-216 Key West, FL 33040i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1988-2010 ACORD R ATION- All riahts reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 ,A`oRo® CERTIFICATE OF LIABILITY INSURANCE 7TJE062012m THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road Cutler Bay, FL 33189 OINSURE CONTACT NAME: Janice Rowton =NONE . 305-238-868 JAIL No): 305-2388-608 noDRess: janice.rowton.icqb@statefarm.com S AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 2517 INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key, FL 33043 INSURERB: INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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�TR TYPE OF INSURANCE ADDL BR POLICY NUMBER POLICY EFF wemw POLICY DI EXP LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F—IOCCUR ❑ ❑ FaCllifle NOV TIME- RECEIVED BY' Developm rr�� U 9 ��'� rit EACH OCCURRENCE $ tu PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: 1-1 POLICY PRO LOC PRODUCTS - COMP/OP AGG $ $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS � ❑ D07 7437 D26 59 r 10/26/2012 04/26/2013 Ea acCOMBcident) ED SIN LE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ PROPERTY TYDAMAGE PReOPPE $E $ UMBRELLA LIAB EXCESS LIAB OCCUROF CLAIMS -MADE AP V Ca G qpBYAl sId' hT EME JT EACH OCCURRENCE $ AGGREGATE $ DE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICE/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A ❑ .+ STATU- OTH- TORWC Y L MIT ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT $ El El DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project Name: Conch Key Fire Station Monroe County Board of County Commissioners as additional insurers The listed insurance policy (s) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County Commissioners Monroe County Board of County Commissioners Monroe Cty Administration Dept., Project Mgmt Dept 1100 Simonton Street, Room 2-216 Key West, FL 33000 CG SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988-2010 ACORD CORPORA N_ All rinhts rnAarvad_ ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 CSR: NR ,0A%4cd:WvEVIDENCE OF PROPERTY INSURANCE F�l1/1 ANY THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A HATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE OF PROPERTY INSURANCE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW AGUNCY 'f .OQ� COMPANY BUTLICSUCKLEY, DE Prasbflarl his CO S131 LAGON BLUE ODR., STE 420 500 Park Blvd Sb 1350 MIAMIFL 33125 IWea, IL 50143 I lark S. Bodenhwow sus coop unu mm PEDRO FALCON ELECTRICAL L)M NNMB6t POLICY NUMBER CONTRACTORS BR70720372 31160AVEC e"MmeoATE EXPINAlmwas CONnNUEDUNTL BIG PINE KEY. FL 3304341515 11=2 IMAM TERMNATEDIFCHECI® THIS REPtAcss MOOR SIACENCE wa®e S.CONCH AVENUE MICH KEY, FL =150 2 STORIES/ OLDS UNDER CONSTRUCTION RENOVATION d ADDITION FIRE STATION. 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 EVIDENCE OF PROPERTY INSURANCE 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 POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAMS. n.-_• -:r_. � is 3-`T 7\": ifs'. - :T.•� 1- � • -i AND HAIL COVERAGE M EXCLUDED CANCELLATION SHOULD AIt1f of THE ABOVE DE>1C ED POLICEB 8E CAI�ELLED sEFa11E THE MnRATIGN DATE THEREOF, THE NiiUNG N OMA WILL EIDEAMOR TO YAL 7Q DAYS WRIITIH NOTICE TO T?E ADDITIONAL INTEREST NAMED BELOW. BUT FALURE TO MAL SUCII NOTICE SHALL IMPOSE NO OBLIGATION OR LIAMM OF ANY KW UPON THE NBURER. rM AGENTS OR REREBENTATIVEL NAME AND ADI NEss MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON STREET KEY WEST, FL 33040 MORTGAGEE AOD"X*ML INSURED Lass PAYEE X ADDITIONAL NAMED INSURED LOAN R / The ACORD nams and boo am ro&b and marks of ACORD c CSR: NR "oI%4cd:W?EVIDENCE OF PROPERTY INSURANCE �l1na" "2 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDRIONAL INTEREST NAMED BELOW. THU EVIDENCE OF PROPERTY INSURANCE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PODS BELOW. woaNCr 305-28MM COMPANY BUTLER, BUCK LEY; DE Pradortan Ins Co 6161 BLUE LAGOON DR., STE 420 t100 Park BW Sfe 1300 MIAMI, FL 33126 Itasca, IL 60143 1111VIL S. Bodsnharnsr aua Conn: SSIUIRRD PEDRO FALCON ELECTRICAL 1O"M "UMNER PauR'~ mm"Elit CONTRACTORS BR70731072 31100 AVE C wvw7mimm 0~1110II DATE CORTINIM UNIX BIG PNE KEY, FL 330434M6 111=2 11/2ZH3 TBeaNMEDIFCHECKM THS RER ACES t•RIDR GATED: 0 S.CONCH AVENUE ONCH KEY, FL 33060 2 STORIES/ BLDG UNDER CONSTRUCTION RENOVATION 3 ADDITION FIRE STATION. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVffHSTANDNG ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTTER DOCUMENT WRTi RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCE 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. LIMfIS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. RY.Y - � FORKIW ND AND HAIL COVERAGE IS EXCLUDED CANCELLATION SHOULD ANY OF THE ABOVE DESXSEDED POLICES BE CANCELLED BEFORE THE lXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MA L 1D DAYS VAUTTEN NOTICE TO THE ADDITIONAL INTEREST NAMED BELOW. BUT FAILURE TO MAL SUCH NOTICE SHALL MPOSE NO OBLIGATION OR LIABLITY OF ANY KID UPON THE INSURER ITS AGENTS OR RERESENTATNES, NAME AND ADDRESS MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON STREET KEY (NEST, FL 33040 ACORD 2P (2oIBUa71 MORTGAGEE ADDITION& INSURED LOM PAYEE X ADDITIONAL NAMED INSURED LOAN # / TINS ACORD narm end boo are no&tsnd marks of ACORD C. � 12L%.20W AN riaMs norwd. ACC>RCERTIFICATE OF LIABILITY INSURANCE V TAS CWTiFICATE 0 ISSUED AS A MATTER OF INFOMIATHON ONLY AAD CONFERS NO MGM UPON THE CERTIFICATE HOLOW TM C$RTMCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. E=111D OR ALTER THE CO IMAGE AFFOIWM BY THE POI.ICMS BELOW. THIS CERTIFICATE OF INSURANCE DOES NaT CONSTITOTE A CONTRACT BIETWIEN THE WUWS MUitTR(3)6 AUTHORS= REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: it am pe"M holder M art AODMt4AL IMURW. ttw poflayon) mu a he sedomed• M SUYROGATI OH Is WAMM w0 jed a ow terme toed eataltles- of Ws pol", eantam pow Mq to*" tan andorsartme A oaI on this aatt ON 11 doss set eoldrr eights to On eeetHHaaeo haldor in Kw tNsueh andomm"a Re It '"D010s" We Milts Inuouve Agency, Inc- COX MIX 20330 Old Cutler Road Ctltier Bay. FL 33189 e Pedro Falcon EWKMcal Contradors, Inc. uaame t 31 IN avenue C Big Fine Kay. FL 33043 GOVOWAGUIS CERTFICATE NUtISM. REytagm NUNBmmi, TM 19 TO CERTFV TWIT THE POLICIES OF RMPANCE LISTED BELOW HAVE BEEN UMUED TO THE INSURED NAMED ABOVE FOR TIE P%ICY PERM INDICATED. NOTYMT)WANUNG ANY REQWREUENT. TERN OR OONGITON OF MY CONTRACT OR UTM R: DOCIMMENT IVITH iESPECr TO WHICH THS CERTEICATE MAY tE 11MU80 OR MAY PERTAIN, THE 1IMMAKE AFFOROEO BY THE POLICIES DESCRIBED H131EIN IS Sud.IECT TO ALL THE TERMS, EXCLUSIONS MID CONDMONS OF SUCH POLICES. LIMITS SHOVW MAY HAVE BEEN REDUtMD SY PAD CL Me. 111 TINa OF Lori eENeluLwelleM EACHOOCV10MCE t COMMERMOEMSI 16AKITY ( ?!r€!!1 s aAW►+W OCGAA HEOE7eFlAnean�Fwaw ty — — — -- Pexson+lLaAw�N,iuRr s I ZENERAL A6QREaRTE s WXLA"EVATZUWTAPPLESPER PRDDl1C71-OOGeFNOPIl09 f ev cY LOC s. A AurOMOKE UOAM M Y M 3PI FW 59 121a312012 OQA&W3 s t,000,0ap ~ ANYAuro N=YWAAW(Pwyssw8 A RCC"" x SWEDM i00LY !NRNY{F�►a�d1� 4 s HOMAUTOe AU709 s UNGREI A I" D71a i We OCCUR CLA ♦ Or -FIDA :n+ E oar s AoQTw TC i ReiENtrole s I •.�. f _ won"" aan14►a r4n AND EiYIFWVERSMO M YiN I ANY MIIDFRtETOM'AR.rIEAIO� w4 0"Webtit/ry10NaVai Hir TV -- i ___.. E 4 FACN AOC10iNr .- � IMandaNaF M MN drw, daradla n!a I { E.L Ota61iE • [A i E.t F11�� 8�E •POI CY lWrf S oEdCtIITbNOFOFlRA71ONi/tDCATWNi�YENCifalMpdtACORDtit.AdiiMsWRanwR+Sdudde.Aammspew oa da* Prajea Fire StetIon 4117 Conch Key Dernokm Renavat on S Canso ud,on Monroe Calmly Board of CowNy Cornmissior a as aWt al 4waed The listed mmmance pakcy nay not c canceled on low then 30 days wrrttan rwAm by the inww Monme County aoerd of County Commrssior+era Monroe County Board of County Commissioners Monroe Cty Administration Dept, Project Mgmt Dept 1100 Simonton Shwt, Room 2-216 Key West FL 33040 ACORD 25 (2010rosi SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFIDRE THE EXPIRATION DATE THEREOF. NOTICE MILL BE DEUVERED IN ACCORDANCE W" THE POLICY PROVURONS RE= The ACORD nerve and logo wo moistered marks of ACORD 10014M 1328497 0341-2012 GG, PEDRO-2 OP ID: NR '`, J5* CERTIFICATE OF LIABILITY INSURANCE DAT03/07D/YYYY) F 03/07/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 305-262-0086 CONTACT NAME: WILLIAM BODENHAMER BUTLER, BUCKLEY, DEETS INC. 6161 BLUE LAGOON DR., STE 420 MIAMI, FL 33126 PHONE FAX ac No E t : 786 216 1764 A/CNo): 305 2620086 E-MAIL ADDRESS: BBODENHAMER BBDINS.COM William S. Bodenhamer INSURERS AFFORDING COVERAGE NAIC # INSURER A: FCCI Commercial Insurance CO INSURED PEDRO FALCON ELECTRICAL CONTRACTORS, INC. 31160 AVE C INSURER B : INSURER C BIG PINE KEY, FL 33043-4516 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE J DL UB POLICY NUMBER MM POLICY EFF /DD/YYYY) POLICY EXP (MMIDD/YYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X GL 0008235 4 03/13/13 03/13/14 DAMAGE TO RENTED PREMISES Ea occurrence 100 00 � $ CLAIMS -MADE F7X OCCUR MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY X PRO LOC • $ AUTOMOBILE LIABILITY ANY AUTO BY W �— COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS X UMBRdn ILIA OCCUR EACH OCCURRENCE $ 4,000,00 A Es AB G, CMSTAADE UMB0005173 6 03/13/13 03/13/14 T�DECD AGGREGATE $ 4,000,00 RE TION $ 000 $ A WORKERS dMPENSATION -_ AND EMPLOMS' U UTY ANY PROPRDR/P ER/EXECW1Vt.Y/N II OFFICER/MEWER EX'MDED? L._ I (Mandatory n H) J ,' yes, descr i . der DESCRIPTI F O TIONS b N / A 001-WC11A-65512 11/02/12 11/02/13 X I WC STATU- OTH- I ER E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE $ 500,00 E.L. DISEASE - POLICY LIMIT BOO OO $ s , A INSTALLAMPN FbTR CM0004409-4 03/13/13 03/13/14 RENTAL *SEE NOTE EQUIPMEWJOFQTE BLANKET *SEE NOTE LEASED *SEE NOTE DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) *30 DAYS NOTICE OF CANCELLATION EXCEPT NON PAYMENT OF PREMIUM 10 DAYS/ MONROE COUNTY BOARD OF COUNTY COMMISSIONERS IS NAMED ADDITIONAL INSURED. PROJECT: FIRE STATION#17 CONCH KEY, DEMOLITION, RENOVATION & CONSTRUCTION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MONROE COUNTY BOARD OF COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORD WITH THE POLICY PROVISIONS. COMMISSIONERS %MONROE COUNTY FACILITIES DEVELOPMENT AUTHORIZE NTATIVE 1100 SIMONTON ST, ROOM 2-216 Willia de KEY WEST, FL 33040 CG3 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The LORD name and logo are registered marks of ACORD PEDRO-2 OP ID: NR CERTIFICATE OF LIABILITY INSURANCE DAT0'MM/DD/YYYY) 03/07/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 305-262-0086 CONTACT NAME: ` WILLIAM BODENHAMER BUTLER, BUCKLEY, DEETS INC. 6161 BLUE LAGOON DR., STE 420 MIAMI, FL 33126 PHONE FAx WINE Ext : 786 216 1764 A/C No : 305 2620086 SS: BBODENHAMER BBDINS.COM William S. Bodenhamer -ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:FCCI Commercial Insurance CO INSURED PEDRO FALCON ELECTRICAL CONTRACTORS, INC. 31160 AVE C INSURER B : INSURER C BIG PINE KEY, FL 33043-4516 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000. DAMAGE TO RENTED PREMISES Ea occurrence $ 100,00 A X COMMERCIAL GENERAL LIABILITY X GL 0008235 4 03/13/13 03/13/14 CLAIMS -MADE FXI OCCUR MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY X PRO LOC $ AUTOMOBILE LIABILITY BY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO DATE WAIV A BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Peraccident $ NON -OWNED HIRED9MFOS ' AUTOS $ X UMBRI�LgA LIPQ OCCUR EACH OCCURRENCE $ 4,000,00 A EXCE IAB MS -MADE UMB0005173 6 03/13/13 03/13/14 AGGREGATE $ 4,000,00 DED RETENTION $ _ 10 000 $ WORKERS PWPEAftON _ = X WC STATU- OTH- A AND E11111 ' MMILITY ANY PROPRIETOR/ NER/EXEdttTI� Y/N OFFICE ER UDED? F N / A 001-WC11A-65512 11/02/12 11/02/13 E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE $ 500,00 (Mandato H) — / t If yyes, des and —) OESCRIPT OF TIONS b 1 E.L. DISEASE - POLICY LIMIT $ 500,00 A INSTALU%TIONPSTR 3= CM0004409-4 03/13/13 03/13/14 RENTAL 'SEE NOTEtl EQUIPMENT JOBSITE IBLANKET *SEE NOTE ILEASED 'SEE NOTE DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ADDITIONAL INSURED MONROE COUNTY BOARD OF COUNTY COMMISSIONERS-MONROE COUNTY BOCC. PROJECT: RENOVATION OF THE MONROE COUNTY COURTHOUSE(MARATHON)"30 DAYS NOTICE OF CANCELLATION EXCEPT NON PAYMENT OF PREMIUM 10 DAYS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MONRIE COUNTY BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1100 SIMONTON ST,ROOM 2-216 KEY WEST, FL 33040 AUTHORIZED RE VE William S. r ACORD 25 (2010/06) v ©1988-2WACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACOR" CERTIFICATE OF LIABILITY INSURANCE °03/12/2013 ' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road CONTACT NAME: Janice ROWfOn P 1C, Ext : 305-238-8688 NC No : 305-2388 608 DD ARESS: janice.rowton.icqb@statefarm.com O Cutler Bay, FL 33189 INSURERS) AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 25178 t INSURED Pedro Falcon Electrical Contractors, Inc. INSURERB: INSURER C : 31160 Avenue C Big Pine Key, FL 33043 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 BEE W"BLWAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER eM / p D DIYYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR ❑ ❑ pp ° ' IME. RECEIVED BY:—$ i( J rl .!! . ! t. EACH OCCURRENCE - $ � PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PE� LOC PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO AALL UTOS OWNED x SCHEDULED AUTOS NON -OWNED HIRED AUTOS AUTOS a D07 7437 D26 59 D09 4759 C09 59 022 3871 F03 59 030 5488 B29 59 10/26/2012 03/09/2013 12/03/2012 02/2812013 04/26/2013 09/09/2013 06/03/2013 08/31/2013 MBINEA Ea aDSINGLE LIMIT ctlet $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PerOaccidentDAMAGE $ UMBRELLA LIAB EXCESS LIAB HCLAIMS-MADE OCCUR El ❑ EACH OCCURRENCE $ AGGREGATE $ DEDT I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under nF--rRIPTION OF OPERATIONS haloW N / A El DA WAI _ WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ I E.L. DISEASE - POLICY LIMIT 1 $ El El DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additlonal Remarks Schedule, if more space Is required) Project Name:Conch Key Fire Station Monroe County Board of County Commissioners as additional Insurers The listed insurance policy (s) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County commissioner GtKIH-IGAIt MULUtK liN1YVCLLf1IIVIY Monroe County Board of county Commissioners Monroe Cty Administration Dept., Project Mgmt Dept 1100 Simonton Street, Room 2-216 Key West, FI 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AU ORIZED REPRESENTAMTIVE p ,., tttJ_J_ � ©1988-2010 ACORD COR06R4ffiON. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 C(;16„/At)« A� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDfYYYY) 04/09/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road Cutler Bay, FL 33189 CONTACT NAME: Janice ROwton IAIC.PHONNo,E Ext). 305-238-8688 aC No): 305-2388-608 E-MAIL ADDRESS: 'an ice. rowton.iC b statefarm.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 25178 ` INSURED Pedro Falcon Electrical Contractors, Inc. INSURERB: INSURER C : 31160 Avenue C INSURERD: Big Pine Key, FL 33043 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE I L UBR NUMBER POLICPOLICY MM/DDY EFF MMI D/YYYY LIMITS GENERAL LIABILITY ❑ ❑ EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS -MADE F1 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ POLICY 7 PRO LOC A AUTOMOBILE LIABILITY IV] El645 9389 D09 59 04/09/2013 10/09/2013 MBI CND acccidentSINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS i $ UMBRELLA LIAB OCCUR ❑ ❑ EACH OCCURRENCE - $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE Wa .... DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICE/MEMBER EXCLUDED? N / A ❑ WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under L__ r_1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: Conch Key fire Station Monroe County Board of County Commissioners as additional insurers The listed insurance policy (s) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County Commissioners CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners Monroe Cty Administration Dept., Project Mgmt Dept 1100 Simonton Street, Room 2-216 Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE tug `lulu ©1988-2010 ACORD CORF(OR4TON. All rights reserved. D ACORD 25 (2910105) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 C. c. Acc)wa V CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 04/22/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road r.717Cutler Bay, FL 33189 CONTACT NAME: Janice Rowton PWC,HONNo,E Extia 305-238-8688 A/C No): 305-2388-608 E-MAIL ADDRESS: 'an ice. rowton.icb statefarm.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 25178 INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key, FL 33043 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE A L BR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY ❑ EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE1:1 OCCUR ff AP V E BY � PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1-1 POLICY PROJECj 7 LOC $ A AUTOMOBILE LIABILITY FYI ElD07 7437 D26 59 04/26/2013 10/26/2013 Ea acccdentSINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS Monroe COLIW PROPERTY DAMAGE Per accident $ $ Df)Vf. IO ent UMBRELLA LIAB HCLAIMS-MADE OCCUR ❑ ❑ EACH OCCURRENCE _ $ EXCESS LIAB /1 i�j,j �-�t, AGGREGATE $ DED RETENTION $ $ ,a WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER EXCLUDED? N / A ��(NE,�d,,.<, g":-" -- RECEIVED BY: WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT $ If Dyes, describe under ESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project Name:Conch Key Fire Station Monroe County Board of County Commissioners as additional Insurers The listed insurance policy (s) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County commissioner I.K I IFIUA I t MULUtK Monroe County Board of county Commissioners Monroe Cty Administration Dept., Project Mgmt Dept 1100 Simonton Street, Room 2-216 Key West, FI 33040/, 1 LC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1T88-2010 ACORD CORPORATION. All riahts reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 ALCCORL? �..� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 05/31/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Ellie Mills Inusrance Agency,Inc. CONTACT NAME: Janke ROwton 20330 Old Cutler Road Cutler Bay, FL 33189 PWC.HONNo,E Extir 305-238-8688 FAX No): 30-238-8608 E-MAIL ADDRESS: 'anice.rowton.ic b statefarm.com OINSURERS AFFORDING COVERAGE NAIC # INSURER A : State Farm Mutual Automobile Insurance Company 25178 INSURED Pedro Falcon Electrical Contractors, Inc. INSURERB: INSURER C : 31160 Avenue C INSURER D : Big Pine Key, FL 33043 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY ❑ ElEACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY P IGEMENT CLAIMS -MADE OCCUR D MED EXP (Any one person) $ PERSONAL & ADV INJURY $ WAi GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO LOC $ A AUTOMOBILE LIABILITY FYI El022 3871 F03 59 06/03/2013 12/03/2013 Ee aoc den SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB HCLAIMS-MADE OCCUR ❑ ❑ EACH OCCURRENCE_ $ EXCESS LIAB AGGREGATE $ DED I I RETENTION $ $ twitOE' CO WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICE/MEMBER EXCLUDED? N / A ❑ tilt♦®g '' rdO• q�•,' .y WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below..r d El I Gry�y5D DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: Conch Key fire Station Monroe County Board of Commissioner as additional insured The listed insurance policy(s) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County Commissioners Monroe County Board of County Commissioners Monroe Cty Administration Dept, Project Mgt Dept 1100 Simonton Street, Room 2-216 Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE n 1989-2016 ACORD WRP&WATION. All riahts reserved ACORD 25 ( 10/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 CC,: '4COOR V® CERTIFICATE OF LIABILITY INSURANCE ATE (MM/DD/YYY D07/02/20 3n THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road O Cutler Bay, FL 33189 t NAME: CONTACT Janice Rowton . 305-238-8688 FAX No : 30-238-8608 nAREss: 'anice.rowton.i b statefarm.com INSURERS AFFORDING COVERAGE NAIC q INSURER A: State Farm Mutual Automobile Insurance Company 26178 INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key, FL 33043 INSURERB: INSURER C : INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. IEXP LTR TYPE OF INSURANCE IM VD POLICY NUMBER MM DDPOLICY EFF MM DDY/YYYY LIMITS GENERAL LIABILITY ❑ ❑ EACH OCCURRENCE $ PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR AD PPROV R B ' MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY jECTPRO LOC $ A AUTOMOBILE LIABILITY a El898 3933 A08 59 07/08/2013 01/08/2014 Ea accident IN LE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PeOacEcd nDAMAGE $ NON-OHIRED AUTOS X AUTOS EED UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ EXCESS LIAB AGGREGATE $ DIED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICE/MEMBER EXCLUDED? ❑ N / A ❑ WC STATU- OTH- T RY LIMITSER E.L. EACH ACCIDENT $ (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $ ❑ ❑ Monroe County raCIIINGS Development DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project: Conch Key Fire Station TIME: Monroe County Board of Commissioner as additional insured RECEIVED BY: The listed insurance policy(s) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County Commissioners CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners Monroe Cty Administration Dept, Project Mgt Dept 1100 Simonton Street, Room 2-216 Key West, FL 330�0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r ©1988-2010 ACORD CID N. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 AFRO® CERTIFICATE OF LIABILITY INSURANCE are OMMIDIDPOO D08/13120 3Y THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER Ellie Mills lnusrance Agency, Inc. 20330 Old Cutler Road O Cutler Bay, FL 33189 R CONTAC NONE: Janice Row_(on_ - PHONEoem . 305-238-8 Fuc xo:305-2388fi98_ EMAL ADDRESS:'arace.rowton.i b statefarm,com INSURERS AFFORDING COVERAGE NAICI INSURER A:State Farm Mutual Automobile Insurance Company 25179 INSURED Pedro Falcon Electrical Contractors, Inc. INSURER B: INSURER C: 31160 Avenue Big Pine Key, FL 33043 INSURER :--- INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR R TYPEOFINSURANCE AOOL ❑❑ UB POLICY NUMBER OFF USUBDOOl N pCY ELICY %P UNITS GEXERALLIABIIITY COMMERCIAL GENERALLIABILITY CIAIMSM4OE ❑OCCUR A E R A pq� WAV /A EM EACXOCCURRENCE 1 PREMISES Ee ocwme,¢e S MEO E%P (Myone perwnl b, PERSONAL S ADV INJURY GENERALAGGREGATE b GEN'L AGGREGATE POLICV LIMIT APPLIES PER: PRO LOD PRODUCTS - COMP)OP AGG 'b b q ^roRGaI:E:.^a,..TT V ANY AUTO ALLONMEO rXI SCHEDULEU AUTOS AUTOS NON-0VMEO _ HIRED AUTOS AUTOS Y ❑ D094759 C0959 0305488 B2959 0910912013 ON2912013 03/0912014 02/28IM14 - N LE LIMIT Ee ewaem Iy 1,000,000 BODILY INJURY (Per person) Ib - BODILY INJURY (Per acchent),s PROPERTY DAMAGE Ib Per aml0enl _ 3 UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS.MADE EACH OCCURRENCE IS AGGREGATE 's ODo I I RETEN➢ONf pis VpRXERS COMPENSATION ANDEMPLOYERB' LIABILITY Y)N ANY PROPRIETORNARTNEN E-B- OFFICEMEMBER EXCLUDE V+ (MandaloGm NX) ,I yes, deevideurcer NIA❑ /)1Nf1 -OC.pfl,er 00 1R Al,. -OUIJ� °)OOmD n1 0 lGRSTATU- OTX- IMI ER _ E. L. EACH ACCIDENT _ b EL. DISEASE EA EMPLOYE b EL DISEASE -POLICY LIMIT 1 $ ❑ ❑ ENfn DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLE$ (Mach MOM 101, sadalonal RemYMF Schedule, If mom pwe Is rpubM) Project Name'. Conch Key Fire Station Monroe County Board of County Commissioners as additional insured The listed insurance policy (a) may not be Canceled on less than 30 days wntten notice by the insurer Monroe County Board of County Commissioners Monroe County Board of County Commissioners SHOTHELD ANY OF EXPIRATION H DATE VT THEREOF, NOTICE POLICIES WILL CBE CELLED DELIVERED BEFORE IN 1100 Simonton Street RM2-216 ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 Q7 1— roiihW.191.Tr. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 1328497 03-01-2012 u a A CERTIFICATE OF LIABILITY INSURANCE 05/1`�0013' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(SL AUTHORIZED REPRESENTATIVE OR PRODUCER, ANb THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRO010E" Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road Bay, FL 33189 AO"TMTVCT Janice Rowton p"D"E -2 FAX Ne: o JIUL ADDRESS: anice.nmwton.i b statefarm.com OCutler --v INSURE AFFORDING COVERAGE NAIC 0 INSURER A: State Farm Mutual Automobile Insurance Company 178 '"s"`�D Pedro Falcon Electrical Contractors, Inc. INSURER9: 31160 Avenue C INSURER c : INSURER 0: Big Pine Key, FL 33043 INSURER E INSURER F RGnIJ1Vn r�Vn10CR: 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" R TYPE OF INSURANCE am 3W POLICY NUMBER POLICY Will, POLICY UP LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY AP E , MI *T� r,ar --once) s CLAIMS4AADE OCCUR D MEO EXP orrs Mepl) S ! PERSONAL S ADV INJ S W 4 -y GENERAL AGGREGATE S G A AGGREGATE UMITAPPIJES PER: PROOUCTS . COMPIOPAGG S POLICY PRO1EG,LOC S A AUTOMOBILE LIABILITY Y 6511826 E07 69 0510712013 11/07/2013 C�OM,,19S'NGLE OMIT S 1,000.000 ANY AUTO BODILY INJURY (Pw person) S ALL OWNED x 71 Ou1£D BODILY INJURY (Per ewideM) S AUTOS AUTOS NON -OWNED 113 7113E70 59 0511 D12013 11/1 D12013 pE oAM Paracdda S HIRED AUTOS AUTOS S UMBRELLA I" OGCUR Fa Imes Deve U EACH OCCURRENCE S EXCESS LIAR CWMS•MADE pmenl AGGREGATE $ DED RETENTIONS S MAV c WORKERS COMPENSATION AND EMPLOYERS' LIABILITY :.; i .1 C STATU- OTH. ANY PROPRIETORIPARINEROEXECUTIVE Y 1 N TIME: E.L. EACH ACCIDENT S OFFICEIMEMB£R EXCLUOED7 Q N I A EL. DISEASE - EA EMPLOYEE S In NMI If Yee, dew`e wslo, RECEIVED By E.L. DISEASE • POLICY LIMIT $ :19 11 ---------- MMCVM" M OF OPERATIONS I LOCATIONS I VEHICLES (Ahach ACORD 101. Additional Rerrarke Sehedrde, if Mon apace to re4wred) Project: Conch Key Fire Station Monroe County Board of County Commissioners as additional insurers The rested insurance policy (S) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County Commissioners Monroe County Board of County Commissioners Monroe Cty Administration Dept., Project Mgmt Dept 1100 Simonton Street, Room 2-216 Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W ACCORDANCE WITN THE POLICY PROVISIONS. ACORD CORPORATION_ All rinhts marvncl ACORD 25 (20�0/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 C. C�