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Certificates of Insurance F . r ^ — BOARD OF COUNTY COMMISSIONERS — MAYOR, Wilheimina Harvey, District 1 O U N TY o M O N ROE � ►' ° Mayor Pro Tem, Jack London, District 2 Douglas Jones, District 3 A. Earl Cheal, District 4 ` KEY WEST FLORIDA 33040 t�; ?MI ` _ (305) 294 -4641 � 1 1 r 1 " John Stormont, District 4 ,_ n 7" t M E M O R A N D I J -N! To: Beth Leto ` Assistant County Attorney ' From: Kay Bahleda Risk Management Date: December 29, 1992 Subject: American Red Cross Funding Agreement Enclosed please find the original Certificate of Insurance for- warded to the Risk Management office for subject agreement. The insurance coverage is now sufficient to execute this agree- ment. If you have any questions, please call ext 4454. Thank you. CERTIFICATE OF INSURANCE DATE ISSUED 12/22/92 BROKER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. IT DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY(IES) LISTED BELOW. Sedgwick James 5� James o,VIroinu Inc. COMPANIES AFFORDING COVERAGE 4001 North Fairfax Dove. Suite 300, Arlington, Virginia 22203 COMPANY 1 NATIONAL UNION FIRE INS. CO. NOTE For prompt handling, kindly request renewal information through your local American Red Cross Chapter. INSURED COMPANY `2 COMPANY 3 MIN American Red Cross COMPANY 4 17th & D Streets, N.W. Washington, D.C. 20006 COMPANY 5 COVERAGES 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS (000) DATE (MM /DD /YY) DATE (MM /DD /Y1) 1 GENERAL LIABILITY GENERAL AGGREGATE $ 1, 000 X COMMERCIAL GENERAL LIABILITY RMGLA3264903 7/01/92 7/01/93 PRODUCTS - COMP /OPS AGGREGATE + • X X (CLAIMS MADE ❑OCCURRENCE PERSONAL 8 ADVERTISING INJURY X OWNER'S 8 CONTRACTORS PROTECTIVE EACH OCCURRENCE EIMMI FIRE DAMAGE (ANY ONE FIRE) $ , • MEDICAL EXPENSE (ANY ONE PERSON) $ AUTOMOBILE LIABILITY — ANY AUTO CSL $ — ALL OWNED AUTOS BODILY — SCHEDULED AUTOS INJURY $ (PER PERSON) — HIRED AUTOS BODILY INJURY — NON -OWNED AUTOS PER — ' GARAGE LIABILITY �ccIDENn $ PROPERTY DAMAGE $ EXCESS LIABILITY EACH AGGREGATE OCCURRENCE $ $ OTHER THAN UMBRELLA FORM WORKERS' COMPENSATION STATUTORY AND $ (EACH ACCIDENT) $ (DISEASE- POLICY LIMIT) EMPLOYERS' LIABILITY $ (DISEASE - EACH EMPLOYEE) OTHER DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES F X1/E?XXIXIC@(SPECIAL ITEMS Greater Miami Chapter — Additional Insured: Monroe County Board of County Commissioners w /respect to receipt of a grant from the below. CERTIFICATE HOLDER CANCELLATION Monroe County Board of Commission: s THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE c/o Risk Management CERTIFICATE HOLDER NAMED AT THE BOTTOM, S • _ CANCELLATI• TAKE PLACE 5100 College Rd Oi .:•, ' •LICY - URE T• MAI UCH NOTICE ' ALL IMPOSE NO Key West FL 33040 OBLIGATION ORjITY OF ANY IND •'ON THE COM• Y, ITS AGENTS OR REPRESENTA THOR IZED TATIVE lI1� ' X111 Sedgwick James CERTIFICATE OF COVERAGE This is to certify that the Chapter named below is currently self - insured through the American National Red Cross in the State of Florida: Name of Chapter: Greater Miami Chapter -Lower Keys Branch American Red Cross 600 White Street Key West FL 33040 Coverage Type of Coverage Period Limits of Liability Workers' Compensation 01/01/92 to Statutory Benefits 01/01/93 Employers' Liability 01/01/92 to $1,000,000 -Each Bodily Injury by Accident 01/01/93 Accident Employers' Liability 01/01/92 to $1,000,000 -Each Bodily Injury by Disease 01/01/93 Employee Employers' Liability 01/01/92 to $1,000,000 - Policy Bodily Injury by Disease 01/01/93 Limit (From 12:01 A.M. to 12:01 A.M. Standard Time) Date: December 22, 1992 Sedgwick James of Virginia, Inc. BY: A ho iz Representative 4001 Fairfax Dr., Ste 300 Arlington, VA 22203 This certificate is issued as a matter of information only and confers no rights upon the certificate holder. CERTIFICATE OF COVERAGE This is certify that the Chapter named below is currently self insured through the American National Red Cross in the State of FLORIDA: Name of Chapter: Greater Miami Area Chapter -Lower Keys Branch American Red Cross 600 White Street Key West, FL 33040 Type of Coverage Coverage Period Limits of Liability Workers' Compensation 01/01/93 to Statutory Benefits 01/01/94 Employers' Liability 01/01/93 to $ 1,000,000 -Each Bodily Injury by Accident 01/01/94 Accident Employers' Liability 01/01/93 to $ 1,000,000 -Each Bodily Injury by Disease 01/01/94 Employee Employers' Liability 01/01/93 to $ 1,000,000-Policy Bodily Injury by Accident 01/01/94 Limit (From 12:01 A.M. to 12:01 A.M. Standard Time) Date: September 22, 1993 Sedgwick James of Virginia, Inc. By: �� ► ` Aut riz e s� senta ive 4001 Nort Fairfax Drive Suite 300 Arlington, VA 22203 This certificate is issued as a matter of information only and confers no rights upon the certificate holder. CERTIFICATE OF INSURANCE DATE ISSUED 9/22/93 BROKER . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. IT DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY(IES) LISTED BELOW. Sedgwick COMPANIES AFFORDING COVERAGE Sedgwkk James of Virginia, Inc. 4001 North Fairfax Drive, Suite 300, Arlington, Virginia 22203 COMPANY 1 NATIONAL UNION FIRE INS. CO. INSURED COMPANY 2 I COMPANY 3 MIN American Red Cross 0 AI _ COMPANY 4 r ci - mi l t.1 i e .p. .I 17th & D Streets, N.W. x, Washington, D.C. 20006 COMPANY 5 WAIVER: II /A n COVERAGES THIS IS TO CERTIFY THAT POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE"OR 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS 000 I DATE (MM /DD /YY) DATE (MM /DD /YY) ( ) I GENERAL LIABILITY GENERAL AGGREGATE $ 1 000 © COMMERCIAL GENERAL LIABILITY RMGLA1759472 /O1 /93 /01 /94 PRODUCTS - COMP /OPSAGGREGATE $ 1 000 ©© CLAIMS MADE OCCURRENCE PERSONAL & ADVERTISING INJURY $ 1 s 000 © OWNERS 8 CONTRACTORS PROTECTIVE EACH OCCURRENCE $ 1 QQQ III FIRE DAMAGE ANY ONE FIRE) $ 1 QQQ ■ MEDICAL EXPENSE (ANY ONE PERSON) $ 5 I AUTOMOBILE LIABILITY in ANY AUTO CSL $ I. ALL OWNED AUTOS III SCHEDULED SCHEDULED AUTOS INJURY (PER PERSON) $ . HIRED AUTOS BODILY NON -OWNED AUTOS INJURY $ PROPERTY • GARAGE LIABILITY �CCI 111 DAMAGE $ I EXCESS LIABILITY EACH AGGREGATE 1111 OCCURRENCE Q� $ $ 111 OTHER THAN UMBRELLA FORM STATUTORY —A WORKERS' COMPENSATION AND 1. ' eceived MS (EACH ACCIDENT) EMPLOYERS' LIABILITY . & Loss Con • 1 : Q (DISEASE-POLICY LIMIT) •P — — $ (DISEASE -EACH EMPLOYEE) OTHER • ATE INITIAL 44 D ' DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLEX/JQ iJ(IMX /SPECIAL ITEMS Greater Miami Chapter — Additional insured: Monroe County Board of Commissioners w /respect to the receipt of a grant from the below. CERTIFICATE HOLDER CANCELLATION 45 ■ Monroe County Board of Comm THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1XDAYS WRITTEN NOTICE TO THE C /O Risk Management CERTIFICATE HOLDER NAMED AT THE BOTTOM, S • _ CANCELLATI• TAKE PLACE 01 ••LILY - -, : • URE MAI UCH NOTICE • ALL IMPOSE NO 5100 College Road Key West, FL 33040 OBLIGATION ORITY OF ANY IND e•ON THE COM•• Y, ITS AGENTS OR REPRESENTA THOR 1i = 1 <G' 711 / `!6 1 CERTIFICATE OF INSURANCE DATE ISSUED BROKER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. IT DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY(IES) LISTED BELOW. Sedgwick James COMPANIES AFFORDING COVERAGE Sedgwick James of Virginia, Inc. 4001 North Fairfax Drive, Suite 300. Arlington. Virginia 22203 COMPANY 1 NOTE: For prompt handling, kindly request renewal information through NATIONAL UNION FIRE INS. CO. I i your local American Red Cross Chapter. INSURED COMPANY 2 ! , 3 COMPANY 3 Received , � I MIN American Red Cross 1V1ix71t• � 1 '� COMPANY Q DATE o, - 7! 7- / L� • 4 1 1 17th & D Streets, N.W. 1Ni AL ___,.,, �Y , Washington, D.C. 20006 COMPANY 5 Nl f COVERAGES ry• 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 REOUIREMENT, 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS 000 DATE IMM /DD /YY) DATE (MM /DD /YY) ( ) 1 GENERAL LIABILITY GENERAL AGGREGATE $1,000 K COMMERCIAL GENERAL LIABILITY R MGLA32649Q3 7/01/92 7 / 01 / 93 PRODUCTS - COMP /OPS AGGREGATE $1, 000 ( ( ) CLAIMS MADE ❑OCCURRENCE PERSONAL 8 ADVERTISING INJURY $ 1a 000 OWNER'S & CONTRACTORS PROTECTIVE EACH OCCURRENCE $1,000 FIRE DAMAGE (ANY ONE FIRE) $ 1s 000 — MEDICAL EXPENSE (ANY ONE PERSON) $ 5 AUTOMOBILE LIABILITY — "ANY AUTO CSL $ — ALL OWNED AUTOS o ' SCHEDULED AUTOS INJURY HIRED AUTOS (PER PERSON) $ BODILY INJURY — NON-OWNED NON -OWNED AUTOS ZCCIDENT) $ '— GARAGE LIABILITY --, PROPERTY DAMAGE $ EXCESS LIABILITY EACH AGGREGATE OCCURRENCE Q� $ $ OTHER THAN UMBRELLA FORM WORKERS' COMPENSATION STATUTORY AND $ (EACH ACCIDENT) $ (DISEASE- POLICY LIMIT) EMPLOYERS' LIABILITY $ (DISEASE - EACH EMPLOYEE) OTHER s DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLIfO x181 5 /SPECIAL ITEMS pper Keys Chapter — Additional Insured: Monroe County Board of County ommissioners w /respect to receipt of a grant from the below. CERTIFICATE HOLDER CANCELLATION 45 Monroe County Board of Commi sS ione THE ISSUING COMPANY WILL ENDEAVOR TO MAIL i4 DAYS WRITTEN NOTICE TO TH C/O Risk Management CERTIFICATE HOLDER NAMED AT THE BOTTOM, S • ..i. CANCELLATI• TAKE PLACE 5100 College Rd O. ••LIC -, a - URET• MA UCH NOTICE' ALL IMPOSE NO Key 4J s t FL 33040 OBLIGATION ORAIITY OF ANY IN • e - ON THE COM •• Y, ITS AGENTS OR REPRESENTA_ T •RIZED t "EPR — TATIVE ilk i_ 1 40 Sedgwick CERTIFICATE OF COVERAGE This is to certify that the Chapter named below is currently self- insured through the American National Red Cross in the State of Florida: Name of Chapter: Upper Keys Chapter American Red Cross P O Box 672 Tavernier FL 33070 Coverage Type of Coverage Period Limits of Liability Workers' Compensation 01/01/93 to Statutory Benefits 01/01/94 Employers' Liability 01/01/93 to $1,000,000 -Each Bodily Injury by Accident 01/01/94 Accident Employers' Liability 01/01/93 to $1,000,000 -Each Bodily Injury by Disease 01/01/94 Employee Employers' Liability 01/01/93 to $1,000,000- Policy Bodily Injury by Disease 01/01/94 Limit (From 12:01 A.M. to 12:01 A.M. Standard Time) Date: June 14, 1993 Sedgwick James f Virginia, Inc. By: � r , Au o• Representative 4001 N Fairfax Dr., Ste 300 Arlington, VA 22203 This certificate is issued as a matter of information only and confers no rights upon the certificate holder. CERTIFICATE OF INSURANCE DATE ISSUED 7/12/93 BROKER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. IT DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY(IES) LISTED BELOW. , Sedgwick James COMPANIES AFFORDING COVERAGE Ssdgw$ck James of Virginia, Inc. 4001 North Fairfax Drive. Suite 300, Arlington • Virginia 22203 COMPANY 1 NOTE For prompt handling, kindly request renewal information through NATIONAL UNION FIRE INS. CO. your local American Red Cross Chapter. INSURED COMPANY 2 Received COMPANY 3 Risk Mgmt. Loss Control ` + American Red Cross . & o ss COMPANY 4 DATE 7 � �,- 3 17th & D Streets, N.W. INITIAL Washington, D.C. 20006 COMPANY 5 C c COVERAGES 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 REOUIREMENT, 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION 000 TS DATE (MM /DD /YY) DATE (MM /DO /YY) L IABILITY LIMITS (000) t 1 GENERAL LIABILITY GENERAL AGGREGATE $ 1, 000 X COMMERCIAL GENERAL LIABILITY RMOLA1759472 7/01/93 /01/94 PRODUCTS - COMP /OPS AGGREGATE $ 1, 000 X X I CLAIMS MADE DOCCURRENCE PERSONAL 8 ADVERTISING INJURY $ 1, 000 X OWNER'S & CONTRACTORS PROTECTIVE EACH OCCURRENCE $ 1, 000 1AAN r FIRE DAMAGE (ANY ONE FIRE) $ 1, 000 v •i',I l 1 MEDICAL EXPENSE (ANY ONE PERSON) $ 5 AUTOMOBILE LIABILITY '7 4001 * — ANY AUTO j �' CSL $ — ALL OWNED AUTOS filf SCHEDULED AUTOS BODILY DAZE INJURY (PER PERSON) $ — HIRED AUTOS"",., emu r - NON -OWNED AUTOS WAIVER: " . 1 1111.1.. INJURY A $ — GARAGE LIABILITY - PROPERTY DAMAGE $ EXCESS LIABILITY EACH AGGREGATE OCCURRENCE $ $ OTHER THAN UMBRELLA FORM WORKERS' COMPENSATION STATUTORY AND $ $ $ (EACH ACCIDENT) EMPLOYERS' LIABILITY (DISEASE- POLICY LIMIT) $ (DISEASE -EACH EMPLOYEE) OTHER DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLEX X)XXSPECIAL ITEMS Upper Keys Chapter— Additional insured: Monroe County Board of Commissioners w/respect to a grant to conduct Health & Safety courses throughout the policy period. CERTIFICATE HOLDER CANCELLATION Monroe County Board of Commissioners THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED AT THE BOTTOM, S • - .: CANCELLATI• TAKE PLACE c/o Risk Management O. ••LIC , :, - URE T• MA UCH NOTICE ' ALL IMPOSE NO 5100 College Road Key West, FL 33040 OBLIGATION OR JITY OF ANY IND ••ON THE COM Y. ITS AGENTS OR REPRESENTA T •� R IZED Ailit TATIVE ilk 40 Sedgwick CERTIFICATE OF COVERAGE This is to certify that the Chapter named below is currently self - insured through the American National Red Cross in the State of Florida • Name of Chapter: Upper Keys Chapter American Red Cross P.O. Box 672 Tavernier, FL 33070 Coverage Type of Coverage Period Limits of Liability Workers' Compensation 01/01/93 to Statutory Benefits 01/01/94 Employers' Liability 01/01/93 to $1,000,000 -Each Bodily Injury by Accident 01/01/94 Accident Employers' Liability 01/01/93 to $1,000,000 -Each Bodily Injury by Disease 01/01/94 Employee Employers' Liability 01/01/93 to $1,000,000 - Policy Bodily Injury by Disease 01/01/94 Limit (From 12:01 A.M. to 12:01 A.M. Standard Time) Date: July 12, 1993 Sedgwick James of Virginia, Inc. By. � '�1, Au or mid epresentative 4001 N Fairfax Dr., Ste 300 Arlington, VA 22203 This certificate is issued as a matter of information only and confers no rights upon the certificate holder. APPROVED RY!SK MANAGEMENT 9 ,, s'') (c(rlii1.< DATE , r? //4 WAIVER N/A / YES