Certificates of Insurance •
BOARD OF COUNTY COMMISSIONERS
O Wilhelmina Harvey, District 1
KEY WEST, ORIDA 33040 { �i .;, Ed Swift, District 2
(305) 2944641
` MAYOR Jerry Hernandez, District 3
Alison Fahrer, District 4
`et � Mayor Pro tem Ken Sorensen, District 5
` 1
MEMORANDUM
DATE: October 19, 1983
TO: Kermit Lewin
County Administrator
FROM: Lucien C. Proby, Jr.
County Attorney
Enclosed is a copy of the insurance certificate which came
to this office after having made the request of the Finance
Officer of MC, Mr. Harding. If there is any other question about
it, please call. You will note that the body of it states that
the contract with Eden, Hannon, etc. and Monroe County is the
operation that they are insuring.
LUCIEN C. PROBY, JR.
County Attorney
LCPJr /brp
Enclosure
SET TAB STOPS AT ARROWS
Certificate of Insurance
1 a• • - HiS CER F :Ark S ■SSuEJ AS A MATTER O .NF;JRMATON ONL. AND CONFERS NO R■GHTS JPON THE CERT;F.CATF aO
"' IS CE CATE :)DES NOT AMF'N! EXTFNn ;)P A, *i < ° HE COVERAGE AFFORDED B THE POtUCES 1STED HE) OA
AME AND ADDRESS OF AGENCY
Pachence Insurance Agency, COMPANIES AFFORDING COVERAGES
genCy, Inc.
P.O. Box 2340 COMPANY A Aetna Casualty & Surety Co
Hazleton, Pa. 18201 LETTER
COMPANY B
LETTER
NAME AND ADDRESS OF INSURED
COMPANY C
EMCEE &. Del's Tower Service, Inc. LETTER
P.O. BOX 68 COMPANY D
White Haven, Pa. 18661 LETTER
Attn: Mr. Al Harding COMPANY E
LETTER
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. 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.
COMPANY POLICY Limits of Liability in Thousands (000)
LETTER TYPE OF INSURANCE POLICY NUMBER EXPIRATION DATE EACH AGGREGATE
OCCURRENCE
GENERAL LIABILITY
BODILY INJURY $ $
IKI COMPREHENSIVE FORM *44G18422203 5/23/84
® PREMISES— OPERATIONS PROPERTY DAMAGE $ $
® EXPLOSION AND COLLAPSE
A HAZARD Eden UNDERGROUND HAZARD * Includes Eden Hannon
gi PRODUCTS /COMPLETED
��''i yy OPERATIONS HAZARD & Company as Additi (. - 1 BODILY INJURY AND
E CONTRACTUAL INSURANCE Insured PROPERTY DAMAGE $ 500, $500'
® BROAD FORM PROPERTY COMBINED VV
DAMAGE
IN INDEPENDENT CONTRACTORS
® PERSONAL INJURY PERSONAL INJURY $500,
AUTOMOBILE LIABILITY BODILY INJURY
(EACH PERSON) $
A ® COMPREHENSIVE FORM 44PJ029863 5/23/84 BODILY INJURY $
® OWNED (EACH ACCIDENT)
® HIRED PROPERTY DAMAGE $
fil BODILY INJURY AND
NON -OWNED PROPERTY DAMAGE $
COMBINED SOO,
EXCESS LIABILITY
yam+
BODILY INJURY AND
A ® UMBRELLA FORM 44XS214210 5/23/84 PROPERTY DAMAGE $ 5, 009, $ 5,000 0 ,
❑ OTHER THAN UMBRELLA COMBINED
FORM ,
WORKERS' COMPENSATION STATUTORY
— A and 44CY07948 5/23/84
EMPLOYERS' LIABILITY $ 100
(EACH ACCIDENT)
OTHER
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES
Contract with Eden Hannon & Company and Monroe
County Florida Board of County Commissioners for
turnkey operation
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com-
pany will endeavor to mail 1_ days written notice to the below named certificate holder, but failure to
mail such notice shall impose no obligation or liability of any kind upon the company.
NAME AND ADDRESS OF CERTIFICATE HOLDER: �t
. Monroe County Board of DATE ISSUED: 10/14/83
County Commissioners
Rt. 1, Box 779 x, 41 I - %.
Big Pine Key i Florida 33043 AU HORIZED R •ESENTATIVE
Donald M. Pachence
ACORD 25 (1 -79)