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Certificates of Insurance J Of ® CERTIFICATE OF INSURANCE IS SUE DA " '? . 1 :' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, J. MARK WHITEHEAD CO., INC. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Box 967 Maitland, FL 32751 COMPANIES AFFORDING COVERAGE COMPANY A LETTER ! I. ■ , ! - L • COMPANY INSURED LETTER B STATE PAVING CORPORATION COMPANY cr 4300 RAVENSWOOD ROAD FT LAUDERDALE, FL 33312 COMPANY LETTER COMPANY E LETTER 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 POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM /DD/YY) EACH OCCURRENCE AGGREGATE GENERAL LIABILITY -- BODILY COMPREHENSIVE FORM INJURY VI0697567 9/1/88 9/1/89 PREMISES /OPERATIONS PROPERTY _- ti UNDERGROUND DAMAGE EXPLOSION & COLLAPSE HAZARD n PRODUCTS /COMPLETED OPERATIONS CONTRACTUAL COMBINED 10,000 1 0, 0 0 0 n INDEPENDENT CONTRACTORS n BROAD FORM PROPERTY DAMAGE n PERSONAL INJURY PERSONAL INJURY 10,000 II I AUTOMOBILE LIABILITY BODILY gi INJURY A ANY AUTO VA 12 2 4 7 9 0 9/1/88 9/1/89 IPER PERSON) IN ALL OWNED AUTOS (PRIV. PASS.) BDDILY (OTHER THAN) NJORv ALL OWNED AUTOS `PRIV PASS. / PER ACCIDENT n HIRED AUTOS PROPERTY gl NON -OWNED AUTOS DAMAGE . GARAGE LIABILITY CI & BD ■ COMBINED ' "' EXCESS LIABILITY ■ UMBRELLA FORM BI & PD COMBINED ■ OTHER THAN UMBRELLA FORM STATUTORY WORKERS' COMPENSATION AND I i • I (EACH ACCIDENT) A EMPLOYERS' LIABILITY VK 0 6 9 6 714 9/1/88 9/1/89 1 1 1 1 (DISEASE - POLICY LIMIT) i 1 • (DISEASE EACH EMPLOYEE) OTHER DEIFIP T 96 N PFa eN 2 95M 5t s/ ,IAI- E TIFICATE HOLDER BELOW IS NAMED AS AN ADDITIONAL INSURED UNDER THE GENERAL LIABILITY POLICY. BUT ONLY WITH RESPECTS TO LIABILITY ARISING OUT OF "YOUR WORK" AT THE MARATHON AIRPORT PROJECT. SEE OVER. CERTIFICATE HOLDER CANCELLATION MONROE COUNTY BOARD OF CO . COMMI' I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- N DATE THEREOF, THE ISSUING COMPANY WILL Intl xn C/O POST , BUCKLEY , SCHUH & JERNIGA IAA . 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 1 NORTH KROME AVENUE LEFT, AIJxxADAME °�c �>! HOMESTEAD, FLORIDA 33030 AUTHORIZED REPRESENTATIVE , - -, ACORD 25 (8/84) © IIR /ACORD CORPORATION 1984 t 1 Of ® CERTIFICATE OF INSURANCE ISSUE DATE (M 1 1 : • PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, J. MARK WHITEHEAD CO., INC. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Box 967 1 Maitland, FL 32751 COMPANIES AFFORDING COVERAGE COMPANY A i LETTER COMPANY INSURED LETTER B STATE PAVING CORPORATION COM C 4300 RAVENSWOOD ROAD FT LAUDERDALE, FL 33312 COMPANY LETTER COMPANY E LETTER 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 POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS 1 LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM /DD/YY) DATE (MM /OD/Y11 EACH OCCURRENCE AGGREGATE GENERAL LIABILITY BODILY IIN COMPREHENSIVE FORM INJURY VI0697567 9/1/88 9/1/89 PI PREMISES /OPERATIONS PROPERTY PI — _ UNDERGROUND DAMAGE EXPLOSION & COLLAPSE HAZARD m PRODUCTS /COMPLETED OPERATIONS NI CONTRACTUAL COMBINED 10 , 0 0 0 10 , 0 0 0 m INDEPENDENT CONTRACTORS m BROAD FORM PROPERTY DAMAGE 11 PERSONAL INJURY PERSONAL INJURY 10,000 AUTOMOBILE LIABILITY BODILY ipi ANY AUTO INJURY A VAl224790 9/1/88 9/1/89 PERPERSONI MI ALL OWNED AUTOS (PRIV PASS) BODILY INJURY ALL OWNED AUTOS 1RIV RPASSN) 1ER ACCIDENT) pi HIRED AUTOS PROPERTY PI NON -OWNED AUTOS DAMAGE III GARAGE LIABILITY II C BD COMBINED 1 111 EXCESS LIABILITY ■ UMBRELLA FORM BI & PD COMBINED ■ OTHER THAN UMBRELLA FORM STATUTORY WORKERS' COMPENSATION AND 1 1 1 1 (EACH ACCIDENT) A EMPLOYERS' LIABILITY VK 0 6 9 6 714 9/1/88 9/1/89 1 1 1 1 (DISEASE - POLICY LIMIT) 1 i a 1 (DISEASE -EACH EMPLOYEE) OTHER DE RIPTI N O P TI N T ! MA�ATH I O A� �. �g�E�C f --NI — H S b�6�4�4 — (?�1 8 E ; C TIFICATE HOLDER BELOW IS NAMED AS AN ADDITIONAL INSURED UNDER THE GENERAL LIABILITY POLICY, BUT ONLY WITH RESPECTS TO LIABILITY ARISING OUT OF "YOUR WORK" AT THE MARATHON AIRPORT PROJECT. SEE OVER. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- MONROE COUNTY BOARD OF CO. COMMI• 1 °MINN DATE THEREOF, THE ISSUING COMPANY WILL l i1PIXr E C/O POST , BUCKLEY , SCHUH & JERNIGA O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 1 NORTH KROME AVENUE ' � FTIVAVE HOMESTEAD, FLORIDA 33030 AUTHORIZED REPRESENTATIVE ACORD 25 (8/84) IIR /ACORD CORPORATION 1984 I C .„ L am. 1 I Of ® CERTIFICATE OF INSURANCE IS A - ( /Q ° "," :• I II PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, J. MARK WHITEHEAD CO., INC. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Box 967 Maitland, FL 32751 COMPANIES AFFORDING COVERAGE COMPANY A LETTER _ ■ ► G ■ • COMPANY INSURED LETTER B STATE PAVING CORPORATION COM C 4300 RAVENSWOOD ROAD FT LAUDERDALE, FL 33312 COMPANY D LETTER COMPANY E LETTER 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 POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM /DD/YY) DATE (MM /DD/YY) EACH OCCURRENCE AGGREGATE GENERAL L BODILY - COMPREHENSIVE FORM A 11 COMPREHENSIVE 9/1/88 9/1/89 NJURY ii PREMISES /OPERATIONS PROPERTY ii U PLOSIO EXPLOSION &COLLAPSE HAZARD DAMAGE n PRODUCTS /COMPLETED OPERATIONS 1 CONTRACTUAL COMBINED 1 0 , 000 1 0, 0 0 0 INDEPENDENT CONTRACTORS n BROAD FORM PROPERTY DAMAGE n PERSONAL INJURY PERSONAL INJURY 10 000 AUTOMOBILE LIABILITY BODILY pi INJURY A ANY AUTO V A 12 2 4 7 9 0 9/1/88 9/1/89 PER PERSONI wa ALL OWNED AUTOS (PRIV PASS.) BoDo OTHE R HAN INJURY ALL OWNED AUTOS PRIV. PATSS !PER ACCIDENn in HIRED AUTOS PROPER fl NON -OWNED AUTOS DAMAGE - ■ GARAGE LIABILITY II. C BO COMBINED 10 000 EXCESS LIABILITY I . UMBRELLA FORM BI & PD COMBINED ■ OTHER THAN UMBRELLA FORM STATUTORY WORKERS' COMPENSATION AND 0 0 0 0(EACH ACCIDENT) A EMPLOYERS' LIABILITY VK 0 6 9 6 714 9/1/88 9/1/89 $ 11 1 (DISEASE - POLICY LIMIT) 1 1 1 1 (DISEASE -EACH EMPLOYEE) OTHER DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /SPECIAL ITEMS RE: MARATHON AIRPORT. PROJECT #3 -12- 0044 -0788; THE CERTIFICATE HOLDER BELOW IS NAMED AS AN ADDITIONAL INSURED UNDER THE GENERAL LIABILITY POLICY, BUT ONLY WITH RESPECTS TO LIABILITY ARISING OUT OF YOUR WORK AT THE MARATHON AIRPORT PROJECT. SEE OVER. CERTIFICATE HOLDER CANCELLATION MONROE COUNTY BOARD OF CO. COMMI' 1 F�} D. ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- N DATE THEREOF, THE ISSUING COMPANY WILL 31DUSECA IIII C/O POST , BUCKLEY , SCHUH & JERN I GA Fil . 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 1 NORTH KROME AVENUE LEFT AKKA asd tARidRnkit> MAkk R9iia le-Of »AN XKO8HFR.:1, . X81931011PARTMSCAGENR5EIRIXRERIMENTAT4YeaX HOMESTEAD, FLORIDA 33030 AUTHORIZED REP= SNTATIVE - , 'f,, ACORD 25 (8/84) © IIR /ACORD CORPORATION 1984 O - / or' 411 i Of 1 INSURANCE BINDER ISSUE DATE (MM/DD -4." THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. i PRODUCER COMPANY BINDER NO. I J. Mark Whitehead Company, Inc. Reliance Insurance Company 019BR89 781 Wymore Road DATE EFFECTIVE TIME DATE EXPIRATION TIME Maitland, Florida 32751 AM I x 12 AM a 2 2t00 PM 3/7/89 NOON D 3E THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY PER EXPIRING POLICY NO.: CODE SUB - CODE DESCRIPTION OF OPERATIONSNEHICLES/PROPERTY (INCLUDING LOCATION) I INSURED t Monroe County Board of County Commissioner 1 c/o Post, Buckley, Schuh and Jernigan, Inc 1 North Krome Avenue 1 Homestead, Florida 33030 COVERAGES ALL LIABILITY LIMITS IN THOUSANDS TYPE OF INSURANCE COVERAGES/FORMS AMOUNT DEDUCTIBLE COINSURANCE PROPERTY CAUSES OF LOSS . BASICnBROAD nSPECIAL MI E I GENERAL LIABILITY GENERAL AGGREGATE $ 1 000 1 ■ COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP /OPS AGGREGATE =MO ■- CUM MADE © OCCURRENCE PERSONAL & ADVERTISING INJURY $ 500 OWNER'S & CONTRACTORS EACH OCCURRENCE $ 11 ■PROTECTIVE FIRE DAMAGE (ANY ONE FIRE) $ 50, ! RETRO DATE FOR CLAIMS MADE: MEDICAL EXPENSE (ANY ONE PERSON) $ AUTOMOBILE ALL VEHICLES u SCHEDULED VEHICLES CSL $ ■ LIABILITY BI PERS/ACCID $ ■ NOWOWNED PD $ MI HIRED MED. PAY $ ■ GARAGE PIP $ UM $ AUTO PHYSICAL DAMAGE ALL VEHICLES I I SCHEDULED VEHICLES 1 ACV • COLLISION DED: STATED AMOUNT $ I OTC DED: OTHER EXCESS LIABILITY EACH AGGREGATE SELF - INSURED OCCURRENCE RETENTION ■ UMBRELLA FORM OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: 4 STATUTORY WORKER'S COMPENSATION s $ (EACH ACCIDENT) AND EMPLOYERS' LIABILITY $ (DISEASE - POLICY LIMIT) $ (DISEASE -EACH EMPLOYEE) SPECIAL CONDITIONS /RESTRICTIONS /OTHER COVERAGES Contractor: State Paving Corporation Job: Monroe County, Marathon Airport, Marathon, Florida AIP Project # 3 -12- 0044 -0788 , FDOT WPI Project #6826692 i i NAME & ADDRESS ■ MORTGAGEE ■ ADDITIONAL INSURED LOSS PAYEE LOAN# • I O' ZED REPREE NTA,VE ( I, ACORD 75 -S (11/85) IIR /ACORD CORPORATION 1985 [ ISSUE DAT (MM /DD /YY) ..... " .....: CERTIFICATE •OF INSURANCE 8/ 30/90 ..... .. J.:}:K4:• } }:•: } }:• }:•::::•. i } } }:vi }:. :'i.v . -',.:: C. rvvni • %•'iF)Y.ri:'i: :.CiGi ^i ir: R %Y F: }:v i :....'. : ....... :':. .... .... .. .. ..... ......... ... >s; PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER Of INFORMATION ONLY AND CONFERS NO is 's3 RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, .. Arthur J. Gallagher & Co. —Miami EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ':: P.O. Box 02 -5288 » i i ''' , : Miami, FL 33102 - 5288 COMPANIES AFFORDING COVERAGE imi Company A Midwest Employers Casualty Corp. ;Phone: 305/592 -6080 Letter .. . . Company B INSURED Letter { State Paving Corp., et a l Company N 4300 Ravenswood Road Letter • }: Ft. Lauderdale, FL 33312 Company D Letter Company E x q Fir gnu Letter ` i'iz COVERAGES 1 C p2ii 1'iniu ind rBdu R i tio of Ulw Iofii�Mlity in effect at the irruption of the policies shown. Note the aggregate limits. AN claims paid exhaust the S r ' DRAB IS 10 (FRUIT THAI POLKtES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED T01 HE INSURED NAMED ABOVE FOR 1HE PO- ICY PERIOD INDICAIED HOl WITIISIANDING ANY REQUIREMENT, TERM . ,: :: OR CONDITION Of ANY CONIRACI OR 01 FIE R DOCUMENT wITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERI IHE INSURANCE AFFORDED BY 111E POLICIES DESCRIBED HEREIN IS 3i Si! SUBIECI TO ALL bit 1ERMS. Ir XCIUSIONS, ANDCONDII:ONS OF SUCH POLICIES. -, LIABILITY LIMITS IN THOUSANDS CO TYPE OF INSURANCE POLICY NUMBER POCKY EFFECTNE POCKY EXPIRATION LTR DATE (MM/DD/YY) DATE (MM /DO/YY) ' "` Each A99rpRta ^ ?••`'r''' OaurrMKa General Liability Body t s ❑ Comprehensive Form P . 0 Premises/Operations Property r ❑ Underground Explosion Damage > s Collapse Hazard ❑ Products/Completed BI & PD t t Operations Combined s ❑ Contractual : ❑ Independent Contractors :: ❑ Broad Form Property Damage t > • ❑ Personal Injury Personal Injury ❑ Automobile Liability awl Miury ❑ Any Auto t"...il 0 All Owned Autos Prv. Pass) Bodily { ``.10 %�' ": <a?w...- Injury O All Owned Autos Other than U►wnt) $ ::> :w� t ...,.. Pry Pass) .: }. } }:• : }� ❑ Hired Autos Property $ • ▪ :vz:'•' I ❑ Non -Owned Autos 90 `:•; <:i':.i;: >'`^ } 0 Garage Liability < .F E ?::,' « Liability t I t • '' ` .. � ��.rr r_ RI i PO ❑ ❑ Umbrella form Combined I I Oth Than Umbrella Form I ' er .. I S10 000. Specific Excess € x: :: workers' Compensati - :> < 2,000, (Each Accident) A And 414 4SAFL 9/1/90 9/1/91 : *' -- °Employers' 2,000,(Disease- Polic ?{ '> 2,000, (Disease Each Employee) ig % Other '`: Description of Operations /LocationsNehicles /Special Items RE: Marathon Airport Project #3 -12- 0044 -0788 • E CANCELLATION :' >: t ERTIF RCA HO .: �:: is i . ; n: .......: ::nv::::::;; •• ... :;: ..• :. ::::::.: : . : : ..:: ..:: .:..: ..... .... i ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE Monroe County Board of County Comm . ' : : : : EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 : c/o Post, Buckley, Schuh & Jernigan k: DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 1 North Krome Avenue :ni FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY ;: Homestead, Florida 33030 •s< KIND UPON THE, OMPANY, ITS AGENTS OR REPRESENTATIVES ' uthonzed Re ese tali e Ed Nels n, Asst. Area Vice President :, .; 4 I i�:•?:}:•:: ryn4-$ i^?: Y.' }: ?Ci'r }j.'•`:��i:•i:diiR:vii: p `- ' �{..y }�.. .}. ... -. - -. .:::::::::.v : ^: ..: : ..:... �: v: :.. . •.:{.:i '::$.::::. ' i:iyi ' t t:' rC:,i:j'r:i� } v :::j +'=�.• $ 1 } ' • '�; . :v •: r : , « . <. : : : < a w : s ' €' s:I:..•..:. �`... }; r 1f you have any uestions, please call ; :i1:::a, v. } ;;; ^Sir ii. k } iftiw: }: sx:•}s:::: S i2:ii.' < , ::GBS<R .4,;;.•::.. :.:. . ,,,, .... ... ......... .. ........... ........... .... ......... ......... . :: : :... ....... ..... ..... C -01 AJG 6/86 � `, � ISSUE DATE MM /DD /YY p y � �- ^,.� L' L . , PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS SEDGW 1 JAr`1EE Or FLOR I DA t ii-4C NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, SUITE 2400 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW ONE FI!JANCIAL PLAZA COMPANIES AFFORDING COVERAGE FORT LAUDERDALE, FL ;?3394 COMPANY A LETTER RER3• IC -- >.J ss? t- a:l °�-�° INSURANCE CO COMPANY B ci INSURED LETTER REPUBLIC WESTERN INSURANCE CO COMPANY State Paving Corporation LETTER C 4300 Paye7'1 wood Road COMPANY D Fart er a Ee FL 33312 LETTER COMPANY E LETTER 3„�. } Zt s t z i1 s �x 7 y ss a - '.�:�`.' e ,a�, ,� ;�..x .�,a .,� . z .: >.- ��rc��^` rf �u..ea .. ..� e �,R,s s i22" .�:..,.... THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS TR DATE (MM /DD /YY) DATE (MM /DD /YY) A GENERAL LIABILITY fl=,OA7880t '+ _ _ -r•- i1.rt! �? •1 t ? ? _ %i /9 1 GENERAL AGGREGATE $ 2000 X. COMMERCIAL GENERAL LIABILITY PRODUCTS- COMP /OPS AGGREGATE $ 1000 0, CLAIMS MADEX OCCUR. PERSONAL & ADVERTISING INJURY $ _ 00 0 OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ .' MEDICAL EXPENSE (Any one person) $ "'_ AUTOMOBILE LIABILITY SE A , I^0:? y 0 a ti", ; i 1 ,; c 1 COMBINED ANY AUTO SINGLE $ LIMIT i ALL OWNED AUTOS BODILY SCHEDULED AUTOS INJURY $ I (Per person) 'A HIRED AUTOS BODILY X NON -OWNED AUTOS INJURY $ (Per accident) GARAGE LIABILITY PROPERTY DAMAGE EXCESS LIABILITY EACH AGGREGATE OCCURRENCE $ $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY AND $ (EACH ACCIDENT) $ f (DISEASE— POLICY LIMIT) EMPLOYERS' LIABILITY $ (DISEASE —EACH EMPLOYEE) 0000 OTHER .1 1990 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLE*(9011`i1,6MS RE MARATHON AIRPORT PROD ", =CT #3 1 -• -1: 4 —t Y THE CERTIFICATE HOLDER BELOW IS NAMED r . r. ., It .: INSURED g .F U J^E u � �`i -._ it . , F'i m_? v } " f '..Hr, GENERAL LIABILITY POLICY BUT ONLY WITH RESPECTS TO LIAR ARISING OUT OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MOr.!ROE COUNTY BOARD .RD OF ,yImo?,Mn t MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE % POET: 3UCIRLE Y , SC 9 C'• ; .DER 1 CAN s, LEFT, BUT FAILURE TO AIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 1 r: WiROrrE AVENUE LIABILITY OF ANY ND UP* THE COMPANY IT./ GENTS OR REPRESENTATIVES. - S HOMETEAD, FL =3030 AUTHORIZED REPRESEN A ' / ■ // At/