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Certificate of Insurance Ctient#: 5675 HORNWIL3 ACORDTM CERTIFICATE OF LIABILITY INSURANCE °810 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 endorsement(s). PRODUCER CONTACT NAME_ ,,,.„, — , USUSuncoast Tampa PH N ); 813 289 -5200 � Atc, No): 813 289-4561 ' P.O. Box 22668 (NC, DDRESS: Tampa, FL 33622 -2668 ER CUSTOMER ID M: 813 289 -5200 INSURER(S) AFFORDING COVERAGE JNAIC # INSURED INSURER A : XL Specialty Insurance Company 37885 William P. Horn, Architect, P.A. INSURER 6: 915 Eaton Street INSURER C : Key West, FL 33040 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. R ! TYPE OF INSURANCE SSR B hp POLICY NUMBER u ur R rainoIYYYY) (MMIDOIYYYY) LIMITS LT ' GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) , $ .__ J CLAIMS -MADE L OCCUR MED EXP ( . _ A one person) 1 $ _ . . _. PERSONAL & ADV INJURY $ GENERAL AGGREGATE 5 G 'L AGGREGATE LIMIT APPLIES PER: I P RODUCTS - COMP /OP AGG $ I I POLICY n JECT 7 1 LOC $ j AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea dent) l accl ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS i < BODILY INJURY (Per accident) $ ; SCHEDULED AUTOS / I. PROPERTY DAMAGE HIRED AUTOS i , ( Per accident) $ - • NON -OWNED AUTOS i �'' /(` $ lllJ �l1 _.. UMBRELLA UAB 1 I OCCUR OCCURRENCE $ EXCESS LIAB i ; CLAIMS -MADE YYY [EACH $_ DEDUCTIBLE - - - - -- �, $ RETENTION $ $ WORKERS COMPENSATION WC STATU I OTH AND EMPLOYERS' UABIUTY Y / N TORY I HATS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? n N/A (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ I f es, describe nder DESCRIPTION u OF OPERATIONS below ( E.L. DISEASE - POLICY LIMIT j $ A Professional DPS9702624 08/20/2012 08/20/2013 $1,000,000 per claim Liability $1,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mare time is required) Professional Liability coverage is written on a claims -made and reported basis. Project: Stock Island Fire Station. CERTIFICATE HOLDER CANCELLATION Monroe County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Risk Management 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West, FL 33040 0 ' - -41• C1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #53987721 8767 AGB Client #: 1049512 WILLIP4 ACORD,,., CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 08/12/2015 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 thls certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: USI Insurance Services, LLC PHONE 813 321 - 7500 - , No 1715 N. Westshore Blvd. Suite 700 E ADDRESS: Tampa, FL 33607 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Wesco Insurance Company 25011 INSURED INSURER B : William P. Horn, Architect, P.A. INSURER C : 915 Eaton Street INSURER D : Key West, FL 33040 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 CONTRACTOR 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MDD/YYYY) (MMIDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY pAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GE 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY JECT LOC $ AUTOMOBILE LIABILITY CO accident) SINGLE LIMIT $ (Ea ANY AUTO / ^\ BODILY INJURY (Per person) $ ALL OWNED SCHEDULED \ 1 BODILY INJURY (Per accident) $ AUTOS NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS `• fi EP :Y RISK MANAGEMENT (Per accident) $ UMBRELLA LIAB _ OCCUR B �� ' EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE DATE I J II AGGREGATE $ DED RETENTION $ --WAIVER N/' YES_, $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY TORY LIMITS FR l ANY PROPRIETOR!PARTNER/EXECUTIVE Y / N E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ r� If yes, describe under --yy DESCRIPTION OF OPERATIONS below i E.L. DISEASE - POk�Y LIMIT $ Sa A Professional ARAl25557400 08/20/2015 08/20/2016 $2,000,000 afr claim t/) fr1 Liability $2,000,000 3 Laggr. n rri N -rl DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) O C -, (,,) V Professional Liability coverage is written on a claims -made basis. °— 70 Project: Stock Island Fire Station, Bernstein Park, Annual Contract for Architectural Services =' 'v -1' . - p CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Risk Management 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West, FL 33040 0 , © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S15988676/M15988672 KEBEW