Certificates of Insurance, li 'p DATEJMMIDDNYYY)
,ac -1 CERTIFICATE OF LIABILITY INSURANCE 1oroirzol
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 poticy(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
NAML Janioe ROwlan
FAX
PNONE -2
305-238-86 8388-608
Arc No :ce.rowton.i
EMAIL •
ADORE : anib statefarm.com
INSURER(SI AFFORDING COVERAGE
NAIC p
INsuRER A :State Farm Mutual Automobile Insurance Com an
178
_
INSURED Pedro Falcon Electrical Contractors, Inc.
31160 Avenue C
Big Pine Key, FL 33043
INSURER e :
INSURER C :
INSURER 0 :
INSURER E
INSURER F
LUV Cr{P19JCQ
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.
LTA
TYPE OF INSURANCE
POLICY NUMBER
MMR)D/YYYY
MMR)D/YYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
„
SDAMAGE
PREMISES Ea otaulrerxe
s _,
COMMERCIAL GENERAL LIABILITY
MW EXP (Any one person)
5
CLAIMS -MADE OCCUR
PERSONAL NL ADV INJURY
s
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS •COMP/OP AGG
$
Es ae�EenlSINGLELIMIT
$
1,000.000
A
POLICY FCTPRO- F-1 LDC
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED x SCHEDULED
AUTOS NON -OWNED
HIRED AUTOS AUTOS
645 9389 D09 59
10/09/2013
04f09/2014
Y
BODILY INJURY (Per person)
:
BODILY INJURY (Per accident)
$
Per accident)
s
I
(UMBRELLA UAB
EXCESS LIAR
HCLAIMS-MADE
OCCUR
Q
EACH OCCURRENCE
t
AGGREGATE
$ T
F-FoED RETENTION S
WORKERS COMPENSATION
WC STATU- OR -
$
E.L. EACH ACCIDENT
$
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTNE Y 1 N
oFncemEmSER EXCLUDED?
(Mandatory In NH)
IY". descAoe under
N i A
❑
TX,4�
E. L. DISEASE - EA EMPLOYE
3
E.L. DISEASE -POLICY LIMIT
S
FRrPFRATI0NSbalrw
El
DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (Attach ACORD lei, Additional Remarks Schedule, I more space is required)
Key West International Airport Customs Security Enhancements PH I
Monroe County Board of County Commissioners as additional insurers
The listed policy (s) may not be canceled on less than 30 days written notice by the insurer to Monro County Board of Commissioners c -�
t-, C=) TT
C-)
�r
Monroe County Board of County Commission
1100 Simonton Street RM 2-216
Key West, FL 33040
SHOULD ANY OF THE ABOVE DESCRIBEp'PQlIC1E3 Q &AN r -LED BEFORE
THE EXPIRATION DATE THEREOF, .:NIQTtCE WILL.EBE LIVERED IN
ACCORDANCE WITH THE POLICY PROVISIgN?S.
CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001486 132649.7 03-01-2012
ATE (M WDDIYYYY)
a� V CERTIFICATE 4F LIABILITY INSURANCE D16f0112013
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 ed. If SUBROGATION IS WAIVED, subject to the
endors
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).
IT
PRODUCER Ellie Mills Inusrance Agency, Inc. NAME: Janice RowtDn
PHONE 3U5- -8688 FAI�C Noll- 305-2388-608
20330 Old Cutler Road
Cutler Bay, FL 33189 no�ess:'anioe.rowton.i b statefarm.com
OINSURERS AFFORDING COVERAGE NAIC N
d& INSURER A: State Farm Mutual Automobile Insurance Corn an 2 178
INSURED Pedro Falcon Electrical Contractors, Inc. INSURER a :
31160 Avenue C INSURER C :
INSURER D
Big Pine Key, FL 33043 NSURERE:
COVERAGES CERTIFICATE NUMBER:
THIS IS TO CERTIFY THAT THE FOLtC1ES 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,
XCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
E 1. -v er D Y F_X ......
TYPE OF
GENERAL LIABILITY
MERCIAL GENERAL LIABILITY
CLAIMS -MADE n OCCUR
OCCURRENCE
S
PRODUCTS - COMPIOP AGG 13
GEN'L AGGREGATE LIMIT APPLIES PER:
L
S
POLICY PRO L�
-
645 9389 DOS 59
1010912013
04109/2014
Ea.cI art SINGLE I m
$
BODILY INJURY (PatPS(W)
g
A
AUTOMOBILE LIABILITY
Y�
BODILY INJURY (Per accrdent)
$
ANY AUTO
ALLOWWO x SCAUTHEDULED
Per axiderA
S
AUTOS NON -OWNED
$
HIRED AUTOS AUTOS
AP44 Y R{SI(
A
EACH OCCURRENCE
S
UMBRELLA LIAB OCCUR
S
EXCESS LIAR CLAIMS -MADE
AGGREGATE
s
DED RETENTIONS
WIC STATU• M
WtORKERSCOMPENMATION
M ...-.
AND EMPLOYERS' LIABILITY YIN
E.L. EACH ACCIDENT
$
ANY PROPRIETORIPARTNERIEXECunVE Q NIA
A
&SE EA EMPIJOW
S
OFFICEIMEMBER EXCLUDED?
E.L, DIS .
(rzv—
Mandatory in NH)
E.L. DI •POLICY LWS
Ifyes, desabe under
mnnN
_ Ci
"Tj
-I
O
OF OPERATIONS J LOCATIONS I VEHICLES (Attach ACORO 101, Additional Remarks Schedule, Ir more IPacs II required)
-'
DESCRIPTRON
ADA Compliance Segment 1113
�?
Monroe County Board of County Commissioners as additional insurers
by
the insurer to Monro County Board of Commissioners
o
The listed (s) may not be canceled on less than 30 days written notice
cn
Q
policy
SHOULD HABOVE DESCRIBED IE
Monroe County Board of County Commission THEEXPIRAT ONDATE THEREOF, NOTICE WILL CBE CBEFORE
DELIVERED IN
1100 Simonton Street RM 2-216 ACCORDANCE WITH THE POLICY PROVISIONS.
Key West, FL 33040 AUTHOR¢ R RES TATIVE
01988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012
'4`� CERTIFICATE OF LIABILITY INSURANCE
D ATE (MWD0fYYY
10/01/20 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 poticy(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
D Cutler Bay, FL 33189
s
CONTACT
NAME: Janice Rowton
PNONE -23 -8688 FAACC No): 305-2388 08
nouREss: 'anice.rowton.i b statefarm.com
INSURERS AFFORDING COVERAGE
NAIC N
INSURER A : State Farm Mutual Automobile insurance Company
S
INSURED Pedro Falcon Electrical Contractors, Inc.
31160 Avenue C
Big Pine Key, FL 33043
INSURERS:
INSURER C :
INSURER 0:
INSURER E
INSURER F
GDVERAGES CERTIFICATE NUMBER: REVISION NUMRFR-
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
AUDL
SUBF
POLICY NUMBER
POLICY EFF
IMMIDDIYYYYJ
POLICY EXP
tMMIDONYMLIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
PREMISES Ea ooaxrence
s
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE DOCCUR
MED EXP (My One parson)
$
PERSONAL b ADV INJURY
$
GENERAL AGGREGATE
$
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$
POLICY 7 PRO- LOC
S
A
AUTOMOBILE UABILITY
Y
645 9389 D09 59
10109/2013
04/09/2014
Ea COMBIINdE�OiSIN LIMIT
S 1,000,ODD
BODILY INJURY (Per person)
S
ANY AUTO
ALL OWNED rUl SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per aCCidenl
( 1
$
HIREDAUTOS NON-OWNEDPROPERTY
AUTOS
DAMAGE
oriloWerk
s
s
UMBRELLA UAB
OCCUR
�PR E l
EACH OCCURRENCE
S
AGGREGATE
S
EXCESS UAB
CLANKS MADE
YA
DIED I RETENTIONS
s
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y J N
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICEIMEMBER EXCLUDED?
N t A
VdC STATU- OTH-
RY LI S
E.L EACH ACCIDENT
E
E.L. DISEASE - EA EMPLOYE
E
(Mandatory In NH)
N If yes, dssori OF OPERATIONS below order
E.L. DISEASE:?AOLICY LIMIT I Z! TI
VMS
azr
Ell
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORO 101, Additional Remarks Schedule, It more spans Is mqulred) - O
ADA Compliance Segment X 4
Monroe County Board of County Commissioners as additional insurers
The listed policy (s) may not be canceled on less than 30 days written notice by the insurer to Morro County Board of Commissii Ors tV
Monroe County Board of County Commission
1100 Simonton Street RM 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.
ti
1989-2010 ACORD CORPORATION All rinh}o ro &m d
ACORD 25 (2010106) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012
A d CERTIFICATE OF LIABILITY INSURANCE DATE
—
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 la an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the
brine and conditions of the policy, certain policies may require an endorsement A statement on this certificate don not confer tights to the
certificate holder In lieu of such endorsement(s).
PRODUCE` Elite Mills Inusrance Agency, Inc. CONTACT
Mare Janice Rowtan
20330 Old Cutler Road PMOX:FM, 3osz3e-Bees PFM N .30s23ae-Toe _
�[^+_"�] Cutler Bay, FL 33189 ADDRESS'ienice.rowtOn.lcob®statefarm.cam
ID NSUREWS)AFFORDING COVEM°E MC II
INSURER A:State Farm Mutual Automobile Insurance Company 25179
NSUREO Pedro Falcon Electrical Contractors, Inc. INSURER e:
31180 Avenue C INSURER c:
Big Pine Key, FL 33043 INSURER o:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT TIE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIE INSURED NAMED MOW FOR THE POLICY PERIOD
INDICATED. NOTMTHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTRCATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS MD CONDITIONS OF SUCH POLICIES.UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NW
TTRR TYPII OF MDIC MRR rillPOLICY NURSES =CET 11 UNITS
GENERAL MEWS EACH CCCURRENCE
OA :0 HEN m
—1 AVa:
,COMMERCIAL GENERAL LIABILITY PREMISES(ES La nu)
CWMMME n OCCUR S®FAP(Any arm PorLDH
PERSONAL 6/IIJ ENURE
GENERAL AGGREGATE
CENT AGGREGATE LIANAPPLIES PER: PRODUCTS-COMP/OP AGO
7 POLICY l^I JPaw fl LOC
A AUTONx�I=LTTY Y 6459310 DO9 69 10511112013 64M912014 EireliffOMSMaE WAG 1,030:000
.AUTO score NMY(Per PNFm1
_ MHO D x SCHEDULED
D pBOpDytEY�NXp y((APpsreSSil)
HIRED Amos —aRM0 0 IM1 1 E
U"MaLLA Wa p0Cpq ( EACH OCCURRENCE
—LAD QAppyADE AGGREGATE
DEa ' RETERGOMa
NC MRS COlELMC TM NCS LM(TR FRTATIL °
mw
AM EMPLOYERS'L RT1E
OF gMEMOER PW.EDTJMWInF 0 MIA I E.L EACH ACCIDENT
OFFICE/MENDER FRQWEEI
(W,NMryM MN EL DISEASE-EA EMPLOYE
N pa,S w,iuwal
DF NVTInNensPARATVMw eves EL DISEASE.POLICY LINT
♦
RSK
DESCRIPTOR OP DPEMTONS I LOCATMRAINNCM.ASLM AOMD 101,MOMal Ramarkt bMNM,If alas spas M,1lnid1 W _
Key West International Airport Customs Security Enhancements PH I
Monroe County Board of County Commissioners as additional insurers '_T
The listed policy(a)may not be canceled on Ion than 30 days mitten notice by the Insurer to Monrs County Board of ConmAtioners ,y r-
o m
n -111
—
NS G
CERTIFICATE HOLDER CANCELLATION — to-,
3n
Monroe CountyBoard of court Commission SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE=AGRIR..BEFORE
H THE EXPIRATION DATE THEREOF, NOSCO WILL 66 D RED IN
1100 Simonton Street RM 2-216 ACCORDANCE WITH THE POLICY PROVISIONS J:
VJ
Key West, FL 33040 _J_ aAUny E RE ENTATNE
ti
1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010(05) The ACORD name and logo are registered maths of ACORD 1001456 132649.7 03-01-2012