The URL can be used to link to this page

Certificates of Insurance „...'-■mil ® DATE(MM /DD/YYYY) A� ° CERTIFICATE OF LIABILITY INSURANCE 08/15/2018 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 have ADDITIONAL INSURED provisions or 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 w certificate does not confer rights to the certificate holder in lieu of such endorsement(s). c PRODUCER CONTACT NAME: Aon Ri sk Services, Inc. of Washington, D.C. PHONE FAX Aon Risk services Central , Inc. (A/C. No. Ext): (866) 283 - 7122 (A/C. No.): (800) 363 - 0105 13 Chicago IL office E - MAIL e 200 East Randolph ADDRESS: = Chicago IL 60601 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: QBE Specialty Insurance Company 11515 MAXIMUS, Inc. and all subsidiaries INSURER B: XL Specialty Insurance Co 37885 1891 Metro Center Drive INSURER C: The Continental Insurance Company 35289 Reston VA 20190 USA INSURER D: Zuri American Ins Co 16535 INSURER E: American Zurich Ins Co 40142 INSURER F: National Union Fire Ins co of Pittsburgh 19445 COVERAGES CERTIFICATE NUMBER: 570072683715 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. Limits shown are as requested INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM /DDIYYYY1 MM/DD/YYYY) LIMITS O X COMMERCIAL GENERAL LIABILITY GL05096218 03 05/01/2018 05/01/2019 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED $1,000,000 PREMISES Ea occurrence MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE 52,000,000 ib X POLICY I PECOT- n LOC PRODUCTS - COMP /OP AGG $ 2 , 000 , 000 (0 0 OTHER: o r-- D AUTOMOBILE LIABILITY BAP 5096219 03 05/01/2018 05/01/2019 COMBINED SINGLE LIMIT In (Ea accident) $1, 000 000 X ANY AUTO BODILY INJURY ( Per person) o z OWNED — SCHEDULED BODILY INJURY (Per accident) N AUTOS ONLY _ AUTOS in HIRED AUTOS NON -OWNED PROPERTY DAMAGE ONLY — AUTOS ONLY (Per accident) w 1_ d B X UMBRELLA LIAB X OCCUR US00075267L118A 05/01/2018 05/01/2019 EACH OCCURRENCE $3,000,000 0 EXCESS LIAB CLAIMS -MADE AGGREGATE $3,000,000 DED I X RETENTION 510,000 E WORKERS COMPENSATION AND WC509621603 05/01/2018 05/01/2019 X I STATUTE IOTH- EMPLOYERS' LIABILITY STATUTE ER Y N O ANY PROPRIETOR /PARTNER /EXECUTIVE N WC5096217 03 05/01/2018 05/01/2019 E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) WI E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under _ _ __ _ DESCRIPTION OFOPERATIONS - beldw - - E:LT DISEASE = POLICY OMIT - - - 51,000,000 _ — _ F E&O -PL- Primary 017546551 08/01/2018 08/01/2019 Agg/Per Claim $1,000,000 — Claims Made SIR $10,000,000 M SIR applies per policy terns & condi-ions DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) • - fts CERTIFICATE HOLDER IS ADDITIONAL INSW9 K • Ili ,I..) i`': t MEWL ITY AS REQUIRED BY CONTRACT. DATE ` �. dt - - - - - WAIVER 141 / Yak..— a _, - —: CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. MONROE COUNTY BOCC AUTHORIZED REPRESENTATIVE Attn: BILL GRUMHAUS ,3 MONROE COUNTY RISK MANAGER N Ar 1100 SIMONTON STREET J'a 2 e%LZYGCf ✓sae ai"�ee . , na g' m KEY WEST FL 33040 USA . ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 016/03) The ACORD name and logo are registered marks of ACORD c c. AGENCY CUSTOMER ID: 410000000170 LOC #: '44C- ° R°® ADDITIONAL REMARKS SCHEDULE Page _ of AGENCY NAMED INSURED • Aon Risk Services, Inc. of Washington, D.C. MAXIMUS, Inc. and all subsidiaries POLICY NUMBER See Certificate Number:. 570072683715 CARRIER NAIL CODE See Certificate Number: 570072683715 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER • INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy Iimits POLICY POLICY IN . TYPE OF INSURANCE INS I) S�WD POLICY NUMBER EFFECTIVE EXPIRATION LIMITS DATE DATE (MM/DD /YYYY) (MM/DD/YYYY) WORKERS COMPENSATION E N/A WC509621603 05/01/2018 05/01/2019 Deductible $350,000 AOS ACORD 101 (2008/01) @ 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD