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Certificates of Insurance DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/07/2022 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER Bianka Diaz Senan NAME: FAX PHONE Brown & Brown of Florida, Inc.(305) 714-4400(305) 714-4401 (A/C, No): (A/C, No, Ext): E-MAIL 14900 NW 79 Court Suite 200Bianka.Diaz-Senan@Bbrown.com ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # Miami LakesFL33016Harleysville Insurance Company23582 INSURER A : INSURED Nationwide Mutual Insurance Company23787 INSURER B : Florida Keys Children's Shelter, Inc.Ascendant Commercial Insurance Inc13683 INSURER C : 73 Highpoint Rd. INSURER D : INSURER E : TavenierFL33070 INSURER F : 22/23 Master COVERAGESCERTIFICATE 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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED 100,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 5,000 MED EXP (Any one person)$ AYGL0000007559BM03/01/202203/01/20231,000,000 PERSONAL & ADV INJURY$ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 3,000,000 POLICYLOCPRODUCTS - COMP/OP AGG$ JECT Employee Benefits2,000,000 $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY 1,000,000 $ (Ea accident) $ ANY AUTOBODILY INJURY (Per person) OWNEDSCHEDULED AYBA0000007558BM03/01/202203/01/2023 $ BODILY INJURY (Per accident) AUTOS ONLYAUTOS HIREDNON-OWNEDPROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY Medical payments5,000 $ UMBRELLA LIAB OCCUREACH OCCURRENCE$ EXCESS LIAB 14028033 CLAIMS-MADEAGGREGATE$ DEDRETENTION$$ y PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ C N / A WC65365-704/30/202104/30/2022 OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ Aggregate Limit3,000,000 Professional Liability BPL0000007561BM03/01/202203/01/2023Ech Occurrence Limit1,000,000 Claims Made Retro: 3/1/2017 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Locations Insured: 73 High Point Road Tavernier FL 33070 1621 Spalding Ct Units A-B Key West FL 33040 1621 Spalding Ct Units C-D Key West FL 33040 1102 Truman Ave Key West FL 33040 Certificate Holder is listed as Additional Insured with Respects to General Liability and Commercial Auto Liability as required by written contract. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. County of Monroe BOCC PO Box 1026 AUTHORIZED REPRESENTATIVE Key WestFL33040 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD ROE INSURANCE PRO RE l/IIE0 9851 STATE RD 54 COMMERCIAL NEW PORT RICHEY,FL 34655 Policy number: 05944373-3 Underwritten by: Progressive Express Ins Company Insured: MONROE COUNTY BOARD FLORIDA KEYS CHILDREN'S 1100 SIMONTON S KEY WEST,FL 33040 February 29,2020 Policy Period: Mar 1,2020-Mar 1,2021 Mailing Address Progressive Express Ins Company PO Box 94739 Additional insured endorsement Cleveland,OH44101. 1-800-444-4487 Name of Person or Organization .For customer service,24 hours a day, MONROE COUNTY BOARD 7 days a week 1100 SIMONTON S KEY WEST,FL 33040 The person or organization named above is an insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this endorsement will be primary for any power unit specifically described on the Declarations Page. • Limit of Liability -Bodily-Injury — Not-applicable— -- -- Property Damage Not applicable Combined Liability $1,000,000 each accident • All other terms,limits and provisions of this policy remain unchanged. This endorsement applies to Policy Number: 05944373-3 Issued to(Name of Insured):FLORIDA KEYS CHILDREN'S SHELTER,INC Effective date of endorsement:03/01/2020 Policy expiration date: 03/01/2021 Form 1198(01/04) APPROV s 3* WENT BY :'J. . . [� 0 WAIVER N/A '7- • A�® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 03/08/2019 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER .• CONTACT Josephine Mansur NAME: Roe Insurance Inc. (PAHONE Ext): (727)376-0030 (A1XC,No): (727)376-2262 9851 State Road 54 E-MAIL jo@roeins.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# New Port Richey FL 34655 INSURER A: Beazley Insurance Company INSURED INSURER B: Progressive American Ins.Co. 24252 Florida Keys Children's Shelter,Inc. INSURER C: 73 Highpoint Rd INSURER D: INSURER E: Tavernier FL 33070-2005 INSURER F: COVERAGES CERTIFICATE NUMBER: 19-20 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MMIDD/YYYY) (MMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X CLAIMS-MADE OCCUR PREMISES(a occurrence) $ 50,000 X Abuse-$1MII/$1Mil MED EXP(Any one person) $ 5,000 A X Professinal Liability Y B1636N191655 03/01/2019 03/01/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 3,000,000 X OTHER: Non Owned/H C Auto$1Mil SEXUAL ABUSE $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ 1,000,000 B OWNED X SCHEDULED Y 059443732 03/01/2019 03/01/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _AUTOS ONLY (Per accident) 7 Uninsured motorist BI $ 1,000,000 UMBRELLA LIAB OCCUR EACH E C OCCURRENCE EXCESS _ CURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER 0TH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) HOLDER IS NAMED ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY AND COMMERCIAL AUTO AS PER CONTRACT REQUIREMENTS.FAXED TO HOLDER APPROVE AGEMEM' BY DATE WAIVER N/A YE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ACCORDANCE WITH THE POLICY PROVISIONS. 1100 SIMONTON ST AUTHORIZED REPRESENTATIVE KEY WEST FL 33040 /o-ac�,.• cJ 1f ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACC) D® CERTIFICATE OF LIABILITY INSURANCE D11�1/2oN Y) 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 Roe Insurance Inc. 9851 State Road 54 New Port Richey FL 34655 CONTACT p NAME: Josephine Mansur PAU No Ext: (727) 376-0030 FAIC No: (727)376-2262 E-MAIL ADDRESS:o@roeins.com INSURERS AFFORDING COVERAGE NAIL # INSURER A:Beazley Insurance Company INSURED Florida Keys Children's Shelter, Inc. 73 Highpoint Road Tavernier FL 33070-2005 INSURER B:PrO ressive American Ins. Co. 24252 INSURERC: INSURER D : INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:17-18 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. INSR LTR OF INSURANCE ADDLTYPE INSD WVD SUER POLICY NUMBER MMIDIDY� MM DDT LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X I CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES50,000 PREMISES Ea occurrence $ X MED EXP (Any one person) $ 5,000 Abuse-$1Mil/$1Mil X B0385N171655 3/1/2017 3/1/2018 X Professional Liability PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY JECT PRO ❑ LOC PRODUCTS - COMP/OPAGG $ 3,000,000 SEXUALABUSE $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ 1,000,000 B ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS X 059443730 3/1/2017 3/1/2018 BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ Uninsured motorist BI split limit $ 1,000,000 UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) HOLDER IS NAMED ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY AND COMMERCIAL AUTO AS PER CONTRACT REQUIREMENTS. FAXED TO HOLDER AAPOA�qAGEMENT (305)292-4487 Lewinski-Monique@monroecou MONROE COUNTY BOARD OF COUNTY COMMISSIONERS MONROE COUNTY RISK MGT 1100 SIMONTON ST KEY WEST, FL 33040 Gc.� e�V�cwr.ct� UANGtLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Josephine Mansur/JM ACORD 25 (2014/01) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE (MM /DD/YYYY) ACC)R o ® CERTIFICATE OF LIABILITY INSURANCE 09/21/2018 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Amanda Nogues NAME: Eastern Insurance Group, Inc. PHONE FAX (305) 595 -7135 (305) 595 -3323 (A /C. No. Extl: (AIC, No): 9570 SW 107 Avenue E - MAIL amanda @easterninsurance.net ADDRESS: Suite 104 INSURER(S) AFFORDING COVERAGE NAIC # Miami FL 33176 INSURER A: Ascendant Commercial Insurance INSURED INSURER B : Florida Keys Children's Shelter, Inc. INSURER C: 73 High Point Road INSURER D : INSURER E : Tavernier FL 33070 INSURER F : COVERAGES CERTIFICATE NUMBER: Master 18/19 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. LTR TYPE OF INSURANCE NSD S WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDDIYYYY) (MMIDD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO CLAIMS -MADE OCCUR PREMISES (Eaoca RENTED $ MED EXP (Any one person) $ PERSONAL BADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- 1 1 LOC PRODUCTS- COMP /OPAGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED 1 RETENTION $ $ WORKERS COMPENSATION X STATUTE I E AND EMPLOYERS' LIABILITY Y / N 100 A ANY PROPRIETOR/PARTNER/EXECUTIVE N/A W C- 6 5365 - 04/30/2018 04/30/2019 E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED. 100,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under 500, DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Children's Shelter APPR DB• .K� = =�7 BY DATE 110ln1 •1 WAIVER A E CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Suite 2 -268 Key West FL 33040 © 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD A ^ �® ll`w/v��� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) F03/02/2018 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Josephine Mansur NAME: Roe Insurance Inc. AHONN Ext . (727) 376-0030 AIXC, No): (727) 376-2262 E-MAIL jo@roeins.com ADDRESS: 9851 State Road 54 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Beazley Insurance Company New Port Richey FL 34655 INSURED INSURER B : Progressive American Ins. Co. 24252 INSURER C : Florida Keys Children's Shelter, Inc. INSURER D : 73 Highpoint Rd INSURER E : INSURER F : Tavernier FL 33070-2005 COVERAGES CERTIFICATE NUMBER: 18-19 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 MAYBE 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 ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X CLAIMS -MADE OCCUR PREM SES Ea occ."ence S 50,000 X MED EXP (Any one person) S 5,000 Abuse-$1 MII/$1 Mil X Professional Liability PERSONAL&ADV INJURY S 1,000,000 A Y B1636N181655 03/01/2018 03/01/2019 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE S 3,000,000 X POLICY PEA LOG PRODUCTS-COMP/OPAGG $ 3,000,000 SEXUALABUSE $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COEa aMBccINED SINGLE LIMITident $ BODILY INJURY (Per person) $ 1,000,000 ANYAUTO B OWNED ;Z/ SCHEDULED AUTOS ONLY AUTOS Y 059443731 03/01/2018 03/01/2019 BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Uninsured motorist BI $ 1,000,000 7 UMBRELLA LIAB OCCUR EACH OCCURRENCE S HCLAIMS-MADE AGGREGATE S EXCESS LIAB DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE I I ER ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? ❑ NIA A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is reclu e ) HOLDER IS NAMED ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY AND COMMERCIAL UAD REQUIREMENTS. FAXED TO HOLDER , EMENT Q 1. *YFS L:tK I II-IL:A I t MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST 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. AUTHORIZED REPRESENTATIVE L G (,, @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD A� o® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM09/17IDDIYYYY) 112018 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Josephine Mansur NAME: PHONE (727) 376-0030 FAX (727) 376-2262 AIC No Ext : (A/C, No Roe Insurance Inc. E-MAIL jo@roeins.com ADDRESS: 9851 State Road 54 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Beazley Insurance Company New Port Richey FL 34665 INSURED INSURER B: Progressive American Ins. Co. 24252 Florida Keys Children's Shelter, Inc. INSURER C : INSURER D : 73 Highpoint Rd INSURER E : INSURER F : Tavernier FL 33070-2005 COVERAGES CERTIFICATE NUMBER: 18-19 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. INSR LTR TYPE OF INSURANCE ADDL INSD S BR WVD POLICY NUMBER POLICY EFF MMIDDIYYYYI POLICY EXP (MM/DD/YYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X CLAIMS -MADE OCCUR DAMAGE TO RENTED PREM SES (Ea occurs nce $ 50,000 X MEDEXP (Any oneperson) $ 5,000 Abuse-$lMil/$1Mil X Professional Liability PERSONAL & ADV INJURY $ 1,000,000 A B1636N181655 03/01/2018 03/01/2019 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 3,000,000 PRO- JPRO LOC PRODUCTS - COMP/OPAGG $ 3,000,000 SEXUALABUSE $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) S 1,000,000 ANYAUTO B OWNED X SCHEDULED AUTOS ONLY AUTOS 059443731 03/01/2018 03/01/2019 BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Uninsured motorist BI $ 1,000,000 7 UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB DED I i RETENTION S S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) WORKERS COMPENSATION COVERAGE IS PROVIDED UNDER LEASING ARRANGEMENT WITH GEVITY. CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITYAND COMMERCIALAUTO LIABILITYAS REQUIRED BY CONTRACT. F� V' Y MENT A WAIVER A E ._,- CFRTIFICATF HOI_DFR CANOFI_I_ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN COUNTY OF MONROE BOCC ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 1026 AUTHORIZED REPRESENTATIVE KEY WEST FL 33040 l © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (20yfi 03) The ACORD name and logo are registered marks of ACORD CGS A� V CERTIFICATE OF LIABILITY INSURANCE DATE (MM / 01/26/ Y) 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Amanda Nogues NAME: Eastern Insurance Group, Inc. P a/ CC, Ext : (305)595 -3323 q /c, No): (305)595 -7135 E -MAIL amanda @easterninsurance.net ADDRESS: 9570 SW 107 Avenue INSURER(S) AFFORDING COVERAGE NAIC # Suite 104 INSURERA: Ascendant Commercial Insurance Miami FL 33176 INSURED INSURER B: INSURER C: Florida Keys Children's Shelter Inc. INSURER D: 73 High Point Road INSURER E: INSURER I:: CLAIMS -MADE D OCCUR Tavernier FL 33070 COVERAGES CERTIFICATE NUMBER: Master 17 -18 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 SUBJECTTO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DA AGE CLAIMS -MADE D OCCUR PRE S ES( Ea occurrence) $ MED EXP (Any one person) S PERSONAL &ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE S PRODUCTS - COMP /OPAGG S 0 - POLICY PR LOG J $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ H CLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) NIA WC- 65365 -3 04/30 04/30/2018 X STATUTE ER E.L. EACH ACCIDENT 100,000 $ E.L. DISEASE - EA EMPLOYEE S 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Children's Shelter GEMENT JBY * /A W IV C C' r`0Dr1V1('A uni n=D rAMrFI I ATinKi ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Suite 2 -268 Key West C G FL 33040 0 cy ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ACOf2,fl�' CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY) 2/9/2016 THIS CERTIFICATE 13 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 Roe Insurance Inc. CONTACT NAME: Josephine Mansur H No Ext: (727) 376-0030 FNAXC : (727)376-2262 — - --- -- 9851 State Road 54 ADDRESS: joOroeinS.com INSURERS) AFFORDING COVERAGE NAIC i INSURERA Illinois National Ins Co New Port Riohey FL 34655 INSURED INSURERBNew Hampshire Insurance Company INSUIRERC: Florida Keys Children's Shelter, Inc. INSURER D 73 Highpoint Road INSURERS: INSURERF. Tavernier FL 33070-2005 COVERAGES CERTIFICATE NUMBER:16-17 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DCYIEFF DIYYW MMIDDIYWY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE OCCUR PREMISEAMAUtS Eaoccurrence IS 100,000 MED EXP (Any one person) $ 10,000 X 06LX066415595-0 3/1/2015 3/1/2017 PER50NAL 6A.DV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY D PRO- ,ECT LOC PRODUCTS - COMP/OPAGG $ 3,000,000 SEXUAL ABUSF $ 1,000,000 OTHER AUTOMOBILE LIABILITY GOMBINED SINGLE LIMIT$ Es accident BODILY INJURY (Per person) $ 1,000,000 BALL Ix ANY AUTO OWNED SCHEDULED AUTOS AUTOS X O1CA04S193005-0 3/1/2016 3/1/2017 BODILYIN,URY(Parecddent) $ PROPERTY DAMAGEHIRED Per accident)$ NON -OWNED AUTOS E AUTOS Uninsured motorist 81 split limit $ 1,000,000 UMBRELLALIAD EACH OCCURRENCE $ HOCCUR AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION I$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIENECUnVE OFFICERIMEMPER EXCLUDED? F-] N/A PER JOTH- STATUTE ER E.L. EACH ACCIDENT _ $ E.L. DISEASE - EA EMPLOYE $ (Mandatory In NH) If yes, describe under DESCRIPT ION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached A mom apace is requirod) HOLDER IS NAMED ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY AND COMMERCIAL AUTO AS PER CONTRACT REQUIREMENTS. FAXED TO HOLDER APPR IQEMENI/ 7�t WAIVERAES CERTIFICATE HOLDER CANCELLATION (305)292-4487 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MONROE COUNTY BOARD OF THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN COUNTY COM+iISSIONERS MONROE COUNTY RISK MT 1100 SIMONTON ST l 1 1 III �AtrAAE WITH THE POLICY PROVISIONS. jjU 00,M �IZEDREPRESENTATIVE KEY WEST, FL 33040 Jose i nsur/JM'"`"`�l�j ^ •g !:iN G 1 Gam-+ ' `V1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered pgrks of ACORD INS025ro1401) A C . I® t`(/J,R CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 5/15/2015 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 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Eastern Insurance Group, Inc. 9570 SW 107 Avenue Suite 104 Miami FL 33176 CONTACT Amanda Nogues AION o (305) 595-3323 A/C No: (305)595-7135 E-MAIL-ADDRESS: amanda@easterninsurance.net INSURERS AFFORDING COVERAGE NAIC # INSURERAAscendant Commercial Insurance INSURED Florida Keys Children's Shelter, Inc. 73 High Point Road Tavernier FL 33070 INSURER B : INSURERC: INSURERD: INSURER E : INSURER F : CnVERAGES CERTIFICATE NUMBER"aster 15-16 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. INSR LTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE -D-A-MAGE $ CLAIMS -MADE OCCUR TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ POLICY PRO ElLOC JECT $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ % PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A WC-65365-1 4/30/2015 4/30/2016 E.L. DISEASE - POLICY LIMIT $ 500,000 ff yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is req I Children"s shelter APPR E T DATE 4L WAIVER NIA C- %,AIYI.CLLA I'J Q�a • x�' 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 j r({� ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street , (,�� 8 ` IN SIDI Suite 2-268 AUTHORIZED REPRESENTATIVE i� Key West, FL 33040 _ i180038 80, 031U David Lopez/ANA U 1933-2014 AGUKU GUKF'UKA I IUN. All rlgnLs reservea. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 r?rrtdtrn OP ID: A CERTIFICATE OF LIABILITY INSURANCE MTEPIM'D M "i 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: It the certlReste holder is an ADDITIONAL INSURED, the policy(les) 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 doss not confer rights to the cordficate holder In lieu of such endorseme a . PRODUCER 727-376-0030 (kp Roe Insurance, Inc. 727-375.2262 a State Road 34LA New Port Richey, FL 34653 J Persiohilli-Mansur A205025 COWFACT WAIL maw FAC No ft writaoswomiFLKEYSC NSU AFFORDING COVERAGE NAIL S INSURM Florida Keys Children's Shafter, Inc. 73 Highpoint Road Tavernier, FL 33070-2005 INSURER A: Arch IrAmum Conpa'I' 11150 INSURER B WKWER C: INSURER D NSULER E : N ERF: 9%nV=0A#MCQ 11C92T1VIr_ATP NLIMaPR- REVISION NUMBER: vTHIS,15 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 CONDMON 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 RAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER AW LIMITS A GEMERALLUUIE.ITY X COMMERCIAL GeaRAL LIABILITY CLAIMS-IMDE FK OCCUR X NCPKG010NO2 03101R3 03101/14 EACH OCCURRENCE $ 1'M' PREMI . f 100, MED EXP one parson) f 10. PERSONALaADVINJURY 1 f 1,00, X INCL SONAL ABUBE GENERAL AGGREGATE f 3,000. GEN%AGGREGATE UWT APPLIES PER POLICY Loc PRODUCTS - COMROP AGG f 3,000, Emp Ben. $ 1,000.00 A AUTOMOBILE X X X LUOU Y ANY AUTD ALL OWNEDAUTOS C SCHEDULED AUTOS HIRED AUTOS NON-0WNEDAUTOS x NCAUT0183 z BY K G DA WAIVEh — C 03101/13 ��/1J'[W ( ir;E., 03101/14 COMBINED SINGLE LIMIT (Es aaW") f 1,000, BODLY INJURY (Per parson) s BODILY INJURY (Par aoddwd) f PROPERTY DAMAGE (P-a ) f : UMBRELLA L" OICESS LUB OCCUR pAIRSPyADE EACH OCCURRENCE5 AGGREGATE f DEDUCTIBLE RETENTION s f riORIC0ISCOMPISIZATION ANDEMPLOYERS' LIABILITY YIN ANY PROPRIETDRIPARTNERIEXECUTIVE R EACLUDED7 M yyeeaa,, des�MDe under DESCRIPTION OF OPERATIONS below N / A I WCSTATU• OTH- E.L. EACH ACCIDENT f EL DISEASE -EA EMPLOYE f EL dSEASE - POLICY LIMIT f q �Crlmlll NCPKGOIOBT02 0310111E 03101114 jEmpl Dish so, DESdIiTNON OF OPERATIONS f LOCATMS I VEHICLU ACORD 101 Adapond RWMwks U 1 Ww a rarwnd) HOLDER IS NAMED ADDITIONAL INSURED WRATH RESPECT TO GENERAL LU(f3tL� D COMMERCIAL. AUTO AS PER CONTRACT REQUIREMENTS. FAXED TO HOLDER 305-2024497. *30 DAYS NOTICE OF CANCELLATION EXCEPT 10 DAYS NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM. MONROE COUNTY BOARD OF COUNTY COMMISSIONERS MONROE COUNTY RISK MGT 1100 SIMONTON ST KEY WEST, FL 33040 MONRCOU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE r / b/ A/4 NCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ® 7UDWZUUa A4VKrl I.VKrVKAI RUN. AR "UHM rsnwrwU- ACORD 25 (200MO) The ACORD narne and logo are registered marks of ACORD