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Certificates of Insurance
r. , •_% CERTIFICATE OF LIABILITY INSURANCE 04-05-2013 THIS CERTIFICATEIS 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 ADDITIONALINSURED, the policy(ies) must be endorsed. If SUBROGATIONIS 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: PAYROLL ASSOCIATES LLC PHONE FAX A/c, No, E a: IN A/c, No): 210731 P: O— F: O— E-MAIL PO BOX 33015 ADDRESS: SAN ANTONI O TX 78265 INSURER(SI AFFORDING COVE E 7 NAIC # INSURER A Multiple Companies L'�+ INSURED INSURER B IMS INFRASTRUCTURE MANAGEMENT SERVICES INSURERC: LLC 1820 W DRAKE DR STE 108 INSURER D TEMPE AZ 85283 INSURER F 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. INSR LT fl TYPE OF INSURANCE INSR WVD POLICY NUMBER POLC F POLICY (MM/DD/VYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY III DAMAGE 1u PREMISES lea occurrence) I $ CLAIMS -MADE OCCUR MED EXP IAny one person) $ a _ _ j PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ AGGREGATE LIMIT APPLIES PER: III' PRODUCTS - COMP/OP AGG S�N,"L POLICY PET l— LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS u AUTOS HIRED AUTOS II I NON -OWNED L AUTOS H _ H PROPERTY DAMAGE (Per accident) $ S I UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE u u I AGGREGATE $ DEDI I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PRO PRI OFFICER/MEMB RREXCRLUDEDEXECUTIVE; (Mandatory in NH) u N/A H 76 WEG LU6745 04/19/2013 04/19/2014 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000, 000 E.L. DISEASE - EA EMPLOYEE) $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 uu DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Those usual to the Insured's Operations. Reference: Asphalt Pavement Evaluation and Management Services CERTIFICATE HOLDER CANCELLATION Monroe County Board of County . . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Commissioners Attn: Ms. Judith Clark BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Director of Engineering Services DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZE R PRESENTATIVE / 1100 S IMONTON ST RM 2 - 216 KEY WEST, FL 33040— ® 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2P10/05) The ACORD name and logo are registered marks of ACORD C. Ctivrvtd, DATE (NSVDD/YYYY) ,4co D® CERTIFICATE OF LIABILITY INSURANCE 4/5/2014 THIS CERTIFICATEIS 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 SUBROGATIONIS 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). PRODLN;I HARTFORD FIRE INSURANCE COMPANY CONTACT NAME: N (A/C, No. Ext): FAX (A/C, No) ADDRIESS: 250760 P: F: INSURER(S) AFFORDING COVERAGE NAIL# PO BOX 33015 INSURERA: Multiple Companies SAN ANTONIO TX 78265 INSURED INSURER B INSURER C: IMS INFRASTRUCTURE MANAGEMENT SERVICES INSURER D : L L C INSURER E: 1820 W DRAKE DR STE 108 INSURER F: TEMPE AZ 85283 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 ADO SUBR POLICYNUWER PMIDD41 FF POLICYEXP LAtI7S COMMERCIAL GENERAL LIABILrfY CLAIMS -MADE ❑ OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ SV E MED EXP (Any one person) S ' 1... PERSONAL & ADV INJURY $ WAIV GENERAL AGGREGATE $ GEN'LAGGREGATELIMIT APPLIES "R: PRODUCTS - COMP/OP AGG $ POLICY PR(X LOC - $ JECT OTHER AUTOMOBILE 1JABILrLY. LIMIT (Ea accident) S BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED UTOS PROPERTY DAMAGE (Per accident) $ S UMBRELLA LIAR OCCUR EACH OCCURRENCE g AGGREGATE $ EXCESS LIAB CLAIMS -MADE DE RETENTION $ WORAMSCOAMENSA77ON ANDEWLOYERS'LLtalLT7T ANY PROPRIETORIPARTNEPJEXECUTIVEYM X PER OTHER- STAME E.L. EACH ACCIDENT 11,000,000 A OFFICERIMEMBEREXCLUDED? ❑ (Arandatory in NH) If yes, describe under wa 76 WEG GD5179 04/19/2014 04/19/2015 E.LDISEASE-EAEMPLOYEE $1, 000, 000 E.L. DISEASE - POLICY LIMIT $ 1 , 0 0 0 , 0 0 0 DESCRIPTION OF OPERATIONS below DESCRF7MOFOPERATIONS /LOCATIONS/ VEHICPMRD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Reference: Asphalt Pavement Evaluation and Management Services �,rere r I � — --- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Monroe County Board of County.. BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Commissioners Attn : Ms. Judith Clark DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Director of Engineering Services AUTHORIIEDREPRESENTATNE - 1100 SIMONTON ST RM 2-216 7a-z— KEY WEST, FL 33040 n 1988-2014 ACORD CORPORATION. All rights resery ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ,--•1 IMS-001 OP ID: JA ,ac�oRo° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/24/2014 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 endorsements . PRODUCER American Ins. & Inv. of Nevada 6765 West Russell Road #150 Las Vegas, NV 89118 CONTACT NAME: PHONE FAX c No): A/c No Ext : AVC. ADDRIESS: INSURERS AFFORDING COVERAGE NAIC q INSURER A: Travelers Ind Co of Amer A+ XV 25666 INSURED IMS Infrastructure Management INSURER B : Travelers Ind Co of CT A+ XV 25682 Services, LLC 1820 W Drake Dr Ste 108 INSURER C : Beazley Ins Co Inc A VIII 37540 Tempe, AZ 85283 INSURER D : INSURER E : INSURER F : nnvs owr_cc f'=12TICICATG w IMRFR- 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 LT OF INSURANCE ADDLTYPE INSR UB POLICY NUMBER MM/DDPOLICY EFF POLICY EXP MM /DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X 680-8926L164-TIA-14 03/26/2014 03/26/2015 IEU PREM SES EaEoccurrence) $ 1,000,00 MED EXP (Any one person) $ 10,00 CLAIMS -MADE Fx—1 OCCUR PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE 3 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 $ POLICY X PRO- LOG AUTOMOBILE LIABILITY Ea acc deDtSIRGlE LIMIT 1,000,00 BODILY INJURY (Per person) $ B X ANY AUTO X BA-8923L36A-14-GRP 03/26/2014 03/26/2016 BODILY INJURY (her accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED PER AC DEN GE $ _ X HIRED AUTOS X AUTOS $ UMBRELLA LIAB OCCUR BY A ENA EACH OCCURRENCE $ . . AGGREGATE $ EXCESS LIAB CLAIMS -MADE BY DED I I RETENTION $ 1 1$ WORKERS COMPENSATION DATE LIMWC STATU- OTH- ER ES_ TOR E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y /❑N WAIVER W E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N / A E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below C Professional Liab. V15SIC140801 03/25/2014 03/25/2015 Per Claim 2,000,00 Claims-Made/Rpt'd RETRO DATE: FULL Aggregate 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: Asphalt Pavement Evaluation and Management Services nroe County, a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, Florida, 33040, its successors and assigns, through the Monroe County Board of County Commissioners, is additional insured with respect to the *CONTINUED ON ATTACHED PAGE* Monroe County Attn: Judith Clarke, P.E. Director of Engineering Sery 1100 Simonton St Rm 2-216 MONROEC 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 © 1933-2010 AGURD GUKNUKA I IUN. All rignts reservea. ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 680-89261-164-TIA-14 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section II): Any person or organization that you agree in a "contract or agreement requiring insurance" to in- clude as an additional insured on this Coverage Part, but only with respect to liability for "bodily in- jury", "property damage" or "personal injury" caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing opera- tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products -completed operations hazard". Such person or organization does not qualify as an additional insured for "bodily injury", "property damage" or "personal Injury" for which that per- son or organization has assumed liability in a con- tract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which cover- age as an additional insured specifically is added by another endorsement to this Cover- age Part. e. This insurance does not apply to the render- ing of or failure to render any "professional services". f. The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "contract or agreement requir- ing insurance to. provide for that additional insured, or the limits shown in the Declara- tions for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section III) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Cov- erage Part must apply. on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such addi- tional insured as a named insured, and we will not share with the other insurance, provided that: . (1) The "bodily injury" or "property damage" for which coverage is sought .occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that 'contract or agreement requiring insurance". But this insur- ance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured, when the insured is an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights of recovery wemay have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, under a 'contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the 'contract or agreement requiring insur- ance" with such person or organization entered into by you before, and in effect when, the "bodily CG D3 81 09 07 ® 2007 The Travelers Companies, Inc. Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc., with its permission POLICY NUMBER: BA-8923L36A-14-GRP COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BLANKET ADDITIONAL INSURED H. AUDI , VISUAL AND DATA INCREASED LIMIT ELECTRONIC EQUB. EMPLOYEE HIRED AUTO C. EMPLOYEES AS INSURED D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS E. TRAILERS — INCREASED LOAD CAPACITY F. HIRED AUTO PHYSICAL DAMAGE G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT A. BLANKET ADDITIONAL INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COV- ERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injuryor "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. B. EMPLOYEE HIRED AUTO The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LI- ABILITY COVERAGE: An "employee" of yours is an "insured" while operating a covered "auto" hired or rented under a contract or agreement in that "em- ployee's" name, with your permission, while I. WAIVER OF DEDUCTIBLE —GLASS J. PERSONAL EFFECTS K. AIRBAGS L. _AUTO LOAN LEASE GAP M. BLANKET WAIVER OF SUBROGATION performing duties related to the conduct of your business. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while perform- ing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". C. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COV- ERAGE: CA T4 20 07 10 ® 2010 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permission. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. AUTO LOAN LEASE GAP The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Auto Loan Lease Gap Coverage for Private Passenger Type Vehicles In the event of a total "loss" to a covered "auto" of the private passenger type shown in the Schedule or Declarations for which Physical Damage Cov- erage is provided, we will pay any unpaid amount due on the lease or loan for such covered "auto" less the following: (1) The amount paid under the Physical Damage Coverage Section of the policy for that "auto'; and COMMERCIAL AUTO (2) Any: (a) Overdue lease or loan payments at the time of the "loss"; (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the les- sor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract exe- cuted prior to any "accident" or "loss", pro- vided that the "accident" or "loss" arises out of the operations contemplated by such con- tract. The waiver applies only to the person or organization designated in such contract. CA T4 20 07 10 ® 2010 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permission.