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Certificates of Insurance
CERTIFICATE OF LIABILITY INSURANCE , DnTEIMMIDDIYYYY) THIS CERTIFICATE 18 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 pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and eonditlons of the policy, certain policies may require an endorsement. A statement on this certificate does not Confer rights to the PRODUCER rise Parkway, Suite 101 OH 44122 INSURED mbi-k2m Architecture, Inc. Spectrum Design Services Inc. 1001 Whitehead St., Suite 101 Key West FL 33040-7522 MBIK2-1 COVERAGES CERTIFICATE NUMBER;193194368 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 ADD POLICY NUMBER POLICY EFF (MM/DRN = POLICY EXP jHNM2a= LIMITS GENERALUANUTY Y Y 45SBA107003 /14/2012 14=13 EACH OCCURRENCE $1,000 000 X COMMERCIAL GENERAL LIABILITY CLAIM64 AAOfl X❑ OCCUR X Al Primary & AP g GE BBYA W NT AMA E N s1.oaD,Doo MED EXP one $10 000 PERSONAL a ADV INJURY S1,000,000 N�GOntnl;*AM GENERAL AGGREGATE $2 000 000 OEML AGGREGATE LIMIT APPLIES PER: .. PRODUCTS - COMP/OP AGO $2 000 000 POLICY X PRO• Lam, S AUTOMOBILE LIABILITY Y y 45SBA107006 14/2012 /14r2013 Ea acc IT =1 000 000 BOON INJURY (Par person) S ANY AUTO ALL OWNED SCHEMLED AUTOS AUTOS BODILY INJURY (Per acC4vht) $ NON,OWNE0 HIRED AUTOS X AUTOS PROPERTY DAMAGE War AW40L- S s X AI Primary X UMBRA U AR X OCCUR Y V1412012 114/2013 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,I)DO EXCESS LIAR I CLAlMS.MAOE 1468BA107003 DED 11 1 RETENTION$10.000 Excludes Professional s A WORKERS COMPBNSATM AND EMPLOYERV LIABILITY ANY PROPRIETOR/PARTNER0EXECUTIVE YIN OFFICERIMEMBER EXCLUDED9 N❑ N / A Y 45SBA107008 /1412012 311412013 WC STATU- X OrH- OH -STOP GAP E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1 000 000 INandstary In NH) N yyeess deacnbe under DESCRIPTION OF OPERATNON$ balgw E.L. DISEASE • POLICY LIMIT $1 000 000 B Professional Liawity ClaLns Made Retm Date: 9/1 /2001 N Y AEE7204506 /13/2013 /13/2014 Each Claim $1,000,000 Aggregate 51,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VFJ41CLES (A/hch ACORD 101, Additional Kwnarke SehsduM. If mare Spam Is m9tilmd) Additional Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured by written contract or agreement. MK-�t: SPSCe Planning Facilities Assessment Report Monroe County Ann M. Riger 1100 Simonton Street, Room 2.216 Key West FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE VALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTNORGM0 REPRUENTATIVE 01988-2010 ACORN? CORPORATION. All rights reserved. ACORD 25 (20107 The ACORD name and logo are registered marks of ACORD Lc, ACORV CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/12/2013 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 Oswald Companies 3401 Enterprise Parkway, Suite 101 Beachwood OH 44122 co C Q' NTA T NAE: M Patricia Cholewa PHONE - - FAX - - 2807 A/C No AD2815 E-MAIL DRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:Hartford Casualty ins, Co. 29494 INSURED MB#61 J INSURER B INSURER C : mbi-k2m Architecture, Inc. " Spectrum Design Services Inc. 1001 Whitehead St., Suite 101 INSURER D : Key West FL 33040-7522 it sd INSURER E : INSURER F : COVERAGES CERTI NUMBER: 1113201791 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 INSR R WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY Y Y 45SBA107008 /14/2012 /14/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR E Y GE NT DAMAGE TO REN—TE17— PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) _ $10,000 PERSONAL 8 ADV INJURY $1,000,000 X AI Primary & 'PPRO X Non -Contributory GENERAL AGGREGATE $2,000,000 W GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X PRO- X LOC $ A AUTOMOBILE LIABILITY Y Y 45SBA107008 /14/2012 /14/2013 Ea accident) $1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY t DAMAGE Per acciden $ NON -OWNED HIRED AUTOS AUTOS X $ Al Primary A X UMBRELLA LIAB X OCCUR Y Y 45SBA107008 /14/2012 /14/2013 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 EXCESS LIAB CLAIMS -MADE DED X I RETENTION$10,000 Excludes Professional $ q WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N Y 45SBA107008 /14/2012 /14/2013 WC STATU- X OTH- TORY LIMITS I ER OH -STOP GAP E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatoryin NH) H yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 B Professional Liability N Y AEE7204506 /13/2013 /13/2014 Each Claim $1,000,000 Claims Made Aggregate $1,000,000 Ratio Date: 9/1/2001 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured by written contract or agreement. Project: Space Planning Facilities Assessment Report, MK-12243 CERTIFICATE HOLDER CANCELLATION Monroe County Ann M. Riger 1100 Simonton Street, Room 2-216 Key West 33040 GC_ 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 �ct. }/ 6� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 40 tHUMA Care Payro� Norman Resarses Rak Mkenagli WMd BerN% 9501 UNION CEMETERY ROAD LOVELAND, OH 45140 PHONE (513) 605-3522 FAX (513) 605-3523 MBI/K2M ARCHITECTURAL and HUMACare, Inc.- Consolidated Employee Management have entered into a co -employer / PEO relationship in which HUMACare Inc. assumes workers' compensation liability under the certificate attached. Questions regarding the certificate and/or the liability relationship should be directed to the Risk Management Department, 513-605-3522. °' Bureau of Workers' Ohio Compensation 3o s, Spring 43 15 Columtws, OH 43215 Certificate of Premium Payment This certifies the employer fisted below has paid into the Ohio State Insurance Fund as required by law. Therefore, the employer is entitled to the rights and benefits of the fund for the period specified. For more information, call 1-800-OHIOBWC. This certificate must be conspicuously posted. Policy No. and Employer Period Specified Below 1349248 ohiobwc.oDrn HUMACARE 9501 UNION LOVELAND, 1."013—ru-1R013 MGT INC You can reproduce this certificate as needed. Ohio Bureau of Workers' Compensation Required Posting ws.+.r..brory Effective Oct. 13, 2004, Section 4123.54 of the Ohio Revised Code requires notice of rebuttable presumption. Rebuttable presumption means an employee may dispute or prove untrue the presumption (or belief) that alcohol or a controlled substance not prescribed by the employee's physician is the proximate cause (main reason) of the work -related injury. The burden of proof is on the employee to prove the presence of alcohol or a controlled substance was not the proximate cause of the work -related injury. An employee who tests positive or refuses to submit to chemical testing may be disqualified for compensation and benefits under the Workers' Compensation Act. O{yiBureau of Workers' o Compensation You must post On IwWap with the murex of asp par,wL FACOIRDHP CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 9/17/2013 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 The James B. Oswald Company NAME: Patricia PHONNo,E EXU;216-839-2807 ac No ADDRIESS:P h w I ni m 1100 Superior Avenue, Suite 1500 Cleveland OH 44114 INSURERS AFFORDING COVERAGE NAIL# INSURER A :H I 4 4 INSURED M B I K2-1 INSURER B:Hudson Specialty Insurance Co. mbi-k2m Architecture, Inc. INSURER C 1001 Whitehead St., Suite 101 INSURERD: INSURER E : Key West FL 33040-7522 INSURER F COVERAGES CERTIFICATE NUMBER: 1960338303 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 D L POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD MMIDD A GENERAL LIABILITY MMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR AlPrimary 8 TXPNjon-Contributory Y Y 5SBA107008 /14/2013 /14/2014 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence MED EXP (Any one person) PERSONAL & ADV INJURY =$2,000,000 GENERAL AGGREGATE PRODUCTS - COMP/OP AGG GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X JEC PRO X LOC UUMBINEU SINGLE LIMIT A AUTOMOBILE LIABILITY Y Y 45SBA107008 114I2013 114/2014 Ea accident$1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X Al Primary A X UMBRELLA LIAB EXCESS LIAB X MS MADE tbel. 107008 /14/2013 114/2013 /14/2014 /14/2014 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 Excludes Professional WC sTATu- X oTH- $ OH -STOP GAP DED X RETENTION$1 WORKERS COMPENSATION107008 AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXE OFFICER/MEMBER EXCLUDED? A E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 (Mandatory in Nnd If yas, describe under DESCRIPTION OF OPERATIONSProfessional Liability204506 Claims Made Retro Date: 9/1/2001 /13/2013 /13/2014 E.L. DISEASE - POLICY LIMIT $1,000,000 Each Claim $1,000,000 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured by written contract or agreement. Project: Space Planning Facilities Assessment Report, MK-12243 A MENT B dD WAIVER /A 0 CERTIFICATE HOLDER CANCELLATION rn 0 SHOULD ANY OF THE ABOVE DESCRIBED POLIGtE"IE CANCELQED ORE THE EXPIRATION DATE THEREOF, NOTICE_.,YY41 BE D IVE i IN Monroe County ACCORDANCE WITH THE POLICY PROVISIONS.- _. J Ann M. Riger i 1100 Simonton Street, Room 2-216 AUTHORIZED REPRESENTATIVE J 11 Key West FL 33040 � G, C:) ©1988-2010 ACORD CORPORATION. All rti)ots rJArved. ACOR 225 (2010/05) The ACORD name and logo are registered marks of ACORD