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Certificates of InsurancePEDRO-2 OP ID: NR ACOROp � CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 05/22/13 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 305-262-0086 BUTLER, BUCKLEY, DEETS INC. 6161 BLUE LAGOON DR., STE 420 F S. MIAMWilliam Bode William S. Bodenhamer ACT NAME: NAME' WILLIAM BODENHAMER A/CNNo Ext : 786 2161764 FAAic No): 305 2620086 ADDRESS: BBODENHAMER@BBDINS.COM INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FCCI Commercial Insurance Co 33472 INSURED PEDRO FALCON ELECTRICAL CONTRACTORS, INC. 31160 AVE C BIG PINE KEY, FL 33043-4516 INSURER B : INSURER C INSURERD: INSURER E : 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 LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 100,00 A X COMMERCIAL GENERAL LIABILITY X GL 0008235 4 03/13/13 03/13/14 CLAIMS -MADE FXI OCCUR IVIED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 $ POLICY X PRO - AUTOMOBILE AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS D ' I WAN R N • COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,00 AGGREGATE $ 4,000,00 A EXCESS LIAB CLAIMS -MADE UMB0005173 6 03/13/13 03/13/14 DED I X I RETENTION$ 10,000 $ 1 1 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 001-WC11A-65512 11/02/12 11/02/13 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYE $ 500,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,00 A INSTALLATION FLTR CM0004409-4 03/13/13 03/13/14 RENTAL *SEE NOTE EQUIPMENT JOBSITE BLANKET *SEE NOTE LEASED *SEE NOTE Ln ICE OF CANCELLATION EXCEPT NON tot, Additional Remarks Schedule, if more space is required) 30 DAYS NOOPERATIONS PAYMENT OF PREMIUM 10 DAYS.Project:ADA Compliance Segment #4, Monroe Co., FL, Facilities Interior Public Access Areas. Additional Insured Monroe County Board of County Commissioners Monroe County Board of County Commissioners 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 WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD A R-7� CERTIFICATE OF LIABILITY INSURANCE 092` zrl'"'DOD 3"' THIS CERTIFICATE IS ISSUED AS A t"TTER 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder fr. an ADDITIONAL INSURED, the policy(iss) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and cwdltions of the policy, ccrtain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsoment(s). PRODUCER Ellie Mills Inusrance Agenty, Inc. 20330 Old Cutler Road Cutler Bay, FL 33189 � AM Y• Janice Rowton PRONe23841688 A,c 60 ADDRES nice.rowton.i b efarm.com Blsu s AI°FORDitO COVERAGE MAICIII INSURER A : Slate Form Muhlal Automobile UfsurDnce Cam n INSURED Pedro Falcon Electrical Contractors, Inc. INSURER e : C : 31160 Avenue C. -INSURER INSURI!! :.. Big Pine Key, FL 33043 i INSURER E ! A INSURER F rnvr-DAr-Fc r_Fanvir_ATF NIIMRFR• 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 OESCRLSED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH '"OLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, wsil T TYPE DFINSURANCE 1 PO MBER POLICY POLICY EXP LIMITSGENERAL LIABILITY C0MMERCIALGENERALLIABILITY CLAIMS -MALE OCCUR EACH OCCURRENCE IfM FED PREMISIIEBtE ro+rmnce ,S MED EXP aN n S PERSONAL A ADV INJURY S GENERAL AGGREGATE Ir GENL AGGREGATE UMrt APPLIES PER: POLICY PRE LOC PRODUCTS. COMPfOP AGO 5 S A AUTOMOBILE LIABILITY ANY AL" 0 ALL OWNED x SCHEDULED AUTOS AU OS D HIREDAUTOS AUTOS y 651 1826 E07 59 113 7113 E10 59 DOS 4759 C09 59 O5/OT/2013 05110=13 03t09t2013 11/0712093 11/10/2013 09/MO13 Ea acdda l LIMIT $ 1.000,000 BODILY114JURY (Per person) S BODILY INJURY (Pa seddi n) S E DAMAGE Per --••— 5 _ S UMBRELLA LiAS EXCESSLWB OCCUR CtAI "MADE 9 , AGEMEM EACH OCCURRENCE S AGGREGATE S DEo RETPMON s S WORKERS COMPENSATION ANO EMPLOYERS` LIABILITY ANY PROPRR?TORMARTNENEXECUTIVE Y f N OFFICEMMSER EXCLUDED? (Mandatory in It yea deaarila unCar N f A W - _ . TA ll. O TORMI '-'— E.L. EACH ACCIDENT S -......".A EMPLOYE E.L. DISEASE. FA EMPLOYEE r.� E El DISEASE •POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS / VE1ICI.EB iAlam ACORD 10t, AdMooM RetunYa SuN dWo, If meta peat is Mquirs i Project: ADA Compliance Segment #4 Monroe Co., FL, Facility Interior Pubic Access Areas Monroe County Board of County Comrnissioriers as additional insured the listed insurance Policies may not be carr;elled on less than 30 days written notice by the Insurer Monroe County Board of County Commissioners Monroe County Board of Count%r Commissioners 1100 Simonton Street, room 2-2 f 6 Key West, FI 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. U7A RED REPRESENTATIVE � '" : Br 1968-2010 ACORD IfO14ATtON. All rights reserved. ACORD 25 (2010105) The ACORO name and logo are registered marks of ACORD 1001486 132849.7 03.01-2012 A� oF 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 AFfIRMATWELY 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 holler is an ADDITIONAL INSURED, the policypes) must be endorsed. If SUBROGATION IS WAIVED, subject to N1e terms and conditions of tho policy, certain policies may require an endorsement. A statement an this cerufcate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Eii1e Mites InusranCe Agency, Inc. 203M Old Cutter Road Cutter Say, FL 33189 Ali. NAME CT Tani &.PHOr aDDREss Ianice.rowton.icgbMStatSIMM.Com INSURER AFFOROINO COVERAGE NAIC r INSURER A: State Fann Mutual Automobile Insurenoe company 25176 INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key, FL 33043 INS1yREa0: INSURER G: INSURER 0: RISURER E : 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 IOLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L TYPE OF INSURANCE POLICY 07 POLICY exp LIMITS GENERAL UABILrtY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR ❑ EACH OCCURRENCE 5 PR MS S Esoowrr®eae S MED 6XP jAny oftparwnj 5 PERSONAL A ADY INJURY S GE NERALACGREGATE S GENT. AGGREGATE UWT APPLIES PER: POLICY PRO- LOC PRODUCTS -COMPKOPAGG S S A AUTOMOBILE UASIUTY ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS NON40n�NED HIRED AUTOS AUTOS Y 645 9289 009 59 DOT 743702659 022 3571 F03 59 030 5488 829 59 04/09/2013 0412812013 0610=013 0=812013 1010112013 1012612013 12rOW2413 Ot rZM13 Es eeefdent MI S 1,000,000 BOOLYIWURY(Perpwim) S — � $ ��E��„�E I S L UMBRELLALIAB EXCESS LIAO OCCUR ixAiMSdMDE EACH OCCURRENCE S AGGREGATE S oE0 RETENTIONS S WOAKERiCOMPENSATION AND EN LOVERS' LIABILITY ANY PROPRETORIPARTNEWEXECVTIVE YIN OFFICE/AtEUSeR EXCLUDEO7 (Mandatory In NH) hems, 'm,mloRr N r A WAIN • YrCSTA IN - E.L. ACCIDENT S E.4 DISEASE - EA EMILoyef S E.LDISEASE- POLICY LINT S DESCRIPTION OF OPERATIONS 1 LOCATIONS! VEHICLES tA1tach ACORD 101, AdManal R►nu m Schod%", If non Romp Is required) Project: ADA Complianoe Segment #4 Monroe Co., FL, Facilities Interior Public ACOe53 Areas Monroe county Board of County Commisskriers as additional insured the listed insurance Polices may not be carcelled on less than 30 days written notice by the insurer Monroe County Board of County Commissioners Monroe County Board of Count/ Commissioners THEULD ANY OF THE EXPIRATION DATE vTHEREOF, N07E DESCRIBED ICE POLICIES WILL BE CANCELLEDBEFORE N 1100 Simonton Street, room 2-216 ACCORDANCE W" THE POLICY PROVISIONS. Key West, FI 33040 0 1988-2010 V"' LS All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 100148E 132848.7 03-01-2012 '4� h® CERTIFICATE OF LIABILITY INSURANCE °a�ti2'�20 "" 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(%, 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 tome 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 Ellie N ills lnusrance Agency, Inc. 20330 Did Cutler Road O Cutler Bay, FL 33189 CONTACT N nice Rowion PHONE FAX IN nDORE58.: nfa ace rowlon.ire stateiarm.com INSUR AFF D G COVERAGE N" 0 INSURER A: State Farm Mutual Automobile insurance Company INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key, FL 33043 INSURERS: INSURER C: INSURERS: INSURER E 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 R91UIREMENT, 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 'OL.ICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIR TYPE OF INSURANCE 'IMSH vim POLICYRUMOVIt0 M tam GENERAL LIA91LITY COMMERCIAL GENERAL LMILITY CLAMPSMADE ❑ OCCUR 3 EACH OCCURRENCE $ PREMISES Eadaauwgj S MED�an* Demon) s PERSONAL A ACV INJURY S 6ENLAGGgEGATELIMITAPPLIESPER: ( POLICY PRa LOC GENERAL AGGREGATE _ S PROOUCT8-COMPIOPAGG 3 S A auraraoetLE LIABILITY y ANY AUTO $NED SCHEDULED AUTqS,i HIRED AUTOS)( NON-CANNEDPROPEL AUTOS f 898 3933 A08 39 1 01108=13 07IM201$ �eo25MM- s N u f 1.000.0DD SOSR.Y RL%URY (Par person) S BODILY IWURY (Pot acddwi) Ate"' PM aOdtlarN 4 $ UMSRELLA LIAS ExGESSLIAS HCLA1AI$MADE OCCUR B DA WAI GEMEM EACH OCCURRENCE s AGGREGATE S DIED RETENTION s s WORKERS COMPENSATION AND EMPLOYERS' LIAe1LITY YIN " ANY PROPR2To"ARTNLIMEXECUTIVE -I N / A OFFICENEMBER EXCLUDED? (Mandatory In NNI d yea doaviba undx wG 87ATLL OTH• E.L. EACH ACCI ENT $ - '— E.L DISEASE- EA EMPLOVEG I E.L DISEASE -POLICY LIMIT S ^� DESCRIPTION OF OPERATIONS I LOCATIONS I VEiib X9 (Attach ACORD 1e1. AddiBorAt Ramtrks Schaaute, I nwm s"c1 M MQUlredl Project: ADA Compliance Segment #4 Monroe Co., FL, Facilities Interior Public Access Areas Monroe county Board Of County Commissioners as additional Insured the listed insurance Policies may not be canceled on less than 30 days written nonce by the insurer Monroe County Board of County Commissioners Monroe County Board of Count, Commissioners 1100 Simonton Street, room 2-216 Key West, FI 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 13E CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE to 19118.2010 ACORD ^ate, ACORD 25 (2810105) The ACORD name and logo are registered marks of ACORD 1001486 132B49.7 03-01.2012 A`oRn® CERTIFICATE OF LIABILITY INSURANCE °07/02/2013"' 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 endorsement(s). PRODUCER Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road Cutler Bay, FL 33189 OINSURERS t CONTACT NAME: Janice Rowton PNONE . 305-238-8688 A/c No): 30-238-8608 ADDRESS: 'an ice. rowton.i b statefarm.corn AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 25178 INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key, FL 33043 INSURERB: INSURER C : INSURER D : INSURER E : 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 LTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1:1OCCUR ❑ ❑ - E D WAN EACH OCCURRENCE $ PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMP/OP AGG $ $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS rxAUTOSED FYI El898 3933 A08 59 07/08/2013 01/08/2014 Ea accl dent INGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PeOacEcde (DAMAGE $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE L1 0 EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER EXCLUDED? ❑ (Mandatory In NH) If yes, describe undernFqr.R1PT1QN OF OPERATIONS below N / A ❑ WC STATU- OTH- T RY LIM T R E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DhIPWAP& $ JUL 05 N13 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addltlonal Remarks Schedule, If more space Is required) Project: ADA Segment # 4 JJME__ _----^ Monroe County Board of Commissioner as additional insured 1t�GE'�`FO BY: The listed insurance policy(s) may not be cancelled on less than 30 days written notice by the insurer to Monroe County Board of County Commissioners t;EK I ItIGA I t NULLitK CANCELLATION Monroe County Board of County Commissioners Monroe Cty Administration Dept, Project Mgt Dept 1100 Simonton Street, Room 2-216 Key West, FL 3304 C�C' 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 01988-2010ACORDC614130114ATION. All riahts reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 AC40M CERTIFICATE OF LIABILITY INSURANCE ° 02s"i2o 3 ACORD 25 (2010106) 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: 9 the certificate holder is an ADDITIONAL INSURED, the policypes) 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 Culler Bay, FL 33189 A I CONTACT NAME., Janice Rowton PHONE 305-23MM Fax No. 305-23 -608 ' � nnice.rowton.i b statefarneom INSAFFORDING COVERAGE NAIC t INsuRER A: State Farm Mutual Automobile Insurance Coffyany 2078 Mi INSURED Pedro Falcon Electrical Contractors, Inc. INSURERS: INSURERC: 31160 Avenue C INSURERD: Big Pine Key, FL 33043 INSURER E INSURER P : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISPED 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. TYPE OF INSURANCE ADOL SLIDE POLICY NUMBER POLICY EFF POLICY EXP LMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLA-MADE OCCUR IMS DO _ OCCURRENCE11 f - _ PREMISES Ea cow" nee f MED EXP (Anyone person) f PERSONAL 3 AOV INJURY f GENERAL AGGREGATE f LGENM AGGREGATEMIT LIAPPLIES PER: POLICY PRO F7 LOC PRODUCTS - COMP/OP AGG f f A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED X SCHEDULED HIRED AUTOS AUTOSSED Y DOT 7437 D26 59 10/2612t113 04/2612014 LIMITINGLE f 1,DaD,aOa BODILY INJURY (Perperson) f BODILY INJURY (Per mdderd)AUTOS f Per awldent S f UMBRELLA LIAB EXCESS LAB HOCCUR CtAIMSaYtADE EACH OCCURRENCE f AGGREGATE f DED RETENTION f ' WORKERS COMPENSATION AND EMPLOYER[' LIABILITYANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICFAAFMBER EXCLUDED? (MwKhdwy in NH) If yes, desedhe under F OPERATIONS Wow N / A M; SUATU- OTH- E.LEACH ACCIDENT f E.L. DISEASE -EA EMPLOYE f E.L.nacr�01�1 DISEASE • POLICY LIMIT S P DESCRIPTION OF OPERATIONS i LOCATIONS i VEHICLES (ACaen ACORD 1e1, Additional Remarks SOnedtde, If more apses Is required) A Project ADA Compliance Segment #4 B DA o -T1 Monroe County Board of County Commission 1100 Simonton Street RM 2-216 Key West y FL 33040 AUTHORIZED REPRESENTATIV;;E1� [D!�� i (w'b Q 1988-2010 ACORD The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIB `E¢ OOLIC(ES B CANCELLED BEFORE THE EXPIRATION DATE THEREOF, -NOTICE Wil BE C]EL.iVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. F LSAS EATiOtHhit n'§hts reserved. 1001486 132848.7 03-01-201`e AC Q" PEDRO-2 OP ID: NR �.-- CERTIFICATE OF LIABILITY INSURANCE °A'�("°°' 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: ff the certificate holder is an ADDITIONAL INSURED, the poticy(ies) must tTe 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 endorsemen s). PRODUCER BUTLER, BUCKLEY, DEETS INC. 305-262-0086 iia°MeACT WILLIAM BpDENHAMER 6161 BLUE LAGOON DR, STE 420 PHONE MIAMI, FL 3312E No • 786 216 1764 William S. Bodenhamer EMAIL Nc Na : 305 262008E ennaee.�. RRAr1RAiWAucosaar�..�...........__ INSURED CONTRACTORS, INC. 31160 AVE C BIG PINE KEY, FL 33043-4516 THIS IS TO CERTIFY THAT THE POLICIES OF INDICATED. NOTWITHSTANDING ANY REOU CERTIFICATE MAY BE ISSUED OR MAY PEF EXCLUSIONS AND CONDITIONS OF SUCH POI V E OF INSRACE ADt ITY AL GENERAL LIABILITY X -MADE � OCCUR GZC L AGGREGATE LIMIT APPLIES PER POLICY X PRO LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AU 3S AUTOS HIRED AUTOS AN��WNED X UMBRELLA LIAS OCCUR A EXCESS LIAS cLAINIS•MApE XRETENTI N s 10,000 W ORICERS COIQPEIiSAT1ON AND EMPLOYERS UASU ffy A ANYPROPRIETOR/pARTNER/EXECUTTVE YIN O"ICERIMEMSEREXCLUDE04 a N/ (Mandatory in NM A (INSTALLATION FLTR EQUIPMENT JOBSITE FCCI wnut USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERt00 CH THIS NT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHI THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TERMS, 00082354 �^ ^ v u vccnve a 03113f13 03/13/14 PREWS S a cuPrence S MED EXP one. rson) 5 PERSONAL & ADV INJURY a GENERAL AGGREGATE a PRODUCTS - COMPIOP AGG 5 a I. a ' SINGLE LIMIT as BODILY INJURY (Per person) a BODILY INJURY (Per accident, a PROPERTY DAMAGE a Peracddent a EACH OCCURRENCE a �00051T3 6::::;3/13 031131140311 'SEE NOTE 11102/13 I 11/02/14 3113 1 03113114 a Iccs►acv 'SEE 11LOCATIONS IONS I VEHICLES (Attach ACORD 101. Addnlonat Remarks Schedule, if more space is required) 0 DAYS PiON ro ec-ct.ADA Compliance I., FL, Facilities Interior fditlonCounty Board at Insured Monroe C paR S ME Cv7 Irs gg y `Tl WAfLJ R N/A _ _ . r a Tl CANCELLATION A=1f HE ABOVE DESCRIBED POLMC= BE CAN LLE ' FORE Monroe County Board of County DATE THEREOF, NOTICE-'MLL BE U1/�D IN Commissioners H THE POUCY PROVISIONS: ' 1100 Simonton Street O �' Roam 2-216 TATIVEKey West, FL 33040 hamer CD t_, ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD O CORPORATION Ail rightsreserved. Received DEC 18 2013 A4e�& Finance Dept. k..� CERTIFICATE OF LIABILITY INSURANCE , THM CERTFIrA75 0 ISSIM " A MATTER OF NOW MATIOIa ONLY AND OOHFMs NO I NNM UPON THE CMTr=TE HOL06t. TNb CERTIFICATE D093 NOT AFFNMTNMY OR MMTRIELY AMEND, EXTIEND OR ALTOR TM COVIERApE AFFORD® By THIS POUCWS BELOW Tiffs CIOMPICATO OF VNIAN ANCE DOES NOT COMMUTE A CONTRACT OETYIfWN TIC I311Ume INBURERISIL AUTHORIZED REPREs MTATNE OR PROMM% AND THE CBMRCATE MM M. IMPORTANT. N an r"Ri ate GA—W is sn AODITIONAL vWXt T, tM PWWYPsa) must be ondorsad. If jUNBUT—M Is Yoram. molea t aa* tafss and ooAdMons of UIa Poft, csrlaln polices any Nqu6u as L A st 11 it on thh ssrtllkata doss not canfir doff to do o�Issgss bnAdw In Bss of aueh dal• "le Mft inuvw1ce Agency. Inc. 20330 Old Cutler Road Cutler W FL 33189 sip Anolmwa Nas:a A: INiLInle Pedro Falcon Efechicst Contractors, Ira 31160 Avenue C Big Pine Key, FL 33043 s: TMS 18 TO CERTIFY THAT THE POLICIES OF INSURANCE LUBTTsD BELOW HAVE WEN ISM TO THE INSURED NAMED AB THE FatICY PMt10D NM YN71E IBSU INO ANY R®"EMENT. Tt7iM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VUTH RESPECT TO VIaOM THIS CERTIINDICFICATE CErtTIFlCATE MAY 8E 185U® OR MAY PMTABI THE IN9URAWX AFFOROID BY THE POLICES DESCRIBED Ht]iEIN M SUBJECT TO ALL THE TEM. EXCWNONe AND CONDITIONS OF SUCH POUCWS, LIMITS $NOVYM MAY HAVE BEEN RWO10 BY PAID CLAIMS. Am TM OP INIUROCa IIw= osssff"uass,lrr COIMlIICML a11kWIIL UAMUN ClAauauo SUcDAsesules f 7 Swoo i f OCCUR roN WAW i _moan.ADOIESATauIlrrAVPLIMsnilz "WvMMLoc wlnoMoss s UfIlNK" OENeI1A1 AD1iAEWTt t rllooucn.cow/oaAoa f s A D X KWWWAU100 /yI D Y N12Z 3571 Fos ttlNalssf oewinns w f T.soa ooa soairwiNLrtae t i f 11NsaiiV,A tlAa OCCUR CLAIMOaAlIOa ascas UAallo EACH OCCLislillC! f MITIMINIMA 1Y s rIIDluassscorlraNislaN ANY LMMUitl N cw nc Mash sa<xLaot I1�,[ireNh�tlnM NIA ELIMNACCOW iLDI fAia-EJ1OlI�< i IL DlW" -POLICY Laln f p � oasesrsloMa�arasnoss/LocAnons/vrNNx s pNMnAMDM.Assam sswwftforr^If—.awl AM ftnmt NM, COB8:1008-KA.t1�94.O2.iCl4 NT c7 -TI WCD -: c7) CERINWATEHOL.nM---.--.• ----- Monrloe County 8"rd of Courlby ConMntlston/LDS SNOULD ANY OF nN ABOVE WWR W POLICIES BE CANQSIM se40RE THE 1100 tlidrrlOnton tJI MTm DATE THEREOF, NOTICE YMILL BE OEI. vom IN Rom 2216 ACCORDANCE mm TM POLICY PROVNpDNL Kay West, FL 33040 1- ACORD 23 (2010ATS) MTMOMM M8PFA$WtATM 01985401 ACI The ACORD norm and logo are rooWMsd Mort of ACORD [7w1 1001486 IZ".7 03.01 012 TE :o d CERTIFICATE OF LIABILITY INSURANCE °"1110s20° 3"' THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATNELY 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 INSUIRER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. N SUBROGATION 18 WANED, subject to the terms and conditions of the policy, certain policies may require an endomemenL A statament on this certificate doss not confer rights to the certificate holder in lieu of such endommneM(s). Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road QCutler Bay, FL 33189 Pedro Faloon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key, FL 33043 REVISION NUMBERS COYEIiAUM6 vcR t trtvw 116 nvmvac.. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED SELOW 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 VIMICH 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. R LIMGUERAL TYPE OF INfURANCE N LIMITS LIABILITY COMMERCIAL GENERAL LIABLITY CLAIMS411ADE OCCUR 7 EACH OCCURRENCE i $ 7 NED EV ono I, e PERSONAL A ADV INJURY B GENERAL AGGREGATE e PRODUCTS - COMPIOP AGG S GERL AGGREGATE LIMIT APPLIES PER: POLICY LOC $ A AUTOMOBILE IJA9ILrrY ALL r-1 ANY Auto AUTO X I�UITOBNON-0�mw HIRED AUTOS AUTOS Y 113 7133 E10 59 851 1825 E07 59 1110712013 11WI2013 05107rm14 0=712014 SINGLE UMFr 1,000,000 ODDLY INJURY (Pa pswon) B BODM.Y INJURY (Pw 000fdont) _ UMBRELLA LIAR EXCESS LIAM OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE S f OEp I I RETENTION rroRIM" COMPLNSATM ANY �VE Y-1 Pkaddwy LASER EXCLUDED?N B , drab under / A E.LEACH ACCIDENT i E.L.DIBEASE - EA B E.L. DISEASE - POLICY L rr B N —rT �. O C'. Ti �R D�CRIP110N OF OPERATIONS I LOCATIONS I VEMCLSO Wbeh ACORD te1, Addltland Ronutb BdwduN. N moot opine Is toqulnd) Project: ADA Segment 04 � ?� Policy In effect until 30 day canoellation notice — 3 __ wa rn - � o -- o Monroe County Board of County Commission 1100 Simonton Street RM 2-216 Key West, F133040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOVAIED REPRfSENTATM a Issa zol0 ACORD CORPORATION. All rights reserved. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD 1001488 132649.7 03-01-2012 A� ® DATE (02/2014 Y) CERTIFICATE OF LIABILITY INSURANCE 01/02/2014 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 poll cy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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). _ PRODUCER Ellie Mills Inusrance Agency, Inc. NAME: Janke KOWIOn FAX PHO N 305-238-8688 No): 30 238 8608 20330 Old Cutler Road EMAIL ADDRESS: •anice.rowton.i b statefarm.com Cutler Bay, FL 33189 INSURE S AFFORDING COVERAGE NAIC # O INSURER A: State Farm Mutual Automobile insurance Company 26178 INSURED Pedro Falcon Electrical Contractors, Inc. INSURER 8: 31160 Avenue C INSURER C : Big Pine Key, FL 33043 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE:.TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AD L UB INSSR TYPE OF INSURANCE W LWn POLICY NUMBERLTR POLICY EFF POLICY EXP LIMITS M M D GENERAL LIABILITY ❑ EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ APP RT CLAIMS F—IOCCUR BY MENT MED EXP (Any one person) $ -MADE � PERSONAL 8 ADV INJURY $ WAIV R / r GENERAL AGGREGATE $ PRODUCTS -COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC $ I ED SINGLE LIMIT$ t,000,000 AUTOMOBILE LIABILITY � 898 3933 A08 59 01/08/2014 07/08/2014 Ea accident A BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON -OWNED X PROPERTY DAMAGE Per accident $ HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE JD_ AGGREGATE $ ED RETENTION $ U- OTH- WORKERS COMPENSATION IT R AND EMPLOYERS' LIABILITY Y / N IDENT 7DISEASE!- $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEIMEMBER EXCLUDED? N / A ❑ EA EMPLOYE $ (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT 9 nF—RIPTION OF OPERATIONS below ❑ ❑ f V �y 114 I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is requlreQ(0,1ii 1Fr ryF „PIS DESCRIPTION OF OPERATIONS I LOCATIONS pi11 Ti ADA Segment #4, CDBG: 10DB-K4-11-52-K24 1 JA N , � �p CD TIME, u _' RECEIVED GJ - n Ahrf+CI r ATIf1W Monroe County Board of County Commissioners 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 WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE f I Ia,M O ACORD 25 (2010105) 01988-2010 ACORD The ACORD name and logo are registered marks of ACORD ;ATION. All rights reserved. 1001486 132849.7 03-01-2012 A� ® CERTIFICATE OF LIABILITY INSURANCE 01/0212014 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 Ellie Mills Inusrance Agency, Inc. enc g y 20330 Old Cutler Road Cutler Bay, FL 33189 NAME: J anice Rowton FAX PNONE 305-238-8688 W No:305-2388-608 ADDREss:'anice.rowtonJ b statefarm.com INSURE S AFFORDING COVERAGE NAIL S INSURER A: State Farm Mutual Automobile Insurance Company 2 178 O INSURED Pedro Falcon Electrical Contractors, Inc. INSURERB: INSURER C : 31160 Avenue C Big Pine Key, FL 33043 INSURER D : INSURER E : INSURER F ee�n��ar su rarnco. COVERAGES L cm I Irm m I c munnocn. 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 A Lwyn U POLIW NUMBER POLICY EFF IMM1ODIYYYYlM POLICY EXP IYYYY LIMITS EACH OCCURRENCE $ GENERAL LIABILITY ❑ PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE1:1 OCCUR a 1 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ r�1 PRODUCTS - COMP/OP AGG $ a 6459389 D09 59 113 7113 El 59 4759 C09 59 10/26/2013 11/10/2013 09/09/2013 04/26/2014 05/13/2014 03/09/2014 KEWL AGGREGATE LIMIT APPLIES PER: POLICY j LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS NON-OWNEDD09 HIRED AUTOS AUTOS Ea Iea:dennt I L L $ $ 1,000,000 A BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LtAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ a DED RETENTION $ WORKERS COMPENSATION WC STATU- OTH- TOR1 IT E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICEIMEMBER EXCLUDED? N / A ❑ E.L. DISEASE - EA EMPLOYEO $ (Mandatory in NH) Ir yes, describe under E.L. DISEASE - POLICY LIMIT $ E E MOIL g O t Cou - C, evP n DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD I01, Additional Remaen Schedule, If more space is roqui �t ADA Segment *4, CDBG: 10DB-K4-11-54-02-K24 JAN 0 t'u 14 a TIME._-._.-,,,_� =C '-"' RECENED BY: „J W t7 •• C --- W Monroe County Board of County Commissioners 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 WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE LK52�� 01988-2010 ACOtab 00APORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 A` CMEP CERTIFICATE OF LIABILITY INSURANCE °oiiou20° 4Y' 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 endomement(s). PRODUCER Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road Cutler Bay, FL 33189 O t NAME: Janke Rowton PHONE : 305-238-8688 FAIICC No): 305-2388-608 EA nRE ss: 'anice.rowton.i b statefarm.com INSURERS AFFORDING COVERAGE NAfC # INSURER A.- State Farm Mutual Automobile Insurance Company 26178 INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key, FL 33043 INSURERB: INSURER C : INSURER 0: INSURER E : 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. LTR OF INSURANCE L ADDTYPE SUB POLICY NUMBER MMMIIDDDY EFF MP�CY EXP LIMITS GENERAL LIABILITY El ❑ ` EACH OCCURRENCE $ PREMISES Ea 000urrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PP I NI MED EXP (Any one person) $ PERSONAL & ADV INJURY $ R — GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ POLICY PRO- M LOC A AUTOMOBILE LIABILITY a ❑ 022 3871 F03 59 12/03/2013 OW0312014 Ea accident INEDIN I $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO D07 7437 D26 59W 10/2612013 04/26/2014 BODILY INJURY (Per accident) $ ALL OWNED X SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 651 1826 E07 59T 030 5488 B29 590 11/13/2013 08/29/2013 06/07/2014 02/28/2014 PROPERTY PROPERTY DAMAGE Per t $$ A MBREL LIAB OCCUR EACH OCCURRENCE $ RD AGGREGATE $ XCESS LIAB CLAIMS -MADE ED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICE/MEMBER EXCLUDED? (Mandatory In NH) N / A ❑ TRY IM T O R E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.. ISEASE LICY LIMB 0.4'T1 If yes, describe under QFSCRIPTIr)N OF OPFRATIONS below (;Out*, Ojj t� L� � DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) ADA Segment #4, CDBG: 10DB-K4-11-54-02-K24,tL. DECEIVED 9Y; 3 ;-� cia Monroe County Board of County Commissioners 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 WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010106) ©1988-2010 TION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 DATE (MMIDDIYYYY) ,�`coRo® CERTIFICATE OF LIABILITY INSURANCE 02/25/2014 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 endorsement(s). CONTACT PRODUCER Ellie Mills Inusrance Agency, Inc. NAME: Janice ROWton PHONE 305 238 8688 AIC No): 305-2388-608 20330 Old Cutler Road E-MAIL Bay, FL 33189 ADDREss: 'anice.rowton.i b statefarm.com OCutler INSURERS AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 25178 INSURED Pedro Falcon Electrical Contractors, Inc. INSURERB: 31160 Avenue C INSURER C: Big Pine Key, FL 33043 INSURER D INSURER E : _ 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 DDL R POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MMIDDIWYY GENERAL LIABILITY ❑ ❑ EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE1:1 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7 PRO- LOC $ MBINEDSIN ELIMIT $ 1,000,000 A AUTOMOBILE LIABILITY ❑ 030 5488 B29 59Q 02/28/2014 08/28/2014 Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED X SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON OWNED Per accident 1 4 a t HIRED AUTOS AUTOS r UMBRELLA LIAB OCCUR ❑ ❑ P ENT EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE D ' AGGREGATE $ WAIVER$ DED RETENTION E WC STATU- OTH- WORKERS COMPENSATION T RY LIMIT ER AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA ❑ OFFICEIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ F)Fqr.PIPTION OF OPERATIONS below El El DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) ADA Compliance Segment #4 CERTIFICATE HOLDER ' CANCELLATION Monroe County Board of Count Commission SHOULD ANY OF THE ABOVE DESCRIBED POLICIES WILL CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street RM 2-216 a 1 I� ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL eQ 33040 a6 H 8VW �19Z AUTHORIZED REPRESENTATIVE J /� � n � � y� uj­1� ©1988-2010 ACO C PORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 rcurtw� yr Iu• L.K DATE WAIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE1 Q3„2!4 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate 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 does not confer rights to the certificate holder in lieu of such endorsemen s . PRODUCER BUD-ADA-UUOO NAME: rVJLAAP►Ia1 wvvcl�nn+n�I� BUTLER, BUCKLEY, DEETS INC. PHONE 785 2161764 AfC No : 305 2620086 6161 BLUE LAGOON DR., STE 420 MIAMI, FL 33126 ADDRE • BBODENHAMER BBOINS.COM William S. Bodenhamer e„e;lletelNsl lFFOROING covou[aE RAN FCCI Commercial Insurance INBURW PEDRO FALCON ELECTRICAL I INSImER 2: CONTRACTORS, INC. INSURERC: 31160 AVE C BIG PINE KEY, FL 33043-4516 wsuRERo: .,rwr.rinwTc aII IeaSCn. - REVISION NUMBER: GVVCKAUCJ vcl%I Ivma+r... 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. OMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, MiLTIt TYPE Of e13URANCE POLICY NUMBER MNI Y MVWuImTS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS RUDE t. w 1 OCCUR X �GL 0008235 5 03I13114 03113115 EACH OCCURRENCE $ 1,000,0 001 EMISES Es occurrence6nc $ 100,00 MED EXP ( one Person) $ 5,00 01 PERSONAL d ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2+0W00+00 PRODUCTS - COMPtOP AGG 3 2,000, GENL AGGREGATE LIMIT APPLIES PER POLICY 1 1f I PRO toe COMBINED SINGLE LIMITIs $ AUTOMOBILE LIABILITY es BODILY INJURY (Per person) S ANY AUTO ALLOWNED SCHEDULED AUTPRaOr HIRED AUTOS AUTOS BODILY INJURY (Per accdrd) S TY 3 s A X UMBRELLA LIASI excess LJA9 OCCUR HCLAtMS-MADE MOOOOS173 6 03113114 03/13/15 EACH OCCURRENCET_ $ 41000I OIX- AGGREGATE s 4,000+ X YrC STATU OTIh 3 DED I x I RETENTION 10,000 WORKERS COMPENSATION E.L. EACH ACCIDENT s 600,00 A A AND EMPLOYERS UABRM YIN ANY PROPRfETORJPARTNERfEXECUTIVE ® OFFK:ERIMEMBER EXCLUOE07 (Maeda n in NH) a has. dsav+be un'w E IPflON OF OPERATIONS beloer INSTALLATION FLTR EQUIPMENT JOBSITE N i A 01-WC11A-66512 CM0004409.4 I BLANKET *SEE NOTE 11l02/13 03/13114 11l02114 03113116 E L, DISEASE - EA EMPLOYEE 3 500,00 El. DISEASE - POLICY LIMIT 3 500100 RENTAL *SEE N LEASED *SEE NO DESCRIPTIONI OF OPERATIONS 1 LOCATIONS 1 VEHICLES Attach ACORD 181, Additional Remarks Schedule, It mom apse Is required) '30 DAYS NOTICE OF CANCELLATION EXCEPT NOW 3AYMENT OF PREMIUM 10 DAYS.ProjeceADA Compliance Seggment $44, Monroe Co., FL, Facilities Interior B F public Access Areas. Additional Insured Monroe County Board sf County Commissioners D WAN ------------- Monroe County Board of County Commissioners 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 WILL. BE DELIVERED IN ACCORDANCE VWTH THE POLICY PROVISIONS. ACORD 25 (2010105) 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1 a A� o CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/05/2014 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 endorsement(s). PRODUCER Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road Cutler Bay, FL 33189 • t ONTACT NAME: Janice ROWton FAX PNOIAICNE . 305 238-8688 a/c No): 05-2388-608 E-MAIL ADDREss:'anice.rowton.i b statefarm.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 26178 INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key, FL 33043 INSURERS: INSURER C : INSURERD: INSURER E : INSURER F : GVVtKAt9t5 a.cr%1 Sri— - 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. OF INSURANCE A U POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP M/DDMIYY LIMITS TY ❑ EACH OCCURRENCE $ PREMISES Ea occurrence $ L GENERAL LIABILITY MED EXP (Any one person) $ -MADE OCCUR PERSONAL & ADV INJURY $ FRAA GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG $ E LIMIT APPLIES PER: Ea accidenCOINED SINGLE LIMIT $ $ 1,000,000 A PRO JECTLOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED x SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOS NON-OWNED Y ❑ D09 4759 C09 59 03/09/2014 09/09/2014 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident)$ UMBRELLA LIAB OCCUR ❑ EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE WC STATU- OTH- T RY LIMIT ER DIED RETENTION $ WORKERS COMPENSATION E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICE/MEMBER EXCLUDED? N / A ❑ E.L. DISEAS A EMPLOYE (Mandatory in NH) If yes, describe under helm E.L. DISEASE�POLICY LIMIT nF_qr.R1PTIQN OF OPrRATIONS DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project: ADA Compliance Segment #4 K GEMENT C3� YWAIVER N It Monroe County Board of County Commission 1100 Simonton Street RM 2-216 Key West, FL 33040 Attn: Ann Riger SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUT1InD17Cr1 DCDDFCCNTGTIVF 1 0) 1988-2010 ACORD d)hPbAATION. All rights reserved. ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 A� D® CERTIFICATE OF LIABILITY INSURANCE ATE D04/08/20 4 ) 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 Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road O Cutler Bay, FL 33189 CONTACT NAME: Janice ROwton PHONNo,E t • 305-238-8688 A/c No): 305-2388-608 ADDRESS: janice.rowton.l b statefarm.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance COm an 25178 INSURED Pedro Falcon Electrical Contractors, Inc. INSURERB: INSURER C : 31160 Avenue C Big Pine Key, FL 33043 INSURERD: INSURER E : 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 LTR TYPE OF INSURANCE ADDLSUBIR POLICY NUMBER POLICY EFF MM/DD/YYY POLICY EXP MMIDD/YY LIMITS GENERAL LIABILITY ❑ ❑ EACH OCCURRENCE $ MMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ MED EXP (Any one person) $ CLAIMS -MADE F—IOCCUR 4--lo PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ POLICY PRO-JECT LOC A AUTOMOBILE LIABILITY a ❑ 645 9389 D09 59 04/09/2014 10/09/2014 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALL OWNED X SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PeOacEcRde DAMAGE $ UMBRELLA LIAR EXCESS LIAB CLAIMS -MADE El ❑ foe CQU �O jv 05 peVe,Opme EACH OCCURRENCE $ HOCCUR AGGREGATE $ DED I I RETENTION $ $ WORKERS CQIMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICE/MEMBER EXC ED? (Mandatory ImNH) �'_ If yes, descnbe under .-TION OF OPERATION- tglo%� N / A ❑ r y WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEAS A EMPLOY E.L. DISFJ1SGiPOLICY LIMI g ❑ ❑T f=1 DESCRIPTION OF OFERATIOR$I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project: ADA Compliant%'Segment # 4 _ c_ rri I'Mww V. L Monroe County Board of County Commission 1100 Simonton Street RM 2-216 Key West, FI 33040 Attn: Ann Riger SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUU ORIZ�SENTATIVE n IQRR-2010 ACORD ��tDY-\ ATION. All rights reserved. `ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 A� Ra CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDNM) 05/06/2014 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: N the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION 13 WAIVED, subject to the tsma and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate hokter In Ilau of such endorsernent(s). PRODUCER Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road Cutler Bay, FL 33189 Q CONTACT Janice Rowton PHONE F d E nice.rowton.i statefarm.com INSURE AFFORDING COVERAGE NAIC A INSURER A: Slate Farrn Mutual Automobile Insurance Company *=RED Pedro Falcon Electrical Contractors, Inc. INSURER■: INSURER C : 31160 Avenue C Big Pine Key, FIL33043 INSURERD: INSURER E : 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. I TYPE OF INSURANCE POLICY NUMBER LLMITf GENERAL LLr1Y1LLTY COMMERCVIL GENERAL LIABILITY CLAIMS -MADE OCCUR i I i EACH OCCURRENCE S EMI a c c n e S NED EXP orr perun) $ PERSONAL a ADV INJURY $ GENERAL AGGREGATE f GEN'LAGGREGATE LIMIT APPLIES PER- POLICY PRO- LOC PRODUCTS -COMPIOPAGG $ S A AUTOMOBILE LIAs1uTY ANY AUTO ALL ED x AUTOSULEO AUTOSTY HIRED AUTOS AUTOS�D Y 1151 113211 E07 59 I 113 711 E10 59 OM12014 05/10/2014 ' 11/Oli/2014 11/10/2014 I LI a $ 1.000,000 BODILYNJURY (Per pararnO) BODILYINJURY f BODILY INJURY (Peracadent) f PorPRO f f UMBRELLA LLAe EXCESS Lin OCCUR CLAIMS -MADE l I I EACH OCCURRENCE f AGGREGATE f DED RETENTIONS f WORKERS COMPENSATION AND EMPLOYEW LLIIBLRY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICEANld1ABER EXCLUDED? (Mandatory In NH) If yas, describe under NIA 171 I I T TA U- O - EL EACH ACCIDENT E. DISEASE • EA EMPLOYEdi E.L. DISEASE - POLICY LIMIT - f 15 f j Foo//, s toe Cou DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addid"I Remarks 1�uls, if me" "d) � ADA Compliance Segment #4 TI r 08 - ID; ME,• �l4 ^ECEP/fo _-�— WAIV A _ Monroe County Board of County Commission 1100 Simonton Street RM 2-216 Key West, FL 33040 Attn: Ann Rigor SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORMED REPRESENTATIVE TION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-ZUIZ 'k ' ® A`CCW CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDrrM) 05/07/2014 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 endorsement(s). PRODUCER Ellie Mills Inusrance Agency, Inc. 20330 Old Cutler Road Cutler Bay, FL 33189 AINSURER CONTACT NAME_._ Janice Rowton -_ PHONE a/�,_Nw_ t� 305-238-8688 _ i IC,Not: 305-2388-608 E-MAIL ADD RESS:-LaQice.rOWton.ic b statefarm.com INSURERS AFFORDING COVERAGE NAIC # A: State Farm Mutual Automobile Insurance Company 25178 INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key, FL 33043 INSURER B: INSURER C INSURER D : INSURER E : INSURER F : CERTIFICATE NUMBER' REVISION NUMBER: COVERAGES 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 I LTR TYPE OF INSURANCE ADOL SU BR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS GENERAL LIABILITY ❑ ❑ EACH OCCURRENCE $ PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ CLAIMS -MADE 7 OCCUR PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT Ea accident $ $ 1,000,000 A POLICY JECPROT LOC AUTOMOBILE LIABILITY i'I� j ❑� 651 1826 E07 59 05107/2014 11/07/2014 BODILY INJURY (Per person) $ ANY AUTO i D07 7437 D26 59W 04/26/2014 10/26/2014 BODILY INJURY (Per accident) $ ALL OWNED r\ l SCHEDULED ' PROPERTY DAMAGE Per accident $ AUTOS _ UTOS NONI'V� N E D HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR IIL��JJJ EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ STATU $ WORKERS COMPENSATION TORY LIM TS E.L. EACH ACCIDENTOFFICE/MEMBER AND EMPLOYERS' LIABILITY N ANY PROPRIETOR/PARTNERiEXECUTIVE YIN ❑(Mandatory JER DISEASE - EA EMPIfyes, EXCLUDED9 N / A in NH)E.L. describe under OF OPERATION'; bdow E.L. DISEASE -POLICY DrSCRIPTION I I i (Attach ACORD 101, Additional Remarks Schedule, if more space is required) DESCRIPTION OF OPERATIONS Faqffff&N�yVEHIpmen7 Vey O ADA Compliance Segment #4 MAY 121 2014 PPR F,NT`► TIA.A WAIVER N/A YES — HULUtK Monroe County Board of County Commission 1100 Simonton Street Rm 2-216 Key West, FL 33040 Attn: Ann Riger 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 t" ' / V y n 19RR-2010 ACORD 661tP.bRATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 3•1- STATE FARM INSURANCE COMPANIES® A 7401 Cy��e�s Gardena Boulevard Winter Haven FL 33888 DATE OF NOTICE: FEB 21 2013 CODE: 76948 536A AT1 19 000854 0093 MONROE CO ADM DEPT C/O MONROE COUNTY FAC DEV 1100 SIMONTON ST RM 2-216 KEY WEST FL 33040-3110 ADDITIONAL INSURED'S NOTICE OF COVERAGE NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. F�-219d 5 c 013 State Farm Mutual Automobile Insurance Company 6691-F600 NAMED INSURED: POLICY NO: 030 5488-1329-59P COVERAGE: PEDRO FALCON ELECTRICAL YR/MAKE/MODEL: 2008 FORD UTIL TRK BI AND PD LIABILITY CONTRACTORS INC VIN/CAMPER: 1 FDWF36538EE18804 1 MIL 2000 DED. COMP. 12000 31160 AVENUE C AGENT NAME: ELLIE MILLS INS AGCY INC DED. COLL. BIG PINE KEY FL 33043-4516 AGENT PHONE: (305)238-8688 ENDORSEMENT NO: 6028BV POLICY EFFECTIVE o FEB 28 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes poiloy# 0305488-590. The policy includes a lose payable clause protecting the additional insured's interest in the described oar to the extent of the insurance provided and subject to all policy provisions. The additional insured will be given 10 days notice if the policy is terminated. Until such notice Is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do to will render this policy null and void. ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 6691-F600-E NAMED INSURED: POLICY NO: 030 5488-1329-59P COVERAGE: PEDRO FALCON ELECTRICAL YR/MAKE/MODEL: 2008 FORD UTIL TRK BI AND PD LIABILITY CONTRACTORS INC VIN/CAMPER: 1 FDWF36538EE18804 $1 MIL $2000 DED. COMP. 31160 AVENUE C AGENT NAME: ELLIE MILLS INS AGCY INC 2000 DED. COLL. BIG PINE KEY FL 33043-4516 AGENT PHONE: (305)238.8686 ENDORSEMENT NO: 6028BV POLICY EFFECTIVE FEB 28 2013 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 0305488-590. The policy includes a loss payable clause protecting the additional insured's interest in the described oar to the extent of the insurance provided and subject to all policy provisions. The additional insured will be given 10 days notice if the policy is terminated. Until such notice Is provided, it shall be presumed that the required renewal premiums have been paid. The additional Insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. FRT