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Certificates of Insurance 1000ATL-01 REGANL DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F1/13/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CO NTT CT Linda Regan Insurance Office of America PHONE FAX 13361 Overseas Highway (A/C,No,Ext): (305)537-2782 (A/C,No): Marathon,FL 33060 E-MAIL Linda.Regan@ioausa.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Trisura Specialty Insurance Company 16188 INSURED INSURER B:FHM Insurance Company 10699 1000 Atlantic Blvd LLC dba Salute Restaurant INSURER C: 729 Thomas Street INSURER D: Key West,FL 33040 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MMIDDIYYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR OSU100615600 1/13/2023 1/13/2024 DAMAGE TO RENTED 100 000 X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PELT � LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: LIQUOR LIABILIT $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ ANY AUTO X OSU100616600 1/13/2023 1/13/2024 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident) ccident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN WC30600058172023A 1/1/2023 1/1/2024 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County BOCC is additional insured with respect to general liability and auto liability APPROVED BY RISK MANAGEMENT BY DATE 1/18/2023 WAIVER N/A YES CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Monroe County BOCC 1100 Simonton Street '? Key West FL 33040 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY INSURANCE CORPORATION COMMERCIAL PROPERTY POLICY DECLARATIONS POLICY NUMBER: 00039887-9 POLICY PERIOD FROM 10/16/2022 TO 10/16/2023 at 12:01 a.m.Eastern Time Transaction: RENEWAL CNR-W Pay Plan: Citizens Full Pay Bill: Insured Billed Named Insured and Mailing Address Agent FI.Agent Lic.# 1000 ATLANTIC BOULEVARD, LLC SHEILA ANN SERRANO W032348 729 THOMAS ST EAGLE AMERICAN INSURANCE AGENCY, KEY WEST, FL 33040 LLC 1855 W.STATE ROAD 434 LONGWOOD, FL 32750 Telephone: 305-296-8666 Telephone: 407-998-4276 IN RETURN FOR THE PAYMENT OF THE PREMIUM,AND SUBJECT TO ALL THE TERMS OF THIS POLICY,WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE FOR WHICH A PREMIUM IS INDICATED.THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENTS. PREMIUM COMMERCIAL PROPERTY COVERAGE m $19,005.00 Required Additional Charges: 2022 Florida Insurance Guaranty Association (FICA) Regular Assessment $133.00 2022-B Florida Insurance Guaranty Association (FICA) Regular Assessment $247.00 Catastrophe Financing Surcharge $2,851.00 Tax-Exempt Surcharge $333.00 TOTAL: $22,569.00 See Form CDEC-FE-SCH—Commercial Policy Forms And Endorsements Schedule Countersigned: 08/17/2022 Authorized By: SHEILA ANN SERRANO BY: Issued Date: 08/17/2022 e� M Barry J.Gilway President/CEO and Executive Director Citizens Property Insurance Corporation CDEC1 08 21 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 4 with its permission. CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY INSURANCE CORPORATION COMMERCIAL PROPERTY POLICY DECLARATIONS Policy Number: 00039887-9 Effective Date: 10/16/2022 to 10/16/2023 Insured Name: 1000 ATLANTIC BOULEVARD,LLC LOCATION NO. 1 BUILDING OR SPECIAL CLASS ITEM NO. 1 CSP Code: 0542 BUSINESS DESCRIPTION: Restaurants-With cooking DESCRIPTION OF PREMISES 1: 1000 ATLANTIC BLVD ONE STORY MASONRY RESTAURANT BLDG NOT INCLUDING FABRIC CANOPY Location Address Group I Construction Group II Construction Protection Class BCEGS Grade 1000 ATLANTIC BLVD N/A Masonry N/A Ungraded KEY WEST,FL 33040-4852 Group I Territory Group II Territory Coastal Territory No.of Units N/A N/A Monroe-86 1 COVERAGES PROVIDED Insurance at the Described Premises Applies Only For Coverages For Which A Limit Of Insurance Is Shown. Covered Total Replacement Limit Of Causes Cost/BPP Actual Coverage Insurance Of Loss Cash Value Rates Premium First Loss Building(Bldg) $761,000 Wind $761,000 Class $14,587.00 No Business Personal Property(BPP) $150,000 Wind $150,000 Class $2,636.00 No Your coverage limits have been adjusted for inflation. OPTIONAL COVERAGES Applicable Only When Entries Are Made In The Schedule Below Coverage Premium Replacement Cost Building Business Personal Property Yes No DEDUCTIBLE Hurricane,Other Windstorm or Hail Percentage Deductible Deductible Percentage(Deductible Amount) Bldg:3%($22,830) BPP:3%($4,500) WINDSTORM MITIGATION FEATURES Terrain Year Built Roof Cover Roof Deck Roof-Wall SWR C 1949 N/A N/A Connection N/A N/A Building Type Roof Shape Windstorm FBC Wind Speed FBC Wind Design N/A N/A Protective Devices N/A N/A None Mortgageholder(s)&Other Policyholder Interest(s)—See Policy Interest Schedule. PREMIUM: $17,223.00 CDEC1 08 21 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 4 with its permission. CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY INSURANCE CORPORATION COMMERCIAL PROPERTY POLICY DECLARATIONS Policy Number: 00039887-9 Effective Date: 10/16/2022 to 10/16/2023 Insured Name: 1000 ATLANTIC BOULEVARD,LLC LOCATION NO. 1 BUILDING OR SPECIAL CLASS ITEM NO.2 CSP Code: 0542 BUSINESS DESCRIPTION: Fully Enclosed Restroom DESCRIPTION OF PREMISES 1: 1000 ATLANTIC BLVD ONE STORY MASONRY RESTROOM BLDG Location Address Group I Construction Group II Construction Protection Class BCEGS Grade 1000 ATLANTIC BLVD N/A Masonry N/A Ungraded KEY WEST,FL 33040-4852 Group I Territory Group II Territory Coastal Territory No.of Units N/A N/A Monroe-86 N/A COVERAGES PROVIDED Insurance at the Described Premises Applies Only For Coverages For Which A Limit Of Insurance Is Shown. Covered Limit Of Causes Total Coverage Insurance Of Loss Replacement Cost Rates Premium First Loss Building(Bldg) $93,000 Wind $93,000 Class $1,782.00 No Your coverage limits have been adjusted for inflation. OPTIONAL COVERAGES Applicable Only When Entries Are Made In The Schedule Below Coverage Premium Replacement Cost Building Business Personal Property Yes DEDUCTIBLE Hurricane,Other Windstorm or Hail Percentage Deductible Deductible Percentage(Deductible Amount) Bldg:3%($2,790) WINDSTORM MITIGATION FEATURES Terrain Year Built Roof Cover Roof Deck Roof-Wall SWR C 1949 N/A N/A Connection N/A N/A Building Type Roof Shape Windstorm FBC Wind Speed FBC Wind Design N/A N/A Protective Devices N/A N/A None Mortgageholder(s)&Other Policyholder Interest(s)—See Policy Interest Schedule. PREMIUM: $1,782.00 CDEC1 08 21 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 4 with its permission. PHILADELPHIANFIP Policy Number: 8704327227 INS(l RANCF, ("t .MPANIE Company Policy Number: 87043272272021 Agent: -INSURANCE OFFICE OF AMERICA INSURANCE OFFICE OF AMERICA INC 1855 W STATE ROAD 434 Payor: INSURED LONGWOOD,FL 327505069 Policy Term: 10/16/2022 12:01 AM-10/16/2023 12:01 AM Policy Form: GENERAL PROPERTY Agency Phone: (305)289-0213 To report a claim https://phlynood.manageflood.com visit or call us at: (888)200-5603 RENEWAL FLOOD INSURANCE POLICY DECLARATIONS NATIONAL FLOOD INSURANCE PROGRAM DELIVERY ADDRESS INSURED NAME(S)AND MAILING ADDRESS 1000 ATLANTIC BLVD LLC 1000 ATLANTIC BLVD LLC 729 THOMAS ST 729 THOMAS ST KEY WEST, FL 330407334 KEY WEST, FL 330407334 COMPANY MAILING ADDRESS INSURED PROPERTY LOCATION PHILADELPHIA INDEMNITY INSURANCE COMPANY 1000 ATLANTIC BLVD PO BOX 200584 KEY WEST, FL 330404852 DALLAS,TX 75320-0584 BUILDING DESCRIPTION: OTHER NON-RESIDENTIAL TYPE BUILDING DESCRIPTION DETAIL: RESTAURANT RATING INFORMATION BUILDING OCCUPANCY: NON-RESIDENTIAL BUILDING REPLACEMENT COST VALUE: $596,250 NUMBER OF UNITS: N/A DATE OF CONSTRUCTION: 01/01/1949 PRIMARY RESIDENCE: NO PROPERTY DESCRIPTION: SLAB ON GRADE(NON-ELEVATED),1 FLOOR(S),MASONRY CURRENT FLOOD ZONE: VE CONSTRUCTION FIRST FLOOR HEIGHT(FEET): 1.1 PRIOR NFIP CLAIMS: 0 CLAIM(S) FIRST FLOOR HEIGHT METHOD: FEMA DETERMINED MORTGAGEE/ADDITIONAL INTEREST INFORMATION FIRST MORTGAGEE: LOAN NO: N/A SECOND MORTGAGEE: LOAN NO: N/A ADDITIONAL INTEREST: MONROE COUNTY BOCC LOAN NO: N/A TOURIST DVLPMNT COUNCIL 1100 SIMONTON STREET KEY WEST,FL 330403110 DISASTER AGENCY: CASE NO: N/A DISASTER AGENCY: N/A RATE CATEGORY— RATING ENGINE COVERAGE DEDUCTIBLE COMPONENTS OF TOTAL AMOUNT DUE BUILDING: $200,000 $5,000 BUILDING PREMIUM: $6,336.00 CONTENTS: $150,000 $5,000 CONTENTS PREMIUM: $3,351.00 COVERAGE LIMITATIONS MAY APPLY.SEE YOUR POLICY FORM FOR DETAILS. INCREASED COST OF COMPLIANCE ICC PREMIUM: $75.00 Please review this declaration page for accuracy.If any changes are needed,contact your agent. ( ) Notes: The"FULL RISK PREMIUM"is for this policy term only. It is subject to change annually if there is any MITIGATION DISCOUNT: ($0.00) change in the rating elements.Your property's NFIP flood claims history can affect your premium,for questions COMMUNITY RATING SYSTEM REDUCTION: ($19.00) please contact your agency."MITIGATION DISCOUNTS"may apply if there are approved flood vents and/or the machinery&equipment is elevated appropriately.To learn more about your flood risk,please visit FULL RISK PREMIUM: $9,743.00 FloodSmart.gov/floodcasts. ANNUAL INCREASE CAP DISCOUNT: ($0.00) Irua STATUTORY DISCOUNTS: ($0.00) I DISCOUNTED PREMIUM: $9,743.00 Y, 77 RESERVE FUND ASSESSMENT: $1,754.00 DA:M 0 "I_L _ ,-2-- HFIAA SURCHARGE: $250.00 „_ FEDERAL POLICY FEE: $47.00 � m PROBATION SURCHARGE: $0.00 TOTAL ANNUAL PREMIUM: $11,794.00 IN WITNESS WHEREOF,we have signed this policy below and hereby enter into this insurance agreement. John Glomb/ resident and CEO Edward Sayago/VP&Deputy CLO This declarations page along with the Standard Flood Insurance Policy Form constitutes your flood insurance policy. Zero Balance Due -This IS Not A Bill Policy issued by: PHILADELPHIA INDEMNITY INSURANCE COMPANY Insurer NAIC Number: 18058 IIIIIIIIIIIIIIIIIIIIIIIII File: 21284047 Page 1 of 1 IIIIIIIIIII IIIIIIIIIIII DOCID: 177187089 Printed 10/10/2022 1000ATL-01 REGAN L DIYYYY) DATE(MMID CERTIFICATE OF LIABILITY INSURANCE FDATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CO NTT CT Linda Regan Insurance Office of America PHONE FAX 13361 Overseas Highway (A/C,No,Ext): (305)537-2782 (A/C,No): Marathon,FL 33060 E-MAIL Linda.Regan@ioausa.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Tokio Marine Specialty Insurance Company 23850 INSURED INSURER B:FHM Insurance Company 10699 1000 Atlantic Blvd LLC dba Salute Restaurant INSURER C: 729 Thomas Street INSURER D: Key West,FL 33040 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MMIDDIYYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR RES10335-02 10/16/2021 10/16/2022 DAMAGE TO RENTED 100 000 X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PELT LOC PRODUCTS-COMP/OPAGG $ 1,000,000 OTHER: LIQUOR LIABILIT $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ ANY AUTO X RES10336-02 10/16/2021 10/16/2022 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident) ccident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN WC30600058172022A 1/1/2022 1/1/2023 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County BOCC is additional insured with respect to general liability and auto liability APPROVED N MANAGEMENT Y...._ DATE 9/8/2022 AVE A YE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Monroe County BOCC r 1100 Simonton Streetm_' a.•� Key West FL 33040 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD -'� 1000ATL-01 J OH NSONSO CERTIFICATE OF LIABILITY INSURANCE DATE 10/14/2021Y) �•� 10/14/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Linda Regan Insurance Office of America PHONE FAX 13361 Overseas Highway (A/C,No,Ext): (A/C,No): Marathon,FL 33050 a DD" RIESS:Linda.Regan@ioausa.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Tokio Marine Specialty Insurance Company 23850 INSURED INSURERB:FHM Insurance Company 10699 1000 Atlantic Blvd LLC dba Salute Restaurant INSURER 7 729 Thomas Street INSURER D: Key West,FL 33040 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MWDD/YYYY MWDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR RES10335-02 10/16/2021 10/16/2022 rl DAMAGE TO RENTED 100 000 X PREMISES Ea occurrence $ MED EXP An one person) $ 5,000 Ap roved Risk Management 1 000,000 PERSONAL&ADV INJURY $ ' GEN'L AGGREGATE LIMIT APPLIES PER: � � � ��,� � GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- ❑ LOC 1,000,000 JECT OTHER: 10-20-2021 LIQUOR LIABILIT $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ ANY AUTO X RES10335-02 10/16/2021 10/16/2022 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N WC30600058172021A 1/1/2021 1/1/2022 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County BOCC is additional insured with respect to general liability and auto liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County BOCC AUTHORIZED REPRESENTATIVE Insurance Compliance PO Box 100085-FX Duluth GA 30096 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1000ATL-01 NORTHC A ® CERTIFICATE OF LIABILITY INSURANCE �211ti2TE(020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NA aCT Rick Aiken Insurance Office of America PHONE 13361 Overseas Highway (arc,No,En FAX ):(305)743-0494 I(NC,No);(305)743-0592 Marathon,FL 33050 ADaR s: INSURERIS)AFFORDING COVERAGE NAIC p INSURER A:Tokio Marine Specialty Insurance Company 23850 INSURED INSURER B 1000 Atlantic Blvd LLC dba Salute Restaurant INSURER C: 729 Thomas Street INSURER D Key West,FL 33040 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. ILIR TYPE OF INSURANCE IADN SUBR POLICY NUMBER POLICY EFF POLICY EXP(Mi+VRRIYYY'Q aalvRDIYYm LIMITS A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE S CLAIMS-MADE X OCCUR X RES10335-00 10/1612019 10/16/2020 pREM13 S Ela ra4a,e) $ 100,000 MED ESP(Any one person) S 5,000 PERSONAL II ADV INJURY S 1,000,000 GE/TI.AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000 X POLICY n PRO LOC PRODUCTS S 1,000,000 OTHER: LIQUOR LIABILIT 1,000,000 A AUTOMOBILE LIABILITY (!"d iNED dent) E LIMIT - ANY AUTO RES10335-00 10/16/2019 10116/2020 BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS�� ONLY AUTOS BODILYBODILY INJURY(Per agent) S PROPERTY DAMAGE X AUUTOS ONLY - AUTOS ONLDY (Per t)) S S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE __- DED RETENTIONS 'S WORKERS COMPENSATION PER OTH=' I C. AND EMPLOYERS'LIABILITY Y 1 N STATUTE ER ,ANY PROPRIETOR/PARTNER/EXECUTIVE EL.EACH ACCIDENT --'i S OFFICER/MEMBER EXCLUDED? N r A (Mandatory in NH) EL DISEASE-EA EMPLOYEE S II es.dawtbe under - DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY UNIT S DESCRIPTION OF OPERATIONS 1 LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if mom apace Is required) ^?, The certificate holder is a named additional insured on the general liablity policy. m The General Liability Policy has Hired 8 Non-Owned Auto Forms PLC-GLN-008(10/13)has$1,000,000 Each Occurrence Limit and$1,000,000 Aggregate Limit. B1PPRO\ I - N GEMENT DATE �no WAIVER N/A Y CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Monroe County BOCC �� 1100 Simonton Street (( J�� ,z IKey West,.FLA3040 % ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1000ATL-01 CAPWELLC ACOROA CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYY) 10/16/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEACT Linda Regan Keys Insurance Services a Division of IOA PHONE I FAX P.O.Box 500280 (A/C,No,Ext): (A/C,No): Marathon,FL 33050 ADDRESS:Linda.Regan@ioausa.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Tokio Marine Specialty Insurance Company 23850 INSURED INSURER B: 1000 Atlantic Blvd LLC INSURER C: 729 Thomas Street INSURER D: Key West,FL 33040 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 TYPE OF INSURANCE ANSL D SUBR WVD POLICY NUMBER POLICY EFF POLICY EXPDI LIMITS LTR (MMIOYYYY) (MM(DDIYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR RES10087-00 10/16/2018 10/16/2019 DAMAGE TO RENTED 100,000 X PREMISE. (Fa occurrence) $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 5E9 LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: LiqourLiability $ 1,000,000 AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY �l Y .I K M NA MENT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS DA BODILY INJURY(Per accident) $ _ HIRED NON-OWNED WAIVER / ES_ FpROPERTY DAMAGE AUTOS ONLY -AUTOS ONLY IPer accident) $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $- DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A ((Mandatory in H) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The certificate holder is a named additional insured on the general liablity policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Monroe County Board of County Commissioners 1100 Simonton Street IKey West,FL 33040 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD c � CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY INSURANCE CORPORATION POLICY CHANGE SUMMARY POLICY NUMBER:00039887-5 POLICY PERIOD FROM 10/16/2018 TO 10/16/2019 at 12:01 a.m.Eastern Time Transaction: RENEWAL Item • " ::' ;Prior Policy Information "'Amended Policy Information Locations and Buildings 1:1000 ATLANTIC BLVD 1:ONE STORY MASONRY RESTAURANT BLDG NOT INCLUDING FABRIC CANOPY Coverages Building Coverage Limit 497,000 514,000 Most Recent Inflation Amount Ext 497000.00 514000.00 Most Recent Inflation Amt TRC Ext 497000.00 514000.00 Building Coverage:Total Replacement Cost $497,000 $514,000 Additional Interest:(1st Mortgagee) Added Deleted Additional Interest:CAPITAL BANK,A DIV OF FIRST Added TENNESSEE BANK NA ISAOA ATIMA(1st Mortgagee) Hurricane,Other Windstorm or Hail Deductible Amount $14,910 $15,420 2:ONE STORY MASONRY RESTROOM BLDG Coverages Building Coverage Limit 61,000 63,000 Most Recent Inflation Amount Ext 63000.00 Most Recent Inflation Amt TRC Ext 61000.00 63000.00 Building Coverage:Total Replacement Cost $61,000 $63,000 Additional Interest:(1st Mortgagee) Added Deleted Additional Interest:CAPITAL BANK,A DIV OF FIRST Added TENNESSEE BANK NA ISAOA ATIMA(1st Mortgagee) Hurricane,Other Windstorm or Hail Deductible Amount $1,830 $1,890 dY t<U,-D' `'t`j�•!►I� GI MENT DATE ':jn�� i WAIVER N/A.I'Wf" _once U ) atOCY \j2.1ki't This summary is for informational purposes only and does not change any of the terms or provisions on your policy.Please carefully review your policy Declarations and any attached forms for a complete description of coverage. PCS 01 14 Page 1 of 1 c CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY INSURANCE CORPORATION COMMERCIAL PROPERTY POLICY DECLARATIONS POLICY NUMBER:00039887-5 POLICY PERIOD FROM 10/16/2018 TO 10/16/2019 at 12:01 a.m.Eastern Time Transaction: RENEWAL CNR-W Pay Plan:Citizens Full Pay Bill: Insured Billed Named Insured and Mailing Address Agent FL Agent Lic.# 1000 ATLANTIC BOULEVARD, LLC GRIMILDA BETANCOURT A021050 729 THOMAS ST EAGLE AMERICAN INSURANCE AGENCY, KEY WEST, FL 33040 LLC 5800 OVERSEAS HIGHWAY#43 MARATHON, FL 33050 Telephone:305-296-8666 Telephone:305-743-0494 IN RETURN FOR THE PAYMENT OF THE PREMIUM,AND SUBJECT TO ALL THE TERMS OF THIS POLICY,WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE FOR WHICH A PREMIUM IS INDICATED.THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENTS. PREMIUM COMMERCIAL PROPERTY COVERAGE PART $10,387.00 Required Additional Charges: Catastrophe Financing Surcharge $1,558.00 Tax-Exempt Surcharge $182.00 TOTAL: $12,127.00 See Form CDEC-FE-SCH—Commercial Policy Forms And Endorsements Schedule Countersigned:08/17/2018 Authorized By:GRIMILDA BETANCOURT BY: Issued Date:08/17/2018 Barry J.Gilway President/CEO and Executive Director Citizens Property Insurance Corporation CDEC1 08 18 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 4 with its permission. CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY INSURANCE CORPORATION COMMERCIAL PROPERTY POLICY DECLARATIONS Policy Number:00039887-5 Effective Date: 10/16/2018 to 10/16/2019 Insured Name: 1000 ATLANTIC BOULEVARD, LLC LOCATION NO. 1 BUILDING OR SPECIAL CLASS ITEM NO. 1 CSP Code: 0542 BUSINESS DESCRIPTION: Restaurants-With cooking DESCRIPTION OF PREMISES 1000 ATLANTIC BLVD ONE STORY MASONRY RESTAURANT BLDG NOT INCLUDING FABRIC CANOPY Location Address Group I Construction Group II Construction Protection Class BCEGS Grade 1000 ATLANTIC BLVD N/A Masonry N/A Ungraded KEY WEST,FL 33040 Group I Territory Group II Territory Coastal Territory No.of Units N/A N/A Monroe-86 1 COVERAGES PROVIDED Insurance at the Described Premises Applies Only For Coverages For Which A Limit Of Insurance Is Shown. Total Covered Replacement Limit Of Causes Cost/BPP Actual Coverage Insurance Of Loss Cash Value Coinsurance Rates Premium First Loss Building(Bldg) $514,000 Wind $514,000 80% Class $7,472.00 No Business Personal Property $150,000 Wind $150,000 80% Class $1,999.00 No (BPP) Your coverage limits have been adjusted for inflation. OPTIONAL COVERAGES Applicable Only When Entries Are Made In The Schedule Below Coverage Premium Replacement Cost Building Business Personal Property Yes No DEDUCTIBLE Hurricane,Other Windstorm or Hail Percentage Deductible Deductible Percentage(Deductible Amount) Bldg: 3%($15,420) BPP:3%($4,500) WINDSTORM MITIGATION FEATURES Terrain Year Built Roof Cover Roof Deck Roof-Wall SWR C 1949 N/A N/A Connection N/A N/A Building Type Roof Shape Windstorm FBC Wind Speed FBC Wind Design N/A N/A Protective Devices N/A N/A None Mortgageholder(s)&Other Policyholder Interest(s)—See Policy Interest Schedule. PREMIUM:$9,471.00 CDEC1 08 18 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 4 • with its permission. CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY INSURANCE CORPORATION COMMERCIAL PROPERTY POLICY DECLARATIONS Policy Number:00039887-5 Effective Date: 10/16/2018 to 10/16/2019 Insured Name: 1000 ATLANTIC BOULEVARD, LLC LOCATION NO. 1 BUILDING OR SPECIAL CLASS ITEM NO.2 CSP Code:0542 BUSINESS DESCRIPTION: Fully Enclosed Restroom DESCRIPTION OF PREMISES 1000 ATLANTIC BLVD ONE STORY MASONRY RESTROOM BLDG Location Address Group I Construction Group II Construction Protection Class BCEGS Grade 1000 ATLANTIC BLVD N/A Masonry N/A Ungraded KEY WEST,FL 33040 Group I Territory Group II Territory Coastal Territory No.of Units N/A N/A Monroe-86 N/A COVERAGES PROVIDED Insurance at the Described Premises Applies Only For Coverages For Which A Limit Of Insurance Is Shown. Covered Total Limit Of Causes Replacement Coverage Insurance Of Loss Cost Coinsurance Rates Premium First Loss Building(Bldg) $63,000 Wind $63,000 80% Class $916.00 No Your coverage limits have been adjusted for inflation. OPTIONAL COVERAGES Applicable Only When Entries Are Made In The Schedule Below Coverage Premium Replacement Cost Building Business Personal Property Yes DEDUCTIBLE Hurricane,Other Windstorm or Hail Percentage Deductible Deductible Percentage(Deductible Amount) Bldg:3%($1,890) WINDSTORM MITIGATION FEATURES Terrain Year Built Roof Cover Roof Deck Roof-Wall SWR C 1949 N/A N/A Connection N/A N/A Building Type Roof Shape Windstorm FBC Wind Speed , FBC Wind Design N/A N/A Protective Devices N/A N/A None Mortgageholder(s)&Other Policyholder Interest(s)—See Policy Interest Schedule. PREMIUM:$916.00 CDEC1 08 18 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 4' with its permission. CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY INSURANCE CORPORATION COMMERCIAL PROPERTY POLICY DECLARATIONS Policy Number:00039887-5 Effective Date: 10/16/2018 to 10/16/2019 Insured Name: 1000 ATLANTIC BOULEVARD, LLC FLOOD COVERAGE IS NOT PROVIDED BY THIS POLICY. WINDSTORM OR HAIL DEDUCTIBLES ARE CALCULATED ON TOTAL REPLACEMENT COST OR ACTUAL CASH VALUE, NOT THE LIMIT OF INSURANCE. THIS POLICY CONTAINS A CO-PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. Coinsurance contract: The rate charged in this policy is based upon the use of the coinsurance clause attached to this policy, with the consent of the insured. INFORMATION ABOUT YOUR POLICY MAY BE MADE AVAILABLE TO INSURANCE COMPANIES AND/OR AGENTS TO ASSIST THEM IN FINDING OTHER AVAILABLE INSURANCE MARKETS. TO REPORT A LOSS OR CLAIM CALL 866.411.2742 PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY.IF YOU ARE UNABLE TO CONTACT YOUR AGENT,YOU MAY REACH CITIZENS AT 866.411.2742. CDEC1 08 18 Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 4 with its permission. _ CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY INSURANCE CORPORATION COMMERCIAL PROPERTY POLICY FORMS AND ENDORSEMENTS SCHEDULE POLICY NUMBER 00039887-5 POLICY PERIOD FROM 10/16/2018 TO 10/16/2019 at 12:01 a.m.Eastern Time Named Insured 1000 ATLANTIC BOULEVARD, LLC An entry below of"All"indicates the form applies to all items scheduled in the policy Location No. Building No. Form No. Edition Date Description ALL ALL IL 09 35 07 02 EXCLUSION OF CERTAIN COMPUTER- RELATED LOSSES ALL ALL CIT W14 20 02 14 CITIZENS CHANGES-PROPERTY NOT COVERED ALL ALL CP 01 40 07 06 EXCLUSION OF LOSS DUE TO VIRUS OR BACTERIA ALL ALL CIT 03 21 '01 14 WINDSTORM OR HAIL PERCENTAGE DEDUCTIBLE ALL ALL IL P 001 01 04 U.S.TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL("OFAC") ADVISORY NOTICE TO POLICYHOLDERS ALL ALL ' CIT W02 55 02 16 FLORIDA CHANGES-CANCELLATION AND NONRENEWAL ALL ALL CIT W10 10 02 16 CAUSES OF LOSS-WINDSTORM OR HAIL FORM ALL ALL IL 01 75 09 07 FLORIDA CHANGES-LEGAL ACTION AGAINST US ALL ALL CP 00 90 07 88 COMMERCIAL PROPERTY CONDITIONS ALL ALL IL 00 17 11 98 COMMON POLICY CONDITIONS 1 ALL CIT CNRW 01 25 02 16 FLORIDA CHANGES 1 ALL CP 00 10 06 07 BUILDING AND PERSONAL PROPERTY COVERAGE FORM 1 ALL CIT CNRW 00 03 02 16 TABLE OF CONTENTS-BUILDING AND PERSONAL PROPERTY 1 1 CP 12 18 06 07 LOSS PAYABLE PROVISIONS 1 2 CP 12 18 06 07 LOSS PAYABLE PROVISIONS Issued Date:08/17/2018 First Named Insured Copy CDEC-FE-SCH 01 14 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. cr1.— CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY INSURANCE CORPORATION COMMERCIAL PROPERTY POLICY POLICY INTEREST SCHEDULE POLICY NUMBER 00039887-5 POLICY PERIOD FROM 10/16/2018 TO 10/16/2019 at 12:01 a.m.Eastern Time Named Insured 1000 ATLANTIC BOULEVARD, LLC Location No. Building No. Interest Type Name and Mailing Address 1 1 Loss Payable MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST Key West, FL 33040 Loan#TBD 1 1 1st Mortgagee CAPITAL BANK,A DIV OF FIRST TENNESSEE BANK NA ISAOA ATIMA PO BOX 702037 DALLAS,TX 75370-2037 Loan#141419529156 1 2 Loss Payable MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST Key West, FL 33040 Loan#TBD 1 2 1st Mortgagee CAPITAL BANK,A DIV OF FIRST TENNESSEE BANK NA ISAOA ATIMA PO BOX 702037 DALLAS,TX 75370-2037 Loan#141419259156 Issued Date:08/17/2018 First Named Insured Copy CDEC-PI-SCH 01 14 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY INSURANCE COMMON POLICY CHANGE SUMMARY POLICY NUMBER:00039887-5 POLICY PERIOD FROM 10/16/2018 TO 10/16/2019 at 12:01 a.m.Eastern Time Transaction:AMENDED DECLARATIONS Effective:10/30/2018 • Item Prior Policy Information Amended Policy Information Policy Info Affirmation of Coverage Yes Locations and Build ngs 1:1000 ATLANTIC BLVD 1:ONE STORY MASONRY RESTAURANT BLDG NOT INCLUDING FABRIC CANOPY Additional Interest:CAPITAL BANK,A DIV OF FIRST Added. Deleted TENNESSEE BANK NA ISAOA ATIMA(1st Mortgagee) 2:ONE STORY MASONRY RESTROOM BLDG Additional Interest:CAPITAL BANK,A DIV OF FIRST Added Deleted TENNESSEE BANK NA ISAOA ATIMA(1st Mortgagee) 1t ,� EMENT LATE WAVER N/ Sr-- kid a- h - r• This summary is for informational purposes only and does not change any of the terms or provisions on your policy.Please carefully review your policy Declarations and any attached forms for a complete description of coverage. I PCS 01 14 I Page 1 of 1 CRIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPERTY CUSURANCE CORPORATION COMMERCIAL PROPERTY POUCY POLICY INTEREST SCHEDULE POUCY NUMBER 00039887-5 POUCY PERIOD FROM 10118/2018 TO 10/16/2019 at 12:01 a.m.Eastern lime Named Insured 1000 ATLANTIC BOULEVARD,LLC Location No. Building No. Interest Type Name and Mailing Address 1 1 Loss Payable MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST Key West,FL 33040 Loan#TBD 1 2 Loss Payable MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST Key West,FL 33040 Loan#TBD • Issued Date: 10/31/2018 First Named Insured Copy CDEC-PI-SCH 01 14 Includes copyrighted material of Insurance Services Office,Inc., Page 1 of 1 with its permission. tri4 Policy Number:87043272272018 FLOOD POLICY DECLARATIONS °t'■a Philadelphia Indemnity Insurance Company Standard Policy Pre-FIRM Subsidized Type: Renewal Policy Period: 10/16/2018 To 10/16/2019 For payment status, call: (888) 245-7274 Original New Business Effective Date: 10/16/2008 These Declarations are effective Reinstatement Date: as of: 10/16/2018 at 12:01 AM Form: General Property Producer Name and Mailing Address: Insured Name and Mailing Address: EAGLE AMERICAN INSURANCE AGENCY LLC 1000 ATLANTIC BLVD LLC DBA KEYS INSURANCE SERVICES 729 THOMAS ST w PO BOX 500280 KEY WEST, FL 33040-7334 r+ a MARATHON, FL 33050-0280 m m b0 NAIC Number:18058 NFIP Policy Number: 8704327227 .. Agent::Agency h: 1574 Processed by: IZ('G?rt'ncY!#:08648-02057-000 Flood Insurance Processing Center Phone# (305)743-0494 P.O. Box 2057 Kalispell MT 59903-2057 Property Location: Building Description: 1000 ATLANTIC BLVD Non-Res. Business KEY WEST, FL 33040-4852 One Floor O Slab On Grade umRESTAURANT ,i Primary Residence: x a, Premium Payor: Insured Flood Risk/Rated Zone: vE• Current Zone: Newly Mapped into SFHA: gs. Community Number:12 0168 1516 K o Elev DifL VA $, Community Name:KEY WEST, CITY OF Elevated Building: N Grandfathered: No Includes Addition(s) and Extension(s) Pre-Firm Construction Replacement Cost:- $596,250 Program Type: Regular Number of Units: 1 • "'-7 Type Coverage Rates Deduct Discount Sub Total Premium Calculation Building: 200,000 2.510 / 8.590 5,000 458- 6,083.00 Premium Subtotal: 12,960.00 CContent::: 150,000 4.930 /13.650 5,000 518-• 6,677.00 Multiplier, a Contents Lowest Floor Only Above ICC Pramium: 75.00 n: Location: Ground Level C liS Discount: 1,955.00 4 Reservt'Fund Asstnt: 1,662.00 to HFIAA Surehargo: 250.00 a aFederal Policy Fee: 50.00 o I'mbet ion Sunhatge: .00 Entlorsemc:nt Amount: .00 Coverage Limitations May Apply.See Your Policy Dorm for Details. Total Premium Paid: 13,042.00 First Mortgage: Loss Payee: • CAPITAL BANK NA MONROE COUNTY BOCC ISAOA TOURIST DVLPMNT COUNCIL 1100 SIMONTON STREET PO BOX 702037 KEY WEST, FL 33040 4 I DALLAS, TX 75370-2037 hp an Second Mortgage: Disaster Agency: t o ' MEW t�N OV D K BY DATE S WAI 'R Ni Plemd IAEO Sett...:C.ut..:,rt 17045272272018 08/09/2018 Philadelphia IndeanitY Insurance Capons PHLIOC_I IR OXP 000027296901 ACORN® DATE (MMIDDIYYM CERTIFICATE OF LIABILITY INSURANCE 11/10/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ELOW. 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(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 endorsements . PRODUCER CoMTACT Linda Regan Keys Iaauraaee Services PHONE (305) 743-0494 (� Ncic L305)743-ose2 5800 Overseas Hwy E DRESS: lreganBkeysinsurance.com P.O. Box 500280 INSURER{s) AFFORDING COVERAGE ,— _NAIC / Marathon FL 33050 INSURERA:L1oYdo of London INSURED INSURER B • 1000 Atlantic Blvd LLC, DBA: Salute Restaurant INSURER C:� _ 729 Thomas Street INSURERD: INSURER E • Rey West FL 33040 INSURER F: COVERAGES CERTIFICATE NUMBER:2015-2016 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. OISR AOD�iSUeR� POLICY EFF 1-POl1C1f E1IP-i — TYPE OF INSURANCE POUCY NUMN@t UN X COMMERCIAL GENERAL LIABILITY J [ EACHOCCURRENCE : S 11000,000 —t� (� ] i-OAMV0rTO RENTED 50,000 S A OCCUR CLAIMMADE S '_PREMISES {E/�neweL S X ARF0714e61004 10/16/2015 10/16/2016IrMEppjlplq�Irp� �_ S 11000 _ _ PERSONAL a ADV IWURY : S — -1. 000, 000 G_EN L AGGREGATE LIMIT APrPLIES PER. j GENERAL AGGREGATE S 2, 000, 000 X I POLICY �� I J LOC I ` PRODUCTS-COMPIOPAGG I S 1,000,000 OTHER L4= II is 1,000,000 AUTOMOBILE LIABILITY � D SINGLE LIMIT s (Ea scent)-_ I! ANY AUTO — BODILY INJURY (Per person) S � OS OWAS�DDULED I — BODILY IWURY(PeracodeM)j E ll NON -OWNED I HIRED AUTOS AUTOS PROPERTY DAMAGE �IPeraoadernj S — — S UMBRELLA LIAR HOCCUR I I Ij EACH OCCURRENCE S— EXCESS LIAR .MADE i : AGGREGATE_ S_ S I I CEO I RETENTION SI WORKERS COMPENSATION 1 STATUTE Elf AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTTVE I OFFICER UEMBER EXCLUDED? �I NIA I E L. EACH ACCIDENT IS r _. (Mandatory to NN) E L DISEASE - EA EMPLOYEE S M yyesss desrnbe under DESCRI A OF OPERATK)NS below - — -- - E L. DISEASE -POLICY LIMIT S i DESCRIPTION OF OPERATIONS ! LOCATIONS I VEHICLES (ACORD 101. Addidanal Remarks SCMdula, may be aRadhea N move spaco Is PR E RIS AGEMEM PA BD(`�1 �i4Pvj l� • WAVE N/ YE _ c c� CERTIFICATE HOLDER ""' " "' CANCELLATION (305) 292-4487 THE EXPIRATION DATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board Oc&O*nW Z I (COI{ S{Ujn Z ACCORDANCEWITHTHEPOLICY OF, NOTICE WILL BE DELIVERED IN Commissioners 1100 Simonton Street j (j Rey West, YL 330 4 0 �� U J' d 6 0 J Q 311A 1 At/THORI2ED REPRESENTATIVE ACORD 25 (2014101) INS025 (2ot001) Grimi Betancourt/LR ®1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Aco CERTIFICATE OF LIABILITY INSURANCE D/DD 10/16/2014 /1614 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 RESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IROVORTANT: 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 CONTACT Linda Regan Keys Insurance Services PHONE (305) 743-0494 TFAXIA/C (305)743-0582 5800 Overseas Hwy EMAIL .lregan@keys insurance. com P.O. BOX 500280 INSURERS AFFORDING COVERAGE NAIC# Marathon FL 33050 INSURERA:LlO ds of London INSURED INSURER B : 1000 Atlantic Blvd LLC, DBA: Salute Restaurant INSURERC: 729 Thomas Street INSURERD: J Rey West FL 33040 1 INSURERF: I COVERAGES CERTIFiCATF NIIMRFR!2014-2015 RFVISInN NIIMRFR- 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. INR LTR TYPE OF INSURANCE JhMLAaa L U R POLICY NUMBER MO/ DIYYY POI ICY EXP ODfYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR X hRPQ7148610 10/16/2014 10/16/2015 DA AGE To RENTED PREMI ES Ea occurrence $ 50,000 MED EXP (Anyoneperson) $ 1,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 TPOLICY PRO LOC $ (1UTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per. . dent $ HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N ! A TORY LIMITS E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ rks Schedule, If a space Is required) space DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Re:AP P I EME DATE WAIVE / _ C� te CFRTIFICATF H1171 "FR w 1-a A 1MI IU.7 L`ANPCI 1 ATIAW (305) 292 -4487 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board ofq 44 ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West, FL 33040 080338 8O3 03143 Grimi Betancourt/LR AGUKU ZO (ZUIUIU9) 0 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD Part 2: THIS AMENDED DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY 6676 Corpontte Center Parkway, Jacksonville, Florida 32216 -0973 S ale INSURED' S NAME AND ADDRESS �+ CHANGE NO. 1 THIS IS AN AMENDED .,1000 ATLANTIC BOULEVARD, LLC �~ 4ITiENS /79 THOMAS ST GENERAL BUSINESS KEY WEST, FL 33040 THIS CHANGE IS EFFECTIVE 10/16/2013 POLICY TERM 10/16/2013 TO 10/16/2014 AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY PAGE 2 Item AMOUNT 1NSURANCE Percent of Deductible No Building Contents Coinsurance Amount Territory Premium Applicable Nurri rang /nthar Wi nri $ $ % $ $ MORTGAGEE /LOSS PAYEES: 1 * CAPITAL BANK NA ISAOA PO BOX 702037 DALLAS, TX 75370 LOAN #141419529156 2 MONROE COUNTY BOCC (LOSS PAYEE) 1100 SIMONTON ST iS KEY WEST, FL 33040 N N- i t M N; . 10 CO i ' Z Payment Plan - R Total Coverage: Total Premium: = ( mmq ry - 1 CD 0 7...73 c k Subject to Form No (s) : ,=;D H rn £ CIT CP2 02 13 CNRW 01 10 01 10 - rt Mortgagee /Loss Payee 1,11 3? Z m (—) = F .• 0 ....._... t Agent: EAGLE AMERICANS INS 0532 Payor: CD AGENCY LLC INSURED MI i 5800 OVERSEAS HIGHWAY 43 M EEE 'E ARATHON, FL 33050 - Date: (305) 743 -0494 9/10/2013 CIT NO3 -CNR 01 10 05320 Team 3 MORTGAGEE COPY -02 QSY 80101 4 Pert 2: THIS AMENDED DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY 6676 Corporate Center Parkway, Jacksonville, Florida 32216-0973 INSURED' S NAME AND ADDRESS CHANGE NO. 1 THIS IS AN AMENDED 1000 ATLANTIC BOULEVARD, LLC 4 ` CITIZENS 29 THOMAS ST GENERAL BUSINESS KEY WEST, FL 33040 THIS CHANGE IS EFFECTIVE 10/16/2013 POLICY TERM 10/16/2013 TO 10/16/2014 AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY PAGE 1 AMOUNT OF INSURANCE Deductible Item Percent of No. Building Contents Coinsurance Amount Territory Premium Applicable Hnrri - na /n1 Wi nri Reason for Change: CHANGE MORTGAGEE $ $ % $ $ * THIS STATEMENT OF COVERAGE GIVES THE STATUS OF YOUR POLICY AFTER THE RECENT CHANGE(S). NO ADDITIONAL OR RETURN PREMIUM RESULTED FROM THIS CHANGE(S) 1 359,000 80 10,770 T -86 3,241 150,000 80 4,500 T -86 1,241 ONE STORY MASONRY RESTAURANT BLDG & CONTENTS NOT TO INCLUDE FABRIC CANOPY LOC: 1000 ATLANTIC BLVD KEY WEST, MONROE FL 33040 -4852 a n ` 2 59,000 0 80 1,770 T -86 533 0; co ONE STORY MASONRY RESTAURANT AUXILIARY BLDG o` ` . N co p AI 'L�R : CO-- lL w" • . ' _ Cc . }te, got, -Pio Payment Phut Total Coverage: $568,000 Full Pay Total Premium: $6,021 wins Premium Amount $ 5, 015 2005 Citizens Property Insurance Corporation Emergency Assessment $ 50 Tax Exempt Surcharge $ 8 8 2005 Florida Hurricane Catastrophe Fund (FHCF) Emergency Assessment $ 65 Catastrophe Reinsurance Surcharge $ 7 52 - 2009 Florida Insurance Guaranty Association Regular Assessment $ 3 M 2012 Florida Insurance Guaranty Association Regular Assessment $ 4 8 M III Subject to Form No(s): MEE c= WW0 ;— Mortgagee /Loss Payee _-_:C C.n ri l MIE ri MORTGAGEE /LOSS PAYEES LIST ON ADDITIONAL PAGE –7-1 (V CD Agent: EAGLE AMERICANS INS 0532 Payor: ri AGENCY LLC INSURED 9 5800 OVERSEAS HIGHWAY 43 MARATHON, FL 33050 - Date: � _ (305) 743 -0494 9/10/2013 CIT W03 -CNR 01 10 05320 Team 3 MORTGAGEE COPY -02 QSY 80101 3 Yart Z: 1 HIS DECLAKATION PAUE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY 6676 Corporate Center Parkway, Jacksonville, Florida 32216 -0973 INSURED NAME AND ADDRESS CITIZENS THIS IS A 1000 ATLANTIC BOULEVARD, LLC GENERAL BUSINESS 729 THOMAS ST KEY WEST, FL 33040 POLICY TERM 10/16/2013 10/16/2014 AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY PAGE 2 Item AMOUNT OF INSURANCE Percent of DEDUCTIBLES No. Building Contents Coinsurance Te Premium Applicable $ $ % $ $ MORTGAGEE /LOSS PAYEES: 1 CAPITAL BANK NA ISAOA PO BOX 7286 NATCHITOCHES LA 71457 LOAN #141419529156 2 MONROE COUNTY BOCC (LOSS PAYEE) 1100 SIMONTON ST KEY WEST, FL 33040 N CO a v CO v 1 Total Coverage: Payment Plan: Total Premium: mmm r = z Subject to Form No(s): r CIT CP2 02 13 CNRW 01 10 01 10 Mortgagee /Loss Payee: _) Agent: Payor: ZMWal EAGLE AMERICANS INS 0532 INSURED AGENCY LLC MEM 5800 OVERSEAS HIGHWAY 43 MARATHON, FL 33050 — } (305) 743-0494 Date: 8/26/2013 CIT W03 -CNR 01 10 05320 Team 3 MORTGAGEE COPY - 02 QSY R 40111 57 ran 1: 'THIS LELLARAIION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY 6676 Corporate Center Parkway, Jacksonville, Florida 32216 -0973 INSURED NAME AND ADDRESS � " �C ITIZENS THIS IS A 1000 ATLANTIC BOULEVARD, LLC GENERAL BUSINESS 729 THOMAS ST KEY WEST, FL 33040 POLICY TERM 10/16/2013 10/16/2014 AT 12 :01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY PAGE 1 Item AMOUNT OF INSURANCE Percent of DEDUCTIBLES No. Building Contents Coinsurance Applicable Territory Premium $ $ % $ $ 1 359,000 80 10,770 T -86 3,241 150,000 80 4,500 T -86 1,241 ONE STORY MASONRY RESTAURANT BLDG & CONTENTS NOT TO INCLUDE FABRIC CANOPY LOC: 1000 ATLANTIC BLVD KEY WEST, MONROE FL 33040 -4852 2 59,000 0 80 1,770 T -86 533 ONE STORY MASONRY RESTAURANT AUXILIARY BLDG N 0 N 0 m O m $ v O m v m v AP•. bi r ': wiaiku - WA VER N A YES_ (: C ;. �_ . Total Coverage: $568,000 Payment Plan: Full Pay Total Premium: $6,021 — E _ Premium Amount $ 5, 015 2005 Citizens Property Insurance Corporation Emergency Assessment $ 50 t M t Tax Exempt Surcharge $ 88 2005 Florida Hurricane Catastrophe Fund (FHCF) Emergency Assessment $ 65 MEI Catastrophe Reinsurance Surcharge $752 - t 2009 Florida Insurance Guaranty Association Regular Assessment $ 3 MEM 2012 Florida Insurance Guaranty Association Regular Assessment $ 4 8 Subject to Form No(s): LK rl ) ' Mortgagee /Loss Payee: - _ r, r .) � MORTGAGEE /LOSS PAYEES LIST ON ADDITIONAL PAGE C n CD Ms 3 rn Agent: Payor: : _.4 C7 EAGLE AMERICANS INS 0532 INSURED AGENCY LLC Cl1 EFIES'Ei 5800 OVERSEAS HIGHWAY 43 MARATHON, FL 33050 (305) 743 -0494 Date: 8/26/2013 I CIT W03 CNR 01 10 05320 Team 3 MORTGAGEE COPY -02 QSY R 40111 56 1 ® DATE (MM/DDIYYYY) AW ° CERTIFICATE OF LIABILITY INSURANCE 11i1i2012 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 D^''° `TAT rnMCTITIITF A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CE tTIFICAT - IMPORTANT: If the certificate holder is an ADDITIONAL I e i(ies) mus be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pc icies may require an endorsement. A . tatement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NUV — D 12O 0 E ACT Lin. Regan Keys Insurance Services PH Exe: (3 -0494 I aC.Nol: (305)743 -0582 5800 Overseas Hwy #43 l i ss , lre. n@keysinsurance.com P.O. Box 500280 INSURER S AFFORDING COVERAGE l NAIC # w . Na ;,'.."'�� Marathon FL 33050 -02:o r -- ds of London INSURED INSURER B : 1000 Atlantic Blvd LLC, DBA: Salute Restaurant INSURERC: 729 Thomas Street INSURERD: INSURER E : Key West FL 33040 _ INSURERF: COVERAGES CERTIFICATE NUMBER:2012 - 2013 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSR WVD POLICY NUMBER (MM /DD/YYYY) (MM /DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 50,000 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ A CLAIMS -MADE I X OCCUR X ARP1690981001 10/16/201210/16 /2013 MEDEXP(Anyoneperson) $ 1,000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG - $ 1,000,000 nl POLICY nFF nLOC $ AUTOMOBILE LIABILITY • COMBINED SINGLE LIMIT AP' ' • 6 , ' ' I G (Ea accident) ANY AUTO BY \ �� BODILY INJURY (Per person) $ ALL OWNED SCHEDULED DA iMAi', • AUTOS AUTOS �' BODILY INJURY (Per accident) $ _ NON -OWNED W PROPERTY DAMAGE $ HIRED AUTOS AUTOS o:ektvgd (Per accident) — ((. ■ ∎ $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED 1 RETENTION $ $ WORKERS COMPENSATION I TORY LIMITS - I I ER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE Y I N I N / A _ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 1 E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION (3 0 5) 2 92 - 4 4 87 SHOULD ANY OF THE ABA D - CRIBED POLICIES BE CANCELLED BEFORE THE E (RATION D • THE' EOF, NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissions ACCOR ANCE WITH E POLIC PROVISIONS. 1100 Simonton Street Key West, FL 33040 AUTHORIZE REPRES ATIV ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD Part 2: THIS DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY 6676 Co - . . _ ~ • 16-0973 INSURED NAME AND ADDRESS THIS IS A rxeuAr. vsawav ureenw 1000 ATLANTIC BOULEVARD, LLC �Ep GENERAL BUSINESS 729 THOMAS ST KEY WEST, FL 33040 • . 0 • . S' � IZEN' POLICY N0 POLICY TERM 10/16/2012 TO 10/16/2013 AT 12: t M 1473301 INCEPTION DATE EXPIRATION DATE This ■ i . ,� . - '' - '� . C IT . ' This is not a Bill - DO NOT PAY PAGE 1 AMOUNT OF :INSURANCE Percent or Dl Territory ! Premium Tt� . Coinsurance ac. Building Contents Anaiaable $ $ % $ $ 1 357,000 80 10,710 T -86 2,930 150,000 80 4,500 T -86 1,129 ONE STORY MASONRY RESTAURANT BLDG & CONTENTS NOT TO INCLUDE FABRIC CANOPY LOC: 1000 ATLANTIC BLVD KEY WEST, MONROE FL 33040 -4852 2 59,000 0 80 1,770 T -86 484 ONE STORY MASONRY RESTAURANT AUXILIARY BLDG N 0 N 0 M O_ • O APP s 0., To DA - oa:arge ere 6te7-tc. Cc. .6` l' Total Coverage: $566,000 Payment Plan: Full Pay Total Premium: $5,414 Premium Amount $ 4, 543 2005 Citizens Property Insurance Corporation Emergency Assessment $45 Tax Exempt Surcharge $ 8 0 2005 Florida Hurricane Catastrophe Fund (FRCP) Emergency Assessment $ 5 9 Emm Catastrophe Reinsurance Surcharge $ 681 2009 Florida Insurance Guaranty Association Regular Assessment $ 6 Subject to Form No(s): Mortgagee /Loss Payee: MORTGAGEE /LOSS PAYEES LIST ON ADDITIONAL PAGE amm Gc Agent: Payor: C KEYS INS SERVICES, INC. 5017 INSURED P.O. BOX 500280 MARATHON, FL. 33050 Date: 9/11/2012 (305) 743 -0494 CIT NO3 -CNR 01 10 50176 Team 3 MORTGAGEE COPY -02 QSY R 40111 73 Part 2: THIS DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY 6676 Corporate Center Parkway, Jacksonville, Florida 32216-0973 INSURED NAME AND ADDRESS 1/4 -- CITIZENS THIS IS A CITIZENS uae.nar 1000 ATLANTIC BOULEVARD, LLC GENERAL BUSINESS 729 THOMAS ST KEY WEST, FL 33040 POLICY TERM 10/16/2012 TO 10/16/2013 AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a BID - DO NOT PAY Item AMOUNT OF INbURARCE Percent of PAGE 2 DRDUCTI8 8 ri Territory Pretttium No Building Contents applicable $ $ % $ $ MORTGAGEE /LOSS PAYEES: 1 CAPITAL BANK NA ISAOA PO BOX 7286 NATCHITOCHES LA 71457 LOAN #141419529156 2 MONROE COUNTY BOCC (LOSS PAYEE) 1100 SIMONTON ST C KEY WEST, FL 33040 so ro Total Coverage: Payment Plan: Total Premium: Subject to Form No(s): CIT CP2 02 12 CNRW 01 10 01 10 Mortgagee /Loss Payee: Agent: Payor: KEYS INS SERVICES, INC. 5017 INSURED P.O. BOX 500280 Ewa MARATHON, FL 33050 ams MEI (305) 743 -0494 Date: 9/11/2012 CIT NO3 -CNR 01 10 50176 Team 3 MORTGAGEE COPY -02 QSY R 40111 74 ACORD CERTIFICATE F DATE (MANDD/YYYY) OF LIABILITY INSURANCE 4/30/2012 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 CERTIF'.,M, c rIVLUCR. IMPORTANT: If the certificate holder is an ADDITIONAL INSURKICURWID must be ndorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A state ent on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Linda R an 4141[2_ Keys Insurance Services, Inc. (A/C. No, FA: (305) 3 -0494 T (A/ , No): (305)743 -0567 5800 Overseas Hwy #43 AD RESS:lreJ'dn@ ysinsurance.com P.O. Box 500280 MONROMMIT # 00023 20 Marathon FL 33050 -0280 RISK MANAGEMENT ..'.. ER(S)AFFORDINGCOVERAGE NAIL# INSURED INSURER A :Lloyds Of London INSURER B : 1000 Atlantic Blvd LLC, DBA: Salute Restaurant INSURER C: 729 Thomas Street INSURERD: INSURER E : Key West FL 33040 INSURERF: COVERAGES CERTIFICATE NUMBER:Master 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 f ADDL SUBR POLICY EFF POLICY EXP ' LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM /DD/YYYY) (MM /DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ 50,000 A ! I CLAIMS -MADE � X O CCUR X A RPI6909810 10 /1 6 / 20 11 10/16/2 MED EXP (Any one person) _$ 1,000 PERSONAL 8 ADV INJURY I ' I $ 1,000,000 GENERAL AGGREGATE + 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG j $ 1,000,000 X POLICY 78 LOC ( i $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ' $ • (Ea accident) • 1 ANY AUTO • • • ED r 1 ∎ ' A MENT BODILY INJURY (Per person) $ ALL OWNED AUTOS , L� D x r — BODILY INJURY (Per accident) $ • SCHEDULED AUTOS D �� PROPERTY DAMAGE $ I HIRED AUTOS 6+ `6 (Per accident) - I vV r NON -OWNED AUTOS CC • -M (A. $ II os UMBRELLA LIAR I OCCUR EACH OCCURRENCE $ EXCESS LIAB r C LAIMS =MADE AGGREGATE $ r DEDUCTIBLE 1 $ , RETENTION $ $ WO RKERS COMPENSATION TORY I TU- i 1 ER ! AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE' I N / A _ E.L. EACH ACCIDENT $ DESCRIPTION OF OPERATIONS below (fM (Mandatory in N tl E L. DISEASE EA E under EXCLUDED? MFLOY $ E _ 1 rY NH) D E.L. DISEASE POLICY LIMIT $ I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) 0 C c...... rlat- 7 / c..k.._, CERTIFICATE HOLDER CANCELLATION (305) 292 - 44 87 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissions ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West, FL 33040 AUTHORIZED REPRESENTATIVE Frederick Aiken /XM ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (20osos) The ACORD name and logo are registered marks of ACORD . d. �. ..... .......... ..... �..�....,... �..., . ..,..� ....., ..L3..,..., - . A.... A.. .,...,.,..1J......,... 6.2, 11 .. .,,a .,.., .., ..,.... A PART THEREOF, COMPLETE THE BELOW NUMBERED FLORIDA WINDSTORM UNDERWRITING ASSOCIATION POLICY. CITIZENS PROPERTY "_ • •• - : :. • • WIND ONLY l te�rr 667. Corporate aville, Flcida 32216 -8091 INSURED'S NAME AND ADDRESS tV�M J Nc CH! NGE NO. 1 THISISANAMENDED 1000 ATLANTIC BOULEVARD, LLC o ^^�•^ �"�«'�' 729 THOMAS ST GENERAL BUSINESS KEY WEST, FL 33040 MONROE COUNTY THIf, CHANGE IS EFFECTIVE 10/16/2011 RISK MANAGEMENT POLICY TERM 10/16/2011 TO 10/16/2012 NI 1[:U1 A.M. (EST) POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY PAGE 1 AMOUNT OF INSURANCE Percent of Item Deductible No. Building Contents Coinsurance Amount Territory Premium Applicable Hurrir.ana /nthpr Wi nri Reason for Change: CHANGE MORTGAGEE $ $ % $ $ * THIS STATEMENT OF COVERAGE GIVES THE STATUS OF YOUR POLICY AFTER THE RECENT CHANGE(S). NO ADDITIONAL OR RETURN PREMIUM RESULTED FROM THIS CHANGE(S) 1 353,000 80 10,590 T -86 2,634 150,000 80 4,500 T -86 1,026 ONE STORY MASONRY RESTAURANT BLDG & CONTENTS NOT TO INCLUDE FABRIC CANOPY LOC: 1000 ATLANTIC BLVD KEY WEST, MONROE FL 33040 -4852 2 58,000 0 80 1,740 T -86 433 ONE STORY MASONRY RESTAURANT AUXILIARY BLDG N 61\ . (.0 6LCL.:2- 1 N 51/11 O Total Coverage amount: $561,000 Total Premium amount: $4,873 Premium Amount $ 4 , 0 9 3 2005 Citizens Property Insurance Corporation Emergency Assessment $4 1 mmm Tax Exempt Surcharge $ 7 2 2005 Florida Hurricane Catastrophe Fund (FHCF) Emergency Assessment $ 5 3 Catastrophe Reinsurance Surcharge S6 1 4 f swim mmm Subject to Form No(s): mmm mmm Mortgagee /Loss Payee mmm ZEE f MORTGAGEE /LOSS PAYEES LIST ON ADDITIONAL PAGE Producer: KEYS INS SERVICES, INC. 5017 Payor: = s P.O. BOX 500280 INSURED MARATHON, FL 33050 Date: mmm (305) 743 -0494 9/15/2011 CIT W03 -CNR 01 08 50176 Team 3 MORTGAGEE COPY -02 JLE 27490 5 . fl.........Ll tL.,�...,L., ..�..,,., . �. .. . ............ ....., .. &J..,.,., - . fl.... fl.,., ..,...,...,.,.,..,.,..,, . �., 1 1VUU L...,, ..,.tilt A PART THEREOF, COMPLETE THE BELOW NUMBERED FLORIDA WINDSTORM UNDERWRITING ASSOCIATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY 6676 Corporate Center Parkway, Jacksonville, Florida 32216 -8091 INSURED'S NAME AND ADDRESS ' CHANGE NO . 1THIS IS AN AMENDED 1000 ATLANTIC BOULEVARD, LLC CMZENS 729 THOMAS ST GENERAL BUSINESS KEY WEST, FL 33040 THIS CHANGE IS EFFECTIVE 10/16/2011 POLICY TERM 10/16/2011 TO 10/16/2012 AT 12:01 A.M. (EST) POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY PAGE 2 AMOUNT OF INSURANCE Percent of Item Deductible No. Building Contents Coinsurance Amount Territory Premium Applicable Hurri rang /Other Wi nri $ $ % $ $ MORTGAGEE /LOSS PAYEES: 1 * CAPITAL BANK NA ISAOA PO BOX 7286 NATCHITOCHES LA 71457 LOAN #141419529156 2 MONROE COUNTY BOCC (LOSS PAYEE) 1100 SIMONTON ST KEY WEST, FL 33040 0 Q n 3 0 O 0 0 Total Coverage amount: Total Premium amount: Subject to Form No(s): CIT CP2 01 10 CNRW 01 10 01 10 CIT 18 18 01 10 Mortgagee /Loss Payee mimm m Producer: KEYS INS SERVICES, INC. 5017 Payor: = {_ P.O. BOX 500280 INSURED MARATHON, FL 33050 Date: mmm (305) 743 -0494 9/15/2011 CIT W03 -CNR 01 08 50176 Team 3 MORTGAGEE COPY -02 JLE 27490 6 . 1. ACORD ( MM /DD/YYYY CERTIFICATE OF LIABILITY INSURANCE 1 .,.. 010 PRODUCER (305) 743 -0494 FAX: (305) 743 -0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 5800 Overseas Hwy #43 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 500280 Marathon FL 33050 -0280 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Lloyds of London 1000 Atlantic Blvd LLC, DBA: Salute Restaurant INSURERB: 729 Thomas Street INSURER C: INSURER D: Key West FL 33040 INSURER E: COVERAGES 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. ZA REG TE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADD POLICY EFFECTIVE POLICY EXPIRATION CRD TYPE OF INSURANCE POLICY NUMBER DATE (MM /DD/YY) DATE (MM /DD/YY) LIMITS GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 50,000 PREMISES (Ea occurrence) $ A X CLAIMS MADE X OCCUR ARPI6647810 10/16/2009 10/16/2010 MED EXP (Any one person) $ 1,000 PERSONAL&ADVINJURY $ 1,000,000 X Liquor Liability GENERAL AGGREGATE _$ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 1,000,000 "J POLICY ri JECT ri LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS 1l ' BODILY INJURY $ NON -OWNED AUTOS 1 'I/ / 04 (Per accident) — — — �I ��•IIi PROPERTY DAMAGE $ ^\\ (Per accident) GARAGE LIABILITY I -�� (T) \I AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ _ AUTO ONLY: AGG $ EXCESS /UMBRELLA LIABILITY ' _ EACH O(.CIIRRFNCE $ . 7 OCCUR I CLAIMS MADE AGGREGATE $ _$ DEDUCTIBLE $ RETENTION $ 1/ y WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY /�) /,� ( '. • ANY PROPRIETOR/PARTNER /EXECUTIVE �V E .L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE $ SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION (305)295-3179 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County Board of County Commssioner EXPIRATION DATE THEREOF, THE ISSUING ' U R WILL ENDEAVOR TO MAIL 1100 Simonton Street 10 DAYS WRITTEN NOTICE TO THE C • FICA • HOLDER NAMED TO THE LEFT, BUT Key West, FL 33040 FAILURE TO DO SO SHALL IMPOSE N • • BUG! s N OR LIABILITY OF ANY KIND UPON THE i / INSURER, ITS AGENTS 0 R REPRES , E AUTHORIZED REPRESEN • ACORD 25 (2001/08) © ACORD CORPORATION 1988 INS025 (01081.08a Page 1 of 2 tin ADDITIONAL COVERAGES Ref # Description Coverage Code Form No. Edition Date Liquor Liability LIQUR Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 250 Flat Ref # Description Coverage Code Form No. Edition Date Liquor Liability Defense Cost Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 500,000 250 Flat Ref # Description Coverage Code Form No. Edition Date Non -Owned Auto Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium OFADTLCV Copyright 2001, AMS Services, Inc. w Part 2: THIS DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY 6676 Corporate Ceder Parkway, EN RECEIVED • • .. • 1 • orida 32216-0973 T y 4 H S I3 A INSURED NAME AND ADDRESS M.. ____ 1000 ATLANTIC BOULEVARD, LLC GE RAL BUSINESS 729 THOMAS ST SEP 2 2 2009 KEY WEST, FL 33040 POLICY TERM 10/16/2009 10/16/2010 AT 12:01 A.M. (E:T) CIltI2 riV NO. 14 3301 INCEPTION DATE EXPIRATION DATE This is your Policy D : • i i i . • , ' „ 4NT101148 not a Bill DO NOT PAY PAGE 1 : INSURANCE Percent of Item AMOUNT OF < coin r DEDUCTIBLES ler ritOry; Premium No. - Building < ; `� Contents Appl�cabla � � $ $ % $ $ 5 1 351,000 80 10,530 T -86 2,165 150,000 80 4,500 T -86 848 ONE STORY MASONRY RESTAURANT BLDG & CONTENTS NOT TO INCLUDE FABRIC CANOPY LOC: 1000 ATLANTIC BLVD KEY WEST, MONROE FL 33040 -4852 2 58,000 0 80 1,740 T -86 358 ONE STORY MASONRY RESTAURANT AUXILIARY BLDG - - .1. uja, . '1A v..- of ' 0 4 fe,„hl, a o 0 gg 8 Total Coverage: S559,000 Payment Plan: Full Pay Total Premium: $4.041 Premium Amount S3, 2005 Florida Hurricane Catastrophe Fund Emergency Assessment S 34 Tax Exempt Surcharge $59 Catastrophe Reinsurance Surcharge $506 2005 Citizens Emergency Assessment $97 2007 Florida Insurance Guaranty Association Regular Assessment $24 mmmm Subject to Form No (s): mmmm mmmm Mortgagee /Loss Payee: mmmm mmmm MORTGAGEE /LOSS PAYEES LIST ON ADDITIONAL PAGE MENEM MIIIMM OIMMM Agent: y 9 Pa or: K w KEYS INS SERVICES, INC. 5017 INSURED r{ / P.O. BOX 500280 MARATHON, FL 33050 Date: 9/15/2009 (305) 743 -0494 CIT NO3 -CNR 01 08 50176 Team 3 MORTGAGEE COPY -02 QSY R 40111 174 Part 2: THIS DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THERFAF, COMPLETE THE BEIAW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY 6676 Corporate Ceder Partway, Jacksonville, Florida 32216 -0973 INSURED NAME AND ADDRESS `C ITIZENS THIS IS A 1000 ATLANTIC BOULEVARD, LLC GENERAL BUSINESS 729 THOMAS ST KEY WEST, FL 33040 • POLICY TERM 10/16/2009 10/16/2010 AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY PAGE 2 .. ............ . AMOUNT OF INSURANCE Percent of . �/� Item .. aauu DEDUCTIBLES Territory, Premium No.- Building - Contents Appliceble .. ... ... $ g 2 S S S MORTGAGEE /LOSS PAYEES: 1 TIB BANK OF THE FL KEYS ISAOA P 0 BOX 280 KEY LARGO, FL 33037 LOAN #141419529156 2 MONROE COUNTY BOCC (LOSS PAYEE) 1100 SIMONTON ST KEY WEST, FL 33040 0 N to ID a0 Total Coverage: Payment Plan: Total Premium: Subject to Form No(s): CIT CP2 CIT —W06 Mortgagee /Loss Payee: mmmm mmmm mmmm mmmm mmmm mmmm mmmm mmmm Agent: o y g Pe or: KEYS INS SERVICES, INC. 5017 INSURED P.O. BOX 500280 MARATHON, FL 33050 (305) 743 -0494 Date: 9/15/2009 CIT NO3 -CNR 01 08 50176 Team 3 MORTGAGEE COPY -02 QSY R 40111 175 Processed by: POLICY #: 87043272272009 Flood Insurance Processing Center ` .�.. P.O. Box 2057 Kalispell MT 59903-2057 ilberty American Select Insurance Company For payment status, call: (seal 245 -7274 FLOOD POLICY DECLARATIONS Policy Renewal TYPE: GENERAL POLICY PERIOD: 10/16/2009 to 10/16/2010 These Declarations are effective as of: 10/16/2009 at 12:01 AM PRODUCER NAME & MAILING ADDRESS I:: II:■: II: II:::: I: I: II::: II::: ::I:II::I:II:::I::I:II::::::III INSURED NAME & ADDRESS PRODUCER *: 2921 1000 ATLANTIC BLVD LLC KEYS INSURANCE SERVICES INC 729 THOMAS ST PO BOX 500280 KEY WEST, FL 33040-7334 MARATHON, FL 33050-0280 Ref: 08443-00807-000 POLICY INFORMATION PREMIUM PAYOR: Insured COMMUNITY NAME COMMUNITY NUMBER KEY WEST, CITY OF 1201681516K INSURED PROPERTY ADDRESS RESTAURANT POLICY TERM: One Year 1000 ATLANTIC BLVD KEY WEST, FL 33040 -4852 BUILDING DESCRIPTION Coverage Limitations May Apply, Refer CONTENTS LOCATION Non-Residential to your Standard Flood Insurance Lowest Floor Only Above One Floor Policy for details. Ground Level No Basement PROGRAM FLOOD ZONE CONSTRUCTION Regular VE Pre-Firm COVERAGE & RATING INFORMATION Construction BUILDING CONTENTS PREMIUM PAID • Coverage: $200,000 Coverage: $150,000 Premium Subtotal: $5,436.00 Deductible: $5,000 Deductible: $5,000 Previous Premium Subtotal: $5,436.00 ICC Premium: $75.00 Rates: 1.100/ 2.840 Rates: 2.140/ 4.520 CRS Discount: $.00 Expense Constant: $.00 Federal Policy -Fee: $35.00 Endorsement Amount: $.00 Total Premium: $5,546.00 FIRST MORTGAGEE SECOND MORTGAGEE TIB BANK 2 PO BOX 2808 ` KEY LARGO, FL 33037 6 1) d 6 sl 7hf l I3P---' °4 Q) 9 THIRD MORTGAGEE .. MONROE COUNTY BOCC (� 1100 SIMONTON ST 6 1`'' - , KEY WEST, FL 33040 -3110 SEP 2 1 2009 This Declarations Page. in conjuncion with the policy, constitutes your Flood Insurance Policy. IN WITNESS WHEREOF, we have signed this policy below and hereby enter into this Insurance Agreement. PRODUCER COPY OXP - 9/16/2009 C C ' C 444 (. President Secretary 1R AI:111:11. EVIDENCE OF PROPERTY INSURANCE DATE 'DD/ THIS IS EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED, IS IN FORCE, AND CONVEYS ALL THE RIGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY. PRODUCER I N No. Ent: (305)872-9183 COMPANY UNDERWRITERS AT LLOYDS KEYS INSURANCE SERVICES P.O. BOX 500280 MARATHON, FL 33050 CODE: 1 SUB CODE: AGENCY CUSTOMER IO N: INSURED LOAN NUMBER POLICY NUMBER 1000 ATLANTIC BOULEVARD, LLC, DBA SALUTE ARPQ64587 -10 RESTAURANT EFFECTIVE DATE EXPIRATION DATE CONTINUD 729 THOMAS STREET 10/16/08 10/16/09 n TER TEDIFCHECKED KEY WEST, FL 33040 THUS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION DESCRIPTION ONE STORY, MASONRY RESTAURANT LOCATED AT 1000 ATLANTIC BOULEVARD, KEY WEST, FL 33040. COVERAGE INFORMATION COVERAGEIPERIL&FORMS AMOUNT OF INSURANCE DEDUCTIBLE BUILDING, SPECIAL FORM, RC, 90% CD— INSURANCE 596,250 2,500 CONTENTS, PPECIAL FORM, RC, 90% CO— INSURANCE 150,000 2,500 BOILER & MACHINERY 746,250 2,500 ) , REMARKS (Including Special Conditions) CANCELLATION THE POLICY IS SUBJECT TO THE PREMIUMS, FORMS, AND RULES IN EFFECT FOR EACH POLICY PERIOD SHOULD THE POLICY BE TERMINATED, THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW DAYS WRITTEN NOTICE, AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT INTEREST, IN ACCORDANCE WITH THE POLICY PROVISIONS OR AS REQUIRED BY LAW. ADDITIONAL INTEREST NAME AND ADDRESS MORTGAGEE ADDITIONAL INSURED MONROE COUNTY BOCC X LOSS PAYEE 1100 SIMONTON STREET LOAN KEY WEST, FL 33040 AUTHORIZED REPRESENTATIVE ACORD 27 (3/93) ACORD CORPORATION 1993 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MwDDNYT 1n/i /OR PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION KEYS INSURANCE SERVICES ONLY AND CONFERS NO -- L TA RIGHTS UPON THE CERTIFICATE P. O. BOX 500280 HOkO -NS- CERTIFICATE DOES NOT AMEND, EXTEND OR ' '� . I iA ETil'R THE COVERAGE AFFORDED BY THE POLICIES BELOW. MARATHON, FL 33050 I t t_u i_ , Ell 1 .- � I INSURERS 4FFOR) COVERAGE I NAIC # INSURED j . USURER A: �ER1RITERS AT LLOYDS 1000 ATLANTIC BOULEVARD, LLC 1 ,1 I N } 3U RERBi J 729 THOMAS STREET - - - - KEY WEST, FL 33040 ! r(suRERC: J 1ZICK A Wimp E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDY. POLICY EFFECTIVE POUCY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYYI DATEIMUIDDIYY1 LIMITS GENERAL UABIUTY EACH OCCURRENCE �, ODD, 000 — DAMAGE TO RENTED A x X S 50,000 COMMERCIAL GENERAL PREMISES(Eaey_curence) CLAIMS MADE j X OCCUR MED EXP(Anyone person) S 1 ,000 ARPQ64587 -10 10/16/08 10/16/09 PERSONAL aAOV INJURY 1 �Q90,000 GENERAL AGGREGATE I S 2,000,000 GEM. AGGREGATE LIMIT APPLIES PER: , PRODUCTS -COMP/OP AGG . S 1,000,000 POUCY : l JEG `T ! LOC ;TOCX]R LOA. i 1,000,000 AUTOMOBILE UA8ILITY COMBINED SINGLE LIMIT S 1 , 000 000 ANY AUTO (Ea accdent) AU. OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per Person) A X ^ HIREDAUED ARPQ64587 -10 10/16/08 10/16/09 BODILY INJURY S X NON -OWNED AUTOS (Peraocident) PROPERTY DAMAGE S (Per accident) GARAGE UABIUTY AUTO ONLY -EA ACCIDENT S ANY AUTO EA OTHER THAN ACC S — W AUTO ONL AGG $ ' ,......._ EXCESSMMBRELLA UABIUTY EACH OCCURRENCE I s Albs OCCUR I CLAIMS MADE 0 i j) )5 AGGREGATE I S _ (/ S DEDUCTIBLE S RETENTION S S WC STATU- OTH- WORKERS COMPENSATION AND I ORY LLMIIL. . EFL: EMPLOYERS' LUUDILITI ANY PROPRIETOR/PARTNEWEXECIMVE EL. EACH ACCIDENT S i OFF ICERMEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE i S Dyes tlaaWeuntl SPECIAL PROVISIONS balow E.L DISEASE - POLICY LIMIT I S OTHER i 1 I DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS ONE STORY, MASONRY RESTAURANT LOCATED AT 1000 ATLANTIC BOULEVARD, KEY WEST, FL 33040 CERTIFICATE HOLDER IS LIS1'E2) AS AN ADDITIONAL INSURED. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION MONROE COUNTY BOCC DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 0 DAYS WRITTEN 1100 SIMONTON STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL KEY WEST, FL 33040 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHOR! RESE ACORD 25 (2001/08) 0 ACORD CORPORATION 1988 Aeamt11. _ EVIDENCE OF PROPERTY INSURANCE DATE 10/14/08 THIS IS EVIDENCE THAT INSURANCE AS IDENTIRED BELOW UED. IS I FORCE. AND CONVEYS ALL THE RIGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY, r _ IVEll .ROOtHCER 1 "`11 (305)872-918 COMPANY KEYS INSURANCE SERVICES AMERICAN SII�7CP INS. CO. P.O. BOX 500280 MARATHON, FL 33050 E: SUS NROE COUNTY RISK MANAGEMENT INSURED . LOAN NUMBER mum NUMBER 1000 ATLANTIC BOULEVARD, LLC, DBA SALUTE I mum, RESTAURANT EF1(CnVE DATE EXPIRATION DATE I CONnNUED tr•+TIN 729 THOMAS STREET 10/16/08 10/16/09 Iff n:RMaATEOScuEcxEo KEY WEST, FL 33040 7111S REPLACES PRIOR EVIDENCE COATED: PROPERTY INFORMATION LOCATION DESCRIPTION ONE STORY, MASONRY RESTAURANT LOCATED AT 1000 ATLANTIC BOULEVARD, KEY WEST, FL 33040. COVERAGE INFORMATION COYERAGEiPERILS.FORMS I AMOUNT OF INSURANCE DEDUCTIBLE BUILDING, ACV, FLOOD 200,000 5, 000 c c'r rs, ACV, FLOOD 150,000 5,000 1 Al v" `l � I lJ { � I REMARKS (Including Special Conditions) CANCELLATION THE POLICY IS SUBJECT TO THE PREMIUMS. FORMS. AND RULES IN EFFECT FOR EACH POLICY PERIOD. SHOULD THE POLICY BE TERMINATED. THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW 1 0 DAYS WRITTEN NOTICE. AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT INTEREST IN ACCORDANCE WITH THE POUCY PROVISIONS OR AS REOUIRED BY LAW. ADDITIONAL INTEREST NAME AND ADDRESS MORTGAGEE H ADORIONAL NSUREO MONROE COUNTY BOC:C X LOSS PAYEE 1100 SIMCNTTiDN STREET LO"" KEY WEST, FL 33040 AUTHORIZED REPRESENTA E i jaa ACORD V (3193) 0 ACORD CORPORATION 1993 Part 2: THIS DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. p /� CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY / QQ 6676 Corporate Center Parkway Jacksonville, Florida 32216 -0973 INSURED NAME AND ADDRESS �� FT1ZE - �.. ___ - _ THIS IS A .,.fig ; — 1000 ATLANTIC BOULEVARD, LLC { s ..... - �..,..... . i,, GENERAL BUSINESS 729 THOMAS ST s KEY WEST, FL 33040 I DEC 1 r• POLICY TERM 10/16/2008 TO 10/16/2009 AT 12:01 AIM. (ET) CITIZENS POLICY, NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Polley De Page - Thi s i s no a Bill - DO NOT PAY Polley PAGE 1 Item AMOUNT OF INSURANCE Percent of DE•DTICTSBLE - NO Building' Contents Coinsurance ` Terr T Prem Applicable $ $ $ $ $ $ 1 596,250 90 17,887 T -86 3,494 150,000 90 4,500 T -86 806 ONE STORY MASONRY RESTAURANT BLDG & CONTENTS NOT TO INCLUDE FABRIC CANOPY LOC: Non - Homestead Property 1000 ATLANTIC BLVD KEY WEST, MONROE FL 33040 -4852 . . Otairo )1) fala`-°6 ..• (0 • , ci 0 Jae., ' co m i r Pots[ Coverage: $746,250 Payment Plan: Quarterly Total Premium: $5,191 Prey limn Amow:t $4,300 2005 Florida Hurricane Catastrophe Fund Emergency Assessment $43 I Tax Exempt Surcharge $75 Catastrophe Reinsurance Surcharge $645 2005 Citizens Emergencry Assessment $60 2007 Florida Insurance Guaranty Association Regular Assessment $68 Subject to Form No(s): Mo.tgagee /Loss Payee: Egg MORTGAGEE /LOSS PAYEES LIST ON ADDITIONAL PAGE G4 — Agent: Payor: KEYS INS SERVICES, INC. 5017 INSURED P.O. BOX 500280 MARATHON, FL 33050 C (305) 743 -0494 Date 12/03/2008 CIT W03 -CNR 01 08 50176 Team 3 MORTGAGEE COPY -02 DBR N 35330 166 Part 2: THIS DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY 6676 Corporate Center Parkway, Jacksonville, Florida 32216 -0973 INSURED NAME AND ADDRESS 1 r .ITIZE NS THIS IS A 1000 ATLANTIC BOULEVARD, LLC GENERAL BUSINESS 729 THOMAS ST KEY WEST, FL 33040 POLICY TERM 10/16/2008 TO 10/16/2009 AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY PAGE 2 Item AMOUNT OF INSURANCE Percent of DEDUCTIBLES No Building' -. Contents Coinsurance Territory P remi um Applicable S S % S S S MORTGAGEE /LOSS PAYEES: 1 TIB BANK OF THE FL KEYS ISAOA P 0 BOX 280 KEY LARGO, FL 33037 LOAN #141419529156 2 MONROE COUNTY BOCC (LOSS PAYEE) 1100 SIMONTON ST KEY WEST, FL 33040 0 § 07 Total Coverage: Payment Plan: Total Premium: Subject to Form No(s): �� CIT CP2 CIT -W06 Mortgagee /Loss Payee: Agent: Payor: (' KEYS INS SERVICES, INC. 5017 INSURED P.O. BOX 500280 MARATHON, FL 33050 ---2 (305) 743 -0494 Date :12 /03/2008 CIT W03 -CNR 01 08 50176 Team 3 MORTGAGEE COPY -02 DBR N 35330 167 Part 2: THIS AMENDED DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY 6676 Corporate Center Parkway, Jacksonville, Florida 32216 -0973 INSURED' S NAME AND ADDRESS <' CITIZENS CHANGE NO . 1 T�S AN AMENDED 1000 ATLANTIC BOULEVARD, LLC 129 THOMAS ST GENERAL BUSINESS KEY WEST, FL 33040 THIS CHANGE IS EFFECTIVE 10/16/2013 POLICY TERM AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 10 / 16 / 2 013 TO 10/16/2014 - rmao ae vAl1T uftn v nfiu4srsfinn Psae - This is not a BM- DO NOT PAY CIT W03 -CNR 01 10 05320 Team 3 MORTGAGEE COPY -02 QSY 80101 4 Part 2: THIS AMENDED DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY 6676 Corporate Center Parkway, Jacksonville, Florida 32216 -0973 INSURED'S NAME AND ADDRESS 1000 ATLANTIC BOULEVARD, LLC 729 THOMAS ST KEY WEST, FL 33040 ' r CHANGE NO. 1T�S IS AN AMENDED CI TIZENS rsowir. �.sxua� aaatnmr GENERAL BUSINESS THIS CHANGE IS EFFECTIVE 10/16/2013 POLICY TERM 10/16/2013 TO 10/16/2014 AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Dedaration Page - Thh is not a Bid - DO NOT PAY PAGE 1 Item No. AMOUNT OF INSURANCE Percent of Deductible Coinsurance Amount Territory Premium Building Contents licable Reason for Change: CHANGE MORTGAGEE * THIS STATEMENT OF COVERAGE GIVES THE STATUS OF YOUR POLICY AFTER THE RECENT CHANGE(S). NO ADDITIONAL OR RETURN PREMIUM RESULTED FROM THIS CHANGE(S) 1 359,000 80 10,770 T -86 3,241 150,000 80 4,500 T -86 1,241 ONE STORY MASONRY RESTAURANT BLDG & CONTENTS NOT TO INCLUDE FABRIC CANOPY LOC: 1000 ATLANTIC BLVD KEY WEST, MONROE FL 33040 -4852 2 59,000 0 80 1,770 T -86 533 ONE STORY MASONRY RESTAURANT AUXILIARY BLDG P E NT D cGCi WKM NIA � YES Payment Total Cove e: $5 68, 000 IbII Pa Total Premium: $6, 021 Premium Amount $5,015 2005 Citizens Property Insurance Corporation Emergency Assessment $50 Tax Exempt Surcharge $88 2005 Florida Hurricane Catastrophe Fund (FHCF) Emergency Assessment $ 65 Catastrophe Reinsurance Surcharge $752 2009 Florida Insurance Guaranty Association Regular Assessment $ 3 2012 Florida Insurance Guaranty Association Regular Assessment $48 Subject to Form No(s): N Mortgagee /Loss Payee rri CD MORTGAGEE /LOSS PAYEES LIST ON ADDITIONAL PAGE -. v Q 713 Agent: EAGLE AMERICANS INS 0532 Payor: -- C-) INSURED AGENCY LLC o 5800 OVERSEAS HIGHWAY 43 :-:7 MARATHON, FL 33050 — ED Date: (3n5l 743—n494 9/10/2013 CIT NO3 -CNR 01 10 05320 Team 3 MORTGAGEE COPY -02 QSY 80101 3 Part 2: THIS DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORNEMEN 1 b,11' A N Y IbbUril! IV rl A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY 6676 Corporate Center Parkway, Jacksonville, Florida 32216 -0973 INSURED NAME AND ADDRESS "�CITIZENS THIS IS A 1000 ATLANTIC BOULEVARD, LLC 729 THOMAS ST KEY WEST, FL 33040 GENERAL BUSINESS POLICY TERM 10/16/2013 TO 10/16/2014 AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill- DO NOT PAY PAGR ?_ Item No. Percent of DEDUCTIBLES Territory Premium Building Contents A 11cable S S $ S S MORTGAGEE /LOSS PAYEES: 1 CAPITAL BANK NA ISAOA PO BOX 7286 NATCHITOCHES LA 71457 LOAN #141419529156 2 MONROE COUNTY BOCC (LOSS PAYEE) 1100 SIMONTON ST KEY WEST, FL 33040 i Total Coverage: Payment Plan: Total Premium: Subject to Form No(s): CIT CP2 02 13 CNRW 01 10 01 10 Mortgagee /Loss Payee: Agent: EAGLE AMERICANS INS 0532 AGENCY LLC 5800 OVERSEAS HIGHWAY 43 MARATHON, FL 33050 (305) 743 -0494 CIT W03 -CNR 01 10 05320 Team 3 rayor. INSURED Date: 8/26/2013 MORTGAGEE COPY -02 QSY R 40111 57 Part 2: THIS DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORNEMEN t S, It ANY issunu r U r A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY 6676 Corporate Center Parkway, Jacksonville, Florida 32216 -0973 INSURED NAME AND ADDRESS CITIZENS THIS IS A 1000 ATLANTIC BOULEVARD, LLC 729 THOMAS ST KEY WEST, FL 33040 GENERAL BUSINESS POLICY TERM 10/16/2013 TO 10/16/2014 AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY PAGE 1 Item Percent of DEDUCTIBLES Territory Premium No. Building Contents A plicaM P 1 359,000 80 10,770 T -86 3,241 150,000 80 4,500 T -86 1,241 ONE STORY MASONRY RESTAURANT BLDG & CONTENTS NOT TO INCLUDE FABRIC CANOPY LOC: 1000 ATLANTIC BLVD KEY WEST, MONROE FL 33040 -4852 2 59,000 0 80 1,770 T -86 533 ONE STORY MASONRY RESTAURANT AUXILIARY BLDG IS G✓I Cl S AP Tl — Fat - Total Coverage: $568,000 Payment Plan: Full Pa Total Premium: $6,021 Premium Amount $5,015 2005 Citizens Property Insurance Corporation Emergency Assessment $50 Tax Exempt Surcharge $88 2005 Florida Hurricane Catastrophe Fund (FHCF) Emergency Assessment $65 Catastrophe Reinsurance Surcharge $752 2009 Florida Insurance Guaranty Association Regular Assessment $ 3 2012 Florida Insurance Guaranty Association Regular Assessment $48 Subject to Form No(s): C tw t Mortgagee /Loss Payee:' MORTGAGEE /LOSS PAYEES LIST ON ADDITIONAL PAGE -- Q Z rn Agent: EAGLE AMERICANS INS 0532 AGENCY LLC 5800 OVERSEAS HIGHWAY 43 MARATHON, FL 33050 (305) 743 -0494 I CIT NO3 -CNR 01 10 05320 Team 3 INSURED Date: 8/26/2013 MORTGAGEE COPY -02 CJ1 QSY R 40111 56 Part 2: THIS AMENDED DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY 6676 Corporate Center Parkway, Jacksonville, Florida 32216-0973 INSURED' S NAME AND ADDRESS �6 CHANGE NO 1TEIIS IS AN AMENDED 4 ATLANTIC BOULEVARD, LLC CITIZENS 127 — T — H - 0M — A — S — M ----- ' L - GENERAL BUSINESS KEY WEST, FL 33040 THIS CHANGE IS EFFECTIVE 10/16/2013 POLICY TERM 10/16/2013 TO 10/16/2014 AT 12:01 A.M. (EST) CITIZENS POLICY No. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY "", 7 Item No. AMOUNT OF INSURANCE Percent of Deductible A nc Building Contents ae Territory Premium s s e s s MORTGAGEE /LOSS PAYEES: 1 * CAPITAL BANK NA ISAOA PO BOX 702037 DALLAS, TX 75370 LOAN $141419529156 2 MONROE COUNTY BOCC (LOSS PAYEE) 1100 SIMONTON ST KEY WEST, FL 33040 �"VvY pxMirat pi" � Total Coverage: Total Premium: o Subject to Form No (s) : CIT CP2 02 13 CNRW 01 10 01 10 Mortgagee /Loss Payee a - -- CD Agent: EAGLE AMERICANS INS 0532 Payor: c� e AGENCY LLC INSURED a 5800 OVERSEAS HIGHWAY 43 - MARATHON, FL 33050 Date: - - 9/10/2013 = CIT W03 -CNR 01 10 05320 Team 3 MORTGAGEE COPY -02 QSY 80101 4 Part 2: THIS AMENDED DECLARATION PAGE, WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY 6676 Corporate Center Parkway, Jacksonville, Florida 32216 -0973 INSURED' S NAME AND ADDRESS <( CHANGE NO. 1TE IS IS AN AMENDED 1000 ATLANTIC BOULEVARD, LLC ` CITIZENS rxenan.R awn nwr 729 THOMAS ST GENERAL BUSINESS KEY WEST, FL 33040 THIS CHANGE IS EFFECTIVE 10/16/2013 POLICY TERM 10/16/2013 TO 10/16/2014 AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This Is not a Bill - DO NOT PAY PAGE 1 Item No. Percent of Deductible Building Contents Coinsurance Amount Territory Premium rJr-anPJQJ-hPr Wind App licable Reason for Change: CHANGE MORTGAGEE s s e s s * THIS STATEMENT OF COVERAGE GIVES THE STATUS OF YOUR POLICY AFTER THE RECENT CHANGE(S). NO ADDITIONAL OR RETURN PREMIUM RESULTED FROM THIS CHANGE(S) 1 359,000 80 10,770 T -86 3,241 150,000 80 4,500 T -86 1,241 ONE STORY MASONRY RESTAURANT BLDG & CONTENTS NOT TO INCLUDE FABRIC CANOPY LOC: 1000 ATLANTIC BLVD KEY WEST, MONROE FL 33040 -4852 2 59,000 0 80 1,770 T -86 533 ONE STORY MASONRY RESTAURANT AUXILIARY BLDG P MACV�C�t� tl� Total Coverage: $568, Itill Pa Total Premium: $6, 021 Premium Amount $5,015 2005 Citizens Property Insurance Corporation Emergency Assessment $ 50 Tax Exempt Surcharge $88 2005 Florida Hurricane Catastrophe Fund (FHCF) Emergency Assessment $ 65 Catastrophe Reinsurance Surcharge $752 2009 Florida Insurance Guaranty Association Regular Assessment $ 3 2012 Florida Insurance Guaranty Association Regular Assessment $48 Subject to Form No(s): tV -TI -=w O Mortgagee /Loss Payee rrl M CD -v MORTGAGEE /LOSS PAYEES LIST ON ADDITIONAL PAGE - _ N3 -�I O mom 5e Agent: EAGLE AMERICANS INS 0532 Payor: C-) INSURED AGENCY LLC o 5800 OVERSEAS HIGHWAY 43 :-U MARATHON, FL 33050 Date: (3051 743-0494 9/10/2013 CIT W03 -CNR 01 10 05320 Team 3 MORTGAGEE COPY -02 QSY 80101 3 rare L: I nib lJrL;LAKA I ION PAGE WITH POLICY PROVISIONS - PART 1 AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY 6676 Corporate Center Parkway, Jacksonville, Florida 32216 -0973 INSURED NAME AND ADDRESS ° CITIZENS THIS IS A 1000 ATLANTIC BOULEVARD, LLC 729 THOMAS ST KEY WEST, FL 33040 GENERAL BUSINESS POLICY TERM 10/16/2013 TO 10/16/2014 AT 12:01 A.M. (EST) CITIZENS POLICY N 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY Item No. rrr�c c Percent DMUCT IBMS Building Contents Coinsuranc e Territory Premium Applicable MORTGAGEE /LOSS PAYEES: 1 CAPITAL BANK NA ISAOA PO BOX 7286 NATCHITOCHES LA 71457 LOAN #141419529156 2 MONROE COUNTY BOCC (LOSS PAYEE) 1100 SIMONTON ST KEY WEST, FL 33040 i Total Coverage: Payment Plan: Total Premium: Subject to Form No(s): CIT CP2 02 13 CNRW 01 10 01 10 Mortgagee /Loss Payee: L nt. EAGLE AMERICANS INS 0532 AGENCY LLC 5800 OVERSEAS HIGHWAY 43 MARATHON, FL 33050 (305) 743 -0494 CIT W03 -CNR 01 10 05320 Team 3 —y— i INSURED Date: 8/26/2013 MORTGAGEE COPY -02 QSY R 40111 57 m v v v F;4 �u� Part 2: THIS DECLARATION PAGE, WITH POLICY PROVISIONS - PART I AND ENDORSEMENTS, IF ANY ISSUED TO FORM A PART THEREOF, COMPLETE THE BELOW NUMBERED CITIZENS PROPERTY INSURANCE CORPORATION POLICY. CITIZENS PROPERTY INSURANCE CORPORATION, WIND ONLY POLICY 6676 Corporate Center Parkway, Ja Florida 32216 -0973 INSURED NAME AND ADDRESS CITIZENS THIS IS A 1000 ATLANTIC BOULEVARD, LLC 729 THOMAS ST KEY WEST, FL 33040 POLICY TERM 10/16/2013 TO 10/16/2014 AT 12:01 A.M. (EST) CITIZENS POLICY NO. 1473301 INCEPTION DATE EXPIRATION DATE This is your Policy Declaration Page - This is not a Bill - DO NOT PAY PAGE 1 GENERAL BUSINESS Item No. AMOUNT Building OF INSURANCE Percent nc Coinsurance Contents Applicable DEDUCTIBLES Territory Premium 1 359,000 80 10,770 T -86 3,241 150,000 80 4,500 T -86 1,241 ONE STORY MASONRY RESTAURANT BLDG & CONTENTS NOT TO INCLUDE FABRIC CANOPY LOC: 1000 ATLANTIC BLVD KEY WEST, MONROE FL 33040 -4852 2 59,000 0 80 1,770 T - 86 533 ONE STORY MASONRY RESTAURANT AUXILIARY BLDG w1 a BAPP W _Fkc - Total Coverage: $568, Payment Plan: Full Pa y Total Premium: $6, 021 Premium Amount $5,015 2005 Citizens Property Insurance Corporation Emergency Assessment $ 50 Tax Exempt Surcharge $88 2005 Florida Hurricane Catastrophe Fund (FHCF) Emergency Assessment $65 Catastrophe Reinsurance Surcharge $752 2009 Florida Insurance Guaranty Association Regular Assessment $ 3 2012 Florida Insurance Guaranty Association Regular Assessment $48 Subject to Form No (s) : C� 'iz C Mortgagee /Loss Payee: ('ry 77) MORTGAGEE /LOSS PAYEES LIST ON ADDITIONAL PAGE - C11 O _: a 3 M Agent: EAGLE AMERICANS INS 0532 AGENCY LLC 5800 OVERSEAS HIGHWAY 43 MARATHON, FL 33050 (305) 743 -0494 I CIT W03 -CNR 01 10 05320 Team 3 Payor: INSURED C37 � v Date: 8/26/2013 MORTGAGEE COPY -02 QSY R 40111 56