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Certificates of Insurance
nr -_ate. inn TYI ININTF1 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDONY) 8/21/2014 PRODUCER Dealey, Renton $ Associates P. O. Box 12675 Oakland, CA 94604 -2675 510 465 -3090 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED T. Y. Lin international /H.J. Ross 2 Harrison Street, 5th Floor San Francisco, CA 94105 INSURER A: Hartford Fire Ins. Co. INSURER B: Hartford Underwriters Ins. Co. INSURER C: Aspen Specialty Ins. Co. INSURER D: Twin City Fire Ins. Co. INSURER E: V V • Gr\P9V 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. NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE M DATE D LIMITS L A GENERAL LIABILITY 57CESOF1487 03/01/14 03101/15 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $1,000 CLAIMS MADE [i] OCCUR MED EXP (Any one person) $10 X Contract'I Liab. PERSONAL & ADV INJURY $11,000,000 X Cross Liability GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIM ITAPPLIES PER: PRODUCTS - COMP /OPAGG $2000000 1 POLICY X JJE LOC D AUTOMOBILE LIABILITY 57UENPV4294 03101/14 03/01/15 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS BODILY INJURY $ X HIRED AUTOS X (Per accident) NON -OWNED AUTOS PROPERTY DAMAGE $ ENT AJ S Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO WAWR YES— OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR 71 CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND 57WEK08793 03/01/14 03/01/15 X WC STATU- OTH- 1 ER E.L. EACH ACCIDENT $1,000,000 EMPLOYERS' LIABILITY E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT 1 $1,000,000 C OTHER Professional LRA9P0114 02/27114 03/01/15 $2,000,000 per Claim !ability $2,000,000 Anni Aggr. DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS General Liability policy excludes claims arising out of the performance of professional services. Re: Relocation of Atlantic Boulevard at Higgs Beach, Key West, Florida. Monroe County Board of County Commissioners is included as Additional Insured for General and Automobile Liability. Insurance is primary per policy form. SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Monroe County DATE THEREOF, THE ISSUING INSURER WILL j0@ffl8VjNM MAIL 30_ DAYSWRITTEN Board of County Commissioners NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, B1 ORLYM)IQA AKIIKUM 1100 Simonton Street #2 -216 xNx Key West, FL 33040 -3110 AUTHORIZED REPRESENTATIVE ACORD 25-S (7/97)1 Of 1 #S1070659/M889690 NMI- tV M%,Vrcu -.Vnr Vf%^I IM" I. -- POLICY NUMBER: 57CESOF1487 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations Re: Relocation of Atlantic Boulevard at Higgs Beach, Key West, Florida. Monroe County Board of County Commissioners 1100 Simonton Street #2 -216 Key West, FL 33040 -3110 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER: 57CESOF1487 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Or Organization(s): Operations Monroe County Re: Relocation of Atlantic Boulevard at Higgs Beach, Key West, Florida. Board of County Commissioners 1100 Simonton Street #2 -216 Key West, FL 33040 -3110 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard ". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1