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Certificates of Insurance® ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) g/17/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Hylant Group Inc - Ann Arbor 24 Frank Lloyd Wright Dr J4100 Ann Arbor MI 48105 CONTACT NAME: PHONE q/C No c. No. Exti6734-741-0044 E -MAIL ADDRESS: U1061922047 INSURERS AFFORDING COVERAGE NAIC # INSURER A :COntinental Insurance Company 5289 INSURED HIGGI -5 INSURER B:Continental Casualty Company 44 INSURER C:Valley Forge I nsurance Douglas N. Higgins, Inc. INSURER D:Greenwich Insurance Com n 2 22 3390 Travis Pointe, Suite A Ann Arbor MI 48108 $15,000 CLAIMS -MADE li—I OCCUR INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1218072831 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 1MTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL IN SR SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM /DD/YYYY I LIMITS A GENERAL LIABILITY U1061922047 12/10/2013 2/10/2014 EACH OCCURRENCE $1,000,0 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISE Ea occurrence $500,000 IVIED EXP (Any one person) $15,000 CLAIMS -MADE li—I OCCUR PERSONAL BADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 $ POLICY X PRO- M LOC A AUTOMOBILE LIABILITY U1061922033 1211012013 2/1012014 Ea accident $1,000, BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAB X OCCUR U1061922050 12/10/2013 2/10/2014 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $10,000 $ 1 C WORKERS COMPENSATION WC161922016 12/10/2013 2/10/2014 X WC STATU- 7 AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? N❑ (Mandatory in NH) N/A E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below D Professional/ Pollution PECO025095 12/10/2013 2/10/2014 2,000,000 Each Claim 4,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Job: Monroe County Key West International Airport Improve Runway 27 Safety Area. Project #GAKA157 Additional Insured for General Liability and Automobile Liability on a primary/non - contributory basis as required by written contract- Monroe County Board of County Commissioners, its employees, officials, agents and volunteers rccTirlrnTG LJnI nFR CANCELLATION © 1988 -2010 ACURU GURPORA TiON. An ngnis reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 500 Whitehead Street Key West FL 33040 AUTHORIZED REPRESENTATIVE txtu +' © 1988 -2010 ACURU GURPORA TiON. An ngnis reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD DATE (M MIDDNY' ACOR" EVIDENCE OF PROPERTY INSURANCE 9/17/2014 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PHONE may" 734- 741 -0044 COMPANY Hylant Group Inc - Ann Arbor 24 Frank Lloyd Wright Dr J4100 Ann Arbor MI 48105 AGCS Marine Insurance Company 33 West Monroe Street Chicago IL 60603 FAX 734- 741 -1850 1 EAIL Debbie. Neff @hylant.com A/C No): ADDR CODE: SUB CODE: AG..I.T HIGGI -5 CUSTOMFR INSURED Douglas N. Higgins, Inc. 3390 Travis Pointe, Suite A Ann Arbor MI 48108 PROPERTY INFORMATION LOCATION /DESCRIPTION LOAN NUMBER POLICY NUMBER MXI93026986 EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 12/10/2013 12/10/2014 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION COVERAGE /PERILSIFORMS Installation Floater - "Special" cause of loss form, Replacement Cost t Job Site emporary Storage Location n Transit Flood Sublimit Earthquake Sublimit 2% deductible for Florida windstorm subject to $22,500 minimum REMARKS (Including S pecia l Conditions AMOUNT OF INSURANCE I DEDUCTIBLE 5,000,000 5,000 530,000 5,000 340,000 5,000 1,000,000 25,000 1,000,000 25,000 Job: Monroe County Key West International Airport Improve Runway 27 Safety Area. Project #GAKA157 Additional Insured /Loss Payee - Monroe County Board of County Commissioners, its employees, officials, agents an volunteers 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. ADDITIONAL INTEREST F1 NAME AND ADDRESS MORTGAGEE ADDITIONAL INSURED _� LOSS PAYEE Monroe County Board of Commissioners LOAN# 500 Whitehead Street Key West FL 33040 - AUTHORIZED REPRESENTATIVE &u 1�� ACORD 27 (2009/12) © 1993 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACCIRO CERTIFICATE OF LIABILITY INSURANCE F DATE (MM /DDNYYY) 9/17/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Hylant Group Inc - Ann Arbor 24 Frank Lloyd Wright Dr J4100 Ann Arbor MI 48105 CONTACT NAME: PHONE 4 A/C No : - - E -MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A LIMITS INSURED HIGGI -5 Douglas N. Higgins, Inc. 3390 Travis Pointe, Suite A Ann Arbor MI 48108 INSURER B:Contine Casua 4 INSURERC:Valley F orge U1061922047 INSURER D:Gree Insurance Com 2 INSURER E $1,000,000 INSURER F: $500,000 COVERAGES CERTIFICATE NUMBER: 1218n72831 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL IN R SUBR ,VD POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS A GENERAL LIABILITY U1061922047 12/10/2013 2/10/2014 EACH OCCURRENCE $1,000,000 DAMAGE PREMISE T Ea occu ante $500,000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $15,000 CLAIMS -MADE � OCCUR PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 $ POLICY X PRO- LOC A AUTOMOBILE LIABILITY U1061922033 12110/2013 211012014 Ea accident ) $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED PROPERTY DAMAGE Per accident $ HIRED AUTOS AUTOS $ B X UMBRELLA LIAB X OCCUR U1061922050 12/10/2013 2/10/2014 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DED X I RETENTION $10,000 $ C WORKERS COMPENSATION 0161922016 12/10/2013 2/10/2014 X WC STATU- OTH- E.L. EACH ACCIDENT $500,000 AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $500,000 OFFICER /MEMBER EXCLUDED? N❑ (Mandatory in NH) N/A E.L. DISEASE - POLICY LIMIT $1,000,000 , describe under If I n DESCRIPTION OF OPERATIONS below D Professional/ PECO025095 12/10/2013 2/10/2014 2,000,000 Each Claim Pollution 4,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Job: Monroe County Key West International Airport Improve Runway 27 Safety Area. Project #GAKA157 Additional Insured for General Liability and Automobile Liability on a primary/non- contributory basis as required by written contract- Monroe County Board of County Commissioners, its employees, officials, agents and volunteers I+Cr IVie TC U^1 MCO CANCELLATION ATION (o 19SS -1U1u ACORD CORPORA 1 1VIV. A n ngnis reservuu. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 500 Whitehead Street AUTHORIZED REPRESENTATIVE Key West FL 33040 �w lyt (o 19SS -1U1u ACORD CORPORA 1 1VIV. A n ngnis reservuu. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD , A C O R° ® 9/17//201201 EVIDENCE OF PROPERTY INSURANCE DATE /YYYY) 4 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PH ._,.734-741-0044 COMPANY I Hylant Group Inc - Ann Arbor 24 Frank Lloyd Wright Dr J4100 Ann Arbor MI 48105 FAX No ): 734 741 -1850 ADDRESS: Debbie.Neff @hylant.com rnnF• I SUB CODE: AUL146T HIGGI - 5 rIICTnMFR ID #• INSURED Douglas N. Higgins, Inc. 3390 Travis Pointe, Suite A Ann Arbor MI 48108 AGCS Marine Insurance Company 33 West Monroe Street Chicago IL 60603 LOAN NUMBER EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 12/10/2013 12/10/2014 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: POLICY NUMBER MXI93026986 PROPERTY INFUKMA I IUN LOCATION/DESCRIPTION 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 EVIDENCE OF PROPERTY INSURANCE 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. COVEKAGE INFUKIVIA I IUN COVERAGE /PERILS /FORMS AMOUNT OF INSURANCE DEDUCTIBLE Installation Floater - "Special" cause of loss form, Replacement Cost NAME AND ADDRESS At Job Site 5,000,000 5,000 Temporary Storage Location 530,000 340,000 5,000 5,000 In Transit LOSS PAYEE Flood Sublimit 1,000,000 25,000 Earthquake Sublimit 1,000,000 25,000 2% deductible for Florida windstorm subject to $22,500 minimum REMARKS (including Special conditions Job: Monroe County Key West International Airport Improve Runway 27 Safety Area. Project #GAKA157 Additional Insured /Loss Payee - Monroe County Board of County Commissioners, its employees, officials, agents and volunteers 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. AUUI I IUNAL IN I tKtJ I NAME AND ADDRESS MORTGAGEE ADDITIONAL INSURED LOSS PAYEE LOAN# Monroe County Board of Commissioners 500 Whitehead Street Key West FL 33040 AUTHORIZED REPRESENTATIVE r.�nn n/1�onoA Tll1 AI All r M,+. ►ncorvot� ACUKU Z7 (ZUU9 __ -- • •_ ---- - - - -- - -- _ The ACORD name and logo are registered marks of ACORD ACCT V CERTIFICATE OF L DATE(MMIDDIYYYY) LIABILITY INSURANCE 9/17/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONT CT PRODUCER NAME: FAX Hylant Group Inc - Ann Arbor PHONE Ext),734 C. No : - - 24 Frank Lloyd Wright Dr J4100 E -MAIL Ann Arbor MI 48105 ADDRESS: co'e` ^ ,.,�„e ocnonlur•_ CnvPR A(:F NAIC # INSURER A:L;Qn1 INSURED HIGGI -5 INSURER B: n l WCasualty n 44 Douglas N. Higgins Inc. INSURER C 3390 Travis Polnte, Suite A INSURER D: r n m n 2 Ann Arbor MI 48108 INSURER E: INSURER F: - - - - -- - -- - ...-- - -- . _ -- - - - -_. QFVICInkl NI1MFtFR- GUVtKAUt, 14 1 UU! GVJ I 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. ADDL SUBR POLICY EFF POLICY EXP LIMITS INSR TYPE OF INSURANCE IN SR WVD POLICY NUMBER MM /DD/YYYY MMIDDIYYYY LTR A GENERAL LIABILITY J1061922047 12/10/2013 2/10/2014 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED $500,000 X COMMERCIAL GENERAL LIABILITY PREMISE Ea occurrence CLAIMS -MADE � OCCUR MED EXP (Any one person $15,000 PERSONAL BADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC JFrT A AUTOMOBILE LIABILITY U1061922033 12/10/2013 2/10/2014 Ea accident $ 1 , 000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAB X OCCUR EXCESS LIAB CLAIMS -MADE U1061922050 12/10/2013 2/10/2014 EACH OCCURRENCE $10,000,000 B AGGREGATE $10,000,000 N / A 0161922016 12/10/2013 2/10/2014 X W C STATU- OTH- $ DED X I RETENTION $10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE YIN N OFFICER /MEMBER EXCLUDED? C E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYE $500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Professional/ Pollution PECO025095 1211012013 2/1012014 E.L. DISEASE - POLICY LIMIT 2,000,000 4,000,000 1 $1,000,000 Each Claim Aggregate D DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Job: Monroe County Key West International Airport Improve Runway 27 Safety Area. Project #GAKA157 Additional Insured for General Liability and Automobile Liability on a primary/non- contributory basis as required by written contract- Monroe County Board of County Commissioners, its employees, officials, agents and volunteers CERTIFICATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 500 Whitehead Street Key West FL 33040 AUTHORIZED REPRESENTATIVE o © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD DATE (MM /DD/YYYY) EVIDENCE OF PROPERTY INSURANCE 9/172014 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PHONE 734- 741 -0044 COMPANY Hylant Group Inc - Ann Arbor 24 Frank Lloyd Wright Dr J4100 Ann Arbor MI 48105 FAX No E - MAIL ADDRE Debbie.Neff @hylant.com CODE: I SUB CODE: " "t HIG GI -5 CUSTOMER ID #' INSURED Douglas N. Higgins, Inc. 3390 Travis Pointe, Suite A Ann Arbor MI 48108 AGCS Marine Insurance Company 33 West Monroe Street Chicago IL 60603 LOAN NUMBER EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 12/10/2013 12/10/2014 TERMINATEDIFCHECKED THIS REPLACES PRIOR EVIDENCE DATED: POLICY NUMBER MXI93026986 PKUNtK I Y INFUKIVIA I IVN LOCATIOWDESCRIPTION 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFUKIVIA I IUIN COVERAGE / PERILS I FORMS AMOUNT OF IN SURANCE DEDUCTIBLE Installation Floater - "Special" cause of loss form, Replacement Cost LOSS PAYEE —_ At Job Site 5,000,000 530,000 5,000 5,000 Temporary Storage Location 340,000 5,000 In Transit Flood Sublimit 1,000,000 1,000,000 25,000 25,000 Earthquake Sublimit 2% deductible for Florida windstorm subject to $22,500 minimum REMARKS (including Special Conditions Job: Monroe County Key West International Airport Improve Runway 27 Safety Area. Project #GAKA157 Additional Insured /Loss Payee - Monroe County Board of County Commissioners, its employees, officials, agents and volunteers GANGLLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL IN I tKtJ 1 NAME AND ADDRESS MORTGAGEE ADDITIONAL INSURED — � LOSS PAYEE —_ Monroe County Board Of Commissioners LOAN# 500 Whitehead Street Key West FL 33040 AUTHH REPRESENTATIVE n mn r'f %DDnDATlnAl All rinhtc rpcarvarl ACORD 27 (2UU9 /12) The ACORD name and logo are registered marks of ACORD DATE (MMIDD/YYYY) AC" ® CERTIFICATE OF LIABILITY INSURANCE 9/17/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ­Iylant Group Inc - Ann Arbor ?4 Frank Lloyd Wright Dr J4100 \nn Arbor MI 48105 NE INSURED HIGGI -5 INSUREK U: rI III II — Douglas N. Higgins, Inc. INSURER c 3390 Travis Pointe, Suite A INSURER D:Greenwich Insurance m n Ann Arbor MI 48108 INSURER E: INSURER F REVISION NUMBER: COVERAGES CERTIFICATE NUMBER: 1218072831 ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS AND CONDITIONS OF SUCH EXP ADDL SUBR I POLICY E POLICY INSR TYPE OF INSURANCE INS R WVD POLICY NUMBER MM /DDIYYYY MM /DD/YYYY LIMITS LTR U1061922047 12110/2013 211012014 EACH OCCURRENCE $1,000,000 A GENERAL LIABILITY DAMAGE TO RENTED $500,000 X COMMERCIAL GENERAL LIABILITY PREMISE Ea occurrence MED EXP (Any one person) $15,000 CLAIMS -MADE K OCCUR PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: $ POLICY X PRO- LOC 12/1012013 2/10/2014 Ea accident 1 000 000 A AUTOMOBILE LIABILITY U1061922033 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE $ NON -OWNED Per accident HIRED AUTOS AUTOS $ U1061922050 12/10/2013 2/10/2014 EACH OCCURRENCE $10,000,000 B X UMBRELLA LIAR X OCCUR $10,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE DED X RETENTION $10,000 12/10/2013 2110/2014 X WC STATU- OTH- C WORKERS COMPENSATION 0161922016 AND EMPLOYERS' LIABILITY YIN E . EACH ACCIDENT $500,000 ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? N I A E. L. DISEASE -EA EMPLOYE $500,000 (Mandatory in NH) If describe under E.L. DISEASE - POLICY LIMIT $1,000,000 yes, DESCRIPTION OF OPERATIONS below 12110/2013 211012014 2,000,000 Professional) PECO025095 4,000,000 Aggregate Pollution DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Job: Monroe County Key West International Airport Improve Runway 27 Safety Area. Project #GAKA157 General Liability and Automobile Liability on a primary/non- contributory basis as required by written contract- Monroe Additional Insured for County Board of County Commissioners, its employees, officials, agents and volunteers CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 500 Whitehead Street Key West FL 33040 AUTHORIZED REPRESENTATIVE © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ® DATE (MMIDD/YYYY) ACCW ° EVIDENCE OF PROPERTY INSURANCE 9/17/2014 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY I PHONE ��� 734- 741 -0044 COMPANY Hylant Group Inc - Ann Arbor 24 Frank Lloyd Wright Dr J4100 Ann Arbor MI 48105 AGCS Marine Insurance Company 33 West Monroe Street Chicago IL 60603 FAX 734- 741 -1850 E -MAIL Debbie.Neff @hylant.com A/C No : ADDRESS: CODE: SUB CODE: AGENC HIGG -5 ruernu ; R iD #• INSURED Douglas N. Higgins, Inc. 3390 Travis Pointe, Suite A Ann Arbor MI 48108 LOAN NUMBER EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 12/10/2013 12/10/2014 TERM INATEDIFCHECKED THIS REPLACES PRIOR EVIDENCE DATED: POLICY NUMBER MXI93026986 PROPERTY INFORMATION LOCATION /DESCRIPTION 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 EVIDENCE OF SUBJECT TO ALL PROPERTY TE TERMS EXCL AND CONDITIONS OF SUCH POLICIES. IN LIMITS SHOWN BEEN O R REDUCED BY DESCRIBED D CLAIMS. IS COVERAGE INFORMATION COVERAGE /PERILS /FORMS AMOUNT OF INSURANCE DEDUCTIBLE Installation Floater - "Special" cause of loss form, Replacement Cost 5,000,000 5,000 At Job Site 530,000 5,000 Temporary Storage Location 340,000 5,000 In Transit 1,000,000 25,000 Flood Sublimit 1,000,000 25,000 Earthquake Sublimit 2% deductible for Florida windstorm subject to $22,500 minimum RFMARKS llnciudina S pecial Conditio Job: Monroe County Key West International Airport Improve Runway 27 Safety Area. Project #GAKA157 Additional Insured /Loss Payee - Monroe County Board of County Commissioners, its employees, officials, agents an volunteers 4NCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL IN NAME AND ADDRESS I MORTGAGEE U ADDITIONAL INSURED LOSS PAYEE Monroe County Board of Commissioners LOAN# 500 Whitehead Street Key West FL 33040 AUTHORIZED REPRESENTATIVE ACORD 27 (2009112) © 1993 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD