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Certificates of Insurance DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 09/20/2023 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 CONTACT Vicky Van Wormer NAME: Brown&Brown of Florida,Inc. a/cNr o Ext: (727)461-6044 a/c,No): (727)442-7695 140 Fountain Parkway N E-MAIL Vicky.VanWormer@bbrown.com ADDRESS: Suite 600 INSURER(S)AFFORDING COVERAGE NAIC# St.Petersburg FL 33716 INSURERA: The Charter Oak Fire Insurance Company 25615 INSURED INSURER B: The Travelers Indemnity Company of America 25666 Kisinger Campo&Associates,Corp.KCCS,Inc.,DBA:Campo& INSURER C: Travelers Casualty and Surety Company 19038 201 N Franklin St,Suite 400 INSURER D: Admiral Insurance Company 24856 INSURER E: Tampa FL 33602 INSURER F: COVERAGES CERTIFICATE NUMBER: 23-24 Cert 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 MAYBE 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDreme $ 300,000 MED EXP(Any one person) $ 10,000 A Y P-630-8254A604-COF-23 10/01/2023 10/01/2024 PERSONAL&ADV INJURY $ 1,000,000 MOTHER LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT: Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y 810-5N338364-23-43-G 10/01/2023 10/01/2024 BODI LY I NJ U RY(Pe r accide nt) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Uninsured motorist $ 1,000,000 UMBRELLA LIAB "`M "'y,_ OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION X1 STATUTE EORH AND EMPLOYERS'LIABI LI TY Y/N SOO,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ C OFFICER/MEMBER EXCLUDED? N/A UB-007J070308 10/03/2023 10/03/2024 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability-Architects& Per Claim 1,000,000 D Engineers E0000027205-09 10/01/2023 10/01/2024 Aggregate 1,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) [Job#:KCA Contract#1202209.00 Job Type:On Call Prof Engineering Srvcs-Monroe County] The Certificate Holder,Monroe County,is an Additional Insured on a primary non-contributory basis including ongoing and completed operations with respect to General Liability if required by written contract and with respect to Auto Liability as per the Auto coverage form. A Waiver of Subrogation in favor of the Certificate Holder applies to General Liability,Auto Liability and Workers Compensation if required by written contract. INT Certificate Holder will be given 60 day notification of cancellation,expect 10 days for non-payment of premium. y IK I 24 By 71 CERTIFICATE HOLDER CANCELLATION I 43 —�m SHOULD ANY OF THE ABOVE WAMM ?kY, THE EXPIRATION DATE THEIR Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Additional Named Insureds Other Named Insureds Campo & Associates, PLLC Doing Business As Campo & Associtates LLC Campo & Associtates, PLLC KCCS, Inc. OFAPPINF(02/2007) COPYRIGHT 2007,AMS SERVICES INC ADDITIONAL COVERAGES Ref# Description Coverage Code Form No. Edition Date Employee Benefits AGG Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 2,000,000 Ref# Description Coverage Code Form No. Edition Date Rental Reinbursement Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref# Description Coverage Code Form No. Edition Date PIP-Basic PIP Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Statutory Ref# Description Coverage Code Form No. Edition Date Medical payments MEDPM Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 5,000 Ref# Description Coverage Code Form No. Edition Date Underinsured motorist combined single limit UNCSL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 Ref# Description Coverage Code Form No. Edition Date Experience Mod Factor 1 EXP01 Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref# Description Coverage Code Form No. Edition Date Increased employer's liability INEL 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 rOFADTLCV Copyright 2001,AMS Services,Inc. DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 09/21/2022 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 Vicky Van Wormer NAME: Brown&Brown of Florida,Inc. a/cNr o Ext: (727)461-6044 a/c,No): (727)442-7695 83 Park Place Blvd,Suite 101 E-MAIL Vick .VanWormer bbrown.com ADDRESS: y INSURER(S)AFFORDING COVERAGE NAIC# Clearwater FL 33759 INSURERA: The Charter Oak Fire Insurance Company 25615 INSURED INSURER B: The Travelers Indemnity Company of America 25666 Kisinger Campo&Associates,Corp. INSURER C: Travelers Casualty and Surety Company 19038 201 N Franklin St,Suite 400 INSURER D: Admiral Insurance Company 24856 INSURER E: Tampa FL 33602 INSURER F: COVERAGES CERTIFICATE NUMBER: 22-23 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDreme $ 300,000 MED EXP(Any one person) $ 10,000 A Y P-630-8254A604 10/01/2022 10/01/2023 PERSONAL&ADV INJURY $ 1,000,000 MOTHER LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y 810-5N338364 10/01/2022 10/01/2023 BODI LY I NJ U RY(Pe r accide nt) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Uninsured motorist $ 1,000,000 UMBRELLA LIAB "`M "'y,_ OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION X1 STATUTE EORH AND EMPLOYERS'LIABI LI TY Y/N SOO,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ C OFFICER/MEMBER EXCLUDED? N/A UB-7J070308 10/03/2022 10/03/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability-Architects& Per claim 1,000,000 D Engineers E0000027205-09 10/01/2022 10/01/2023 Aggregate 1,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) [Job#:KCA Contract#1202209.00 Job Type:On Call Prof Engineering Srvcs-Monroe County] The Certificate Holder,Monroe County,is an Additional Insured on a primary non-contributory basis including ongoing and completed operations with respect to General Liability if required by written contract and with respect to Auto Liability as per the Auto coverage form. A Waiver of Subrogation in favor of the Certificate Holder applies to General Liability,Auto Liability and Workers Compensation if required by written contract. Certificate Holder will be given 60 day notification of cancellation,expect 10 days for non-payment of premium. Ir 'a CERTIFICATE HOLDER CANCELLATION DA SHOULD ANY OF THE N WA THE EXPIRATION DA' Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 1/01/2022 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 Vicky Van Wormer NAME: Brown&Brown of Florida,Inc. a/cNr o Ext: (727)461-6044 a/c,No): (727)442-7695 83 Park Place Blvd,Suite 101 E-MAIL Vick .VanWormer bbrown.com ADDRESS: y INSURER(S)AFFORDING COVERAGE NAIC# Clearwater FL 33759 INSURERA: The Charter Oak Fire Insurance Company 25615 INSURED INSURER B: The Travelers Indemnity Company of America 25666 Kisinger Campo&Associates,Corp. INSURER C: Travelers Property Casualty Company of America 25674 201 N Franklin St,Suite 400 INSURER D: Travelers Casualty and Surety Company 19038 INSURER E: Admiral Insurance Company 24856 Tampa FL 33602 INSURER F: COVERAGES CERTIFICATE NUMBER: 22-23 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDreme $ 300,000 X Contractual Liability MED EXP(Any one person) $ 10,000 A Y Y P-630-8254A604 10/01/2022 10/01/2023 PERSONAL&ADV INJURY $ 1,000,000 MOTHER LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y 810-5N338364 10/01/2022 10/01/2023 BODI LY I NJ U RY(Pe r accide nt) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Uninsured motorist $ 1,000,000 UMBRELLA LIAB X 20,000,000 OCCUR EACH OCCURRENCE $ C EXCESS LAB CLAIMS-MADE Y CUP-7J748484 10/01/2022 10/01/2023 AGGREGATE $ 20,000,000 DED I X1 RETENTION $ 10,000 $ WORKERS COMPENSATION X1 SPER TATUTE EORH AND EMPLOYERS'LIABI LI TY Y/N SOO,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ D OFFICER/MEMBER EXCLUDED? N/A Y UB-7J070308 10/03/2022 10/03/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability-Architects& Per claim 2,000,000 E Engineers E0000027205-09 10/01/2022 10/01/2023 Aggregate 2,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County and FDOT are additional insured with respect to general liability,auto liability and umbrella liability.Endorsements available upon request. Waiver of Subrogation applies to general liability and workers compensation&employers liability.Explosion,Collapse&Underground hazard included in CGL.Sixty(60)day notice of cancellation applies,except for non-payment,which is ten(10)days. I ,pµ Monroe County—Mosquito Creek Bridge Replacement;KCA Contract#1202241.01 ,IBy " .,. 1.. , CERTIFICATE HOLDER CANCELLATION WAMP WO', SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 09/21/2022 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 Vicky Van Wormer NAME: Brown&Brown of Florida,Inc. a/cNr o Ext: (727)461-6044 a/c,No): (727)442-7695 83 Park Place Blvd,Suite 101 E-MAIL Vick .VanWormer bbrown.com ADDRESS: y INSURER(S)AFFORDING COVERAGE NAIC# Clearwater FL 33759 INSURERA: The Charter Oak Fire Insurance Company 25615 INSURED INSURER B: The Travelers Indemnity Company of America 25666 Kisinger Campo&Associates,Corp. INSURER C: Travelers Casualty and Surety Company 19038 201 N Franklin St,Suite 400 INSURER D: Admiral Insurance Company 24856 INSURER E: Tampa FL 33602 INSURER F: COVERAGES CERTIFICATE NUMBER: 22-23 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDreme $ 300,000 MED EXP(Any one person) $ 10,000 A Y P-630-8254A604 10/01/2022 10/01/2023 PERSONAL&ADV INJURY $ 1,000,000 MOTHER LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y 810-5N338364 10/01/2022 10/01/2023 BODI LY I NJ U RY(Pe r accide nt) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Uninsured motorist $ 1,000,000 UMBRELLA LIAB "`M "'y,_ OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION X1 STATUTE EORH AND EMPLOYERS'LIABI LI TY Y/N SOO,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ C OFFICER/MEMBER EXCLUDED? N/A UB-7J070308 10/03/2022 10/03/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability-Architects& Per claim 1,000,000 D Engineers E0000027205-09 10/01/2022 10/01/2023 Aggregate 1,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) [Job#:KCA Contract#1202209.00 Job Type:On Call Prof Engineering Srvcs-Monroe County] The Certificate Holder,Monroe County,is an Additional Insured on a primary non-contributory basis including ongoing and completed operations with respect to General Liability if required by written contract and with respect to Auto Liability as per the Auto coverage form. A Waiver of Subrogation in favor of the Certificate Holder applies to General Liability,Auto Liability and Workers Compensation if required by written contract. Certificate Holder will be given 60 day notification of cancellation,expect 10 days for non-payment of premium. ABy � CERTIFICATE HOLDER CANCELLATIONDA SHOULD ANY OF THE t APM IWA THE EXPIRATION DA' Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MWDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 09/28/2020 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 Vicky Van Wormer NAME: Brown&Brown of Florida,Inc. a/CNr o Ext: (727)461-6044 a/c,No): (727)442-4695 Pinellas Division E-MAIL vvanwormer@bbpinellas.com ADDRESS: 83 Park Place Blvd,Suite 101 INSURER(S)AFFORDING COVERAGE NAIC# Clearwater FL 33759 INSURERA: The Charter Oak Fire Insurance Company 25615 INSURED INSURER B: The Travelers Indemnity Company of America 25666 Kisinger Campo&Associates,Inc.KCCS Inc INSURER C: Travelers Property Casualty Company of America 25674 Campo&Associates,PLLC INSURER D: Travelers Casualty and Surety Company 19038 201 N Franklin St,Suite 400 INSURER E: Admiral Insurance Company 24856 Tampa FL 33602 INSURER F COVERAGES CERTIFICATE NUMBER: 20-21 Master-5M PROF Li 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 MAYBE 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 INSURANCEAUULbUbK POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDrence $ 300,000 X Contractual Liab MED EXP(Any one person) $ 10,000 A X XCU included Y 6308254A604 10/01/2020 10/01/2021 PERSONAL&ADV INJURY $ 1,000,000 MOTHER LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ B X OWNED SCHEDULED Y 8105N338364 10/01/2020 10/01/2021 BODILY INJURY(Pe r accide nt) $ /� AUTOS ONLY AUTOS X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C EXCESS LAB CLAIMS-MADE Y CUP7J748484 10/01/2020 10/01/2021 AGGREGATE $ 4,000,000 DED I X1 RETENTION $ 10,000 $ WORKERS COMPENSATION ER/� STATUTE EORH AND EMPLOYERS'LIABILITY Y/N SOO,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ D OFFICER/MEMBER EXCLUDED? N/A UB7J070308 10/03/2020 10/03/2021 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability Claims Made Per Claim 5,000,000 E Retro Date 11/02/2014 E000002720507 10/01/2020 10/01/2021 Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) [Job#:1201757.00 Job Type:] Certificate holder is an additional insured with respect to general liability,auto liability and umbrella liability.Endorsements available upon request.Waiver of Subrogation applies to general liability and workers compensation&employers liability.Explosion,Collapse&Underground hazard included in CGL. ( T By 10/2 7�2 0 2 - - ,.,--� CERTIFICATE HOLDER -w~ ICELLATION WOW KJKXYW�- IOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners(BOCC) ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AC" " CERTIFICATE OF LIABILITY INSURANCE DATE(M 04/06//2020 Y) 020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND ORALTER 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 Vicky Van Wormer NAME: Brown&Brown of Florida,Inc. a//CNr o Ext: (727)461-6044 (a/c,No): (727)442-4695 Pinellas Division E-MAIL vvanwormer@bbpinellas.com ADDRESS: 83 Park Place Blvd,Suite 101 INSURER(S)AFFORDING COVERAGE NAIC# Clearwater FL 33759 INSURERA: The Charter Oak Fire Insurance Company 25615 INSURED INSURER B: The Travelers Indemnity Company of America 25666 Kisinger Campo&Associates,Inc.,KCCS,Inc. INSURER C: Travelers Property Casualty Company of America 25674 Campo&Associates,PLLC INSURER D: Travelers Casualty and Surety Company 19038 201 N.Franklin Street,Ste.400 INSURER E: Admiral Insurance Company Tampa FL 33602 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2022177433 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 MAYBE 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 AUUL 5UbK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MWDD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR PREMISES DAMAGOEa oNcurrrence $ 300,000 X Contractual Liab MED EXP(Any one person) $ 10,000 A X XCU Included Y 6308254A604 10/01/2019 10/01/2020 PERSONAL&ADV INJURY $ 1,000,000 RTHER AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 OLICY PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED y 8105N338364 10/01/2019 10/01/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X PIP$10,000 $ X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 4,000,000 C EXCESS LIAB CLAIMS-MADE Y CUP7J748484 10/01/2019 10/01/2020 AGGREGATE $ 4,000,000 DED I X1 RETENTION $ 10,000 $ WORKERS COMPENSATION X STER ATUTE X EORH AND EMPLOYERS'LIABILITY Y/N SOO,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ D OFFICER/MEMBER EXCLUDED? N/A UB7J070308 10/03/2019 10/03/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liabiltiy Per Claim 5,000,000 E Claims Made Retro Date 11/2/2014 E000002720506 11/02/2019 10/01/2020 Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Certificate holder is an additional insured with respect to general liability,auto liability and umbrella liability.Endorsements available upon request.Waiver of Subrogation applies to general liability and workers compensation&employers liability.Explosion,Collapse&Underground hazard included in CGL. )"SK ,. 4/8 2020 ®d CERTIFICATE HOLDER WAAW WkXylft�— CELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners(BOCC) ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00217417 LOC#: AC"J?" ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Brown&Brown of Florida,Inc. Kisinger Campo&Associates,Inc. POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance:Notes Certificate holder will be given 60 day notification of cancellation,except 10 days for non payment of premium. KCA Project 1201757.00 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A ® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/25/2018 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 CONTACT NAME: Vicky Van Wormer Brown&Brown Insurance-Clearwater PHONE FFAX 83 Park Place Blvd.,Suite 101 _EALcAtojan.727-450-7018 I(NC.No);727-450-7083 E-MAIL Clearwater FL 33757-2456 _A ss; wanwormer.t:bbpinelias.com INSURER(S)AFFORDING COVERAGE NAIC Y ---------------------------- INSURER A:Admiral Insurance Company 24856 INSURED INSURER B:The Travelers Indemnity Company of America_ 25666 Kisinger Campo&Assoc. Corp.KCCS, Inc. INSURER c:The Charter Oak Fire Insurance Company 25615 — Campo&Associates,PLLC INSURER D:Travelers Casualty and Surety Company 19038 ___ 201 N. Franklin Street, Ste.400 INSURERS: Tampa FL 33602 INSURER F: COVERAGES CERTIFICATE NUMBER:914098674 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. TNSR- TYPE OF INSURANCE ADOL SLIER POUCY EFF POUCY EXP LIMITS LTR INSD WVD POUCY NUMBER JMMf00/YYYYI ( 100IYYYY► C X COMMERCIAL GENERAL LIABILITY 6308254A604 9/1/2018 9/1/2019 EACH OCCURRENCE 51,000,000 RENTED CLAIMS-MADE X OCCUR PPRREMMIISEESD(Es Q00.are e) , 5 300,000 X Contractual Liab AP B <iA EMENT MED EXP(Any one person) $10,000 X XCU Included BY PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. GENERAL AGGREGATE $2,000,000 POLICY I X LOC DATE, PRODUCTS-COMP/OP AGG $2,000,000 OTHER WANES y� _ ��,�.�e $ B AUTOMOBILE LIABILITY 8102G365561 /1/20rB--' 9/1/2019 COMBINED sitst eLIMIT $1.000,000 (Es scUdentl X ANY AUTO BODILY INJURY(Per person) $ — OWNED SCHEDULED BODILY INJURY(Per acadent) $ AUTOS ONLY AUTOS 1 X HIRED X NON-OWNED PROPERTYOIAMAGE $ — AUTOS ONLY AUTOS ONLY _IPM a 101). X Pip$10,000 _ $ B X UMBRELLA LIAB X OCCUR CUP7J748484 9/1/2018 9/1/2019 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED X RETENTION$10 000 $ O WORKERS COMPENSATION UB7J070308 10/3/2018 10/3/2019 X PER y ATUTE X OTH LlS.LJ�. AND EMPLOYERS'LIABILITY - — ANYPROPRIETOR/PARTNER/EXECUTIVE Ya EL EACH ACCIDENT 5500.000 OFFICER/MEMBER EXCLUDED' N/A (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $500,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $500,000 A Professional Liability E000002720505 11/2/2018 11/2/2019 Per Claim 5,000,000 Claims Made Aggregate 5,000,000 Relro Date 11/2/2014 Deductible 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Certificate holder is an additional insured with respect to general liability,auto liability and umbrella liability.Endorsements available upon request.Waiver of Subrogation applies to general liability and workers compensation&employers liability.Explosion,Collapse&Underground hazard Included in CGL. ON-CALL PROFESSIONAL ENGINEERING SERVICES AGREEMENT AND ALL TASK WORK ORDERS AUTHORIZED HEREUNDER. 60-DAYS NOTICE OF CANCELLATION OR NON-RENEWAL PER ATTACHED FORM IH-03020608. (KCA PROJECT#1201316.00) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MONROE COUNTY-BOCC ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: JUDITH S.CLARKE,PE,DIRECTOR OF ENG SVCS AUTHORIZED REPRESENTATIVE 1100 SIMONTON STREET,#216 KEY WEST FL 33040 4411. R.Vu1w 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 016/03) The ACORD name and logo are registered marks of ACORD ACOR 1 0 A� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 10/30/2017 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 endorsements . PRODUCER Brown & Brown Insurance - Clearwater 83 Park Place Blvd., Suite 101 Clearwater FL 33757-2456 CONTNAME: Vicky Van Wormer P"oNE 727-450-7018 FAX 727-450-7083 E-MAIL vvanwormer@bb Ip'nellas.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Admlral Insurance Company 24856 INSURED INSURER B:The Travelers Indemnity Company of.America _ 25666 INSURER C :The Charter Oak Fire Insurance Company 25615 Kisinger Campo & Assoc. Corp. Campo & Associates, PLLC, KCCS, Inc. 201 N. Franklin Street, Ste. 400 INSURER D :Travelers Casualty and Surety Company 19038 Tampa FL 33602 INSURER E : INSURER F : PnVFRAn=Q rFRTIFIr_ATF KII IMRFR• 1031222528 RFVm1om 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. INSR LTR TYPE OF INSURANCE ADDLISUBR INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS C X COMMERCIAL GENERAL LIABILITY 630-8254A604 9/1/2017 91W018 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X� OCCUR DAMAGE TO RENTED PREMISES Ea occur ence $300,000 X MED EXP (Any one person) $10,000 Contractual X XCU Liability PERSONAL& ADV INJURY $1,000,000 LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $2,000,000 POLICY [X]jE LOC M'OTHER: PRODUCTS - COMP/OP AGG $2,000,000 $ B AUTOMOBILE LIABILITY 8108254A604 9/1/2017 9/1/2018 Ee 11acc deO SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED X AUTOS ONLY N AUTOS ONLY B X UMBRELLA LIAB Xd OCCUR CUP7J748484 9/1/2017 9/1/2018 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DIED X I RETENTION$10,000 $ D WORKERS COMPENSATION AND ENIPLOYERa LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE —N OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N / A U62G641560 10/3/2017 10/3/2018 X STNTUTE X ERH U.S�L-.H: E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $500,000 If yes, describe under DESCRIPTION OF OPERATIONS below A Professional Liability Claims Made E000002720504 11/2/2017 11/2/2018 Per Claim 5,000,000 Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability. Explosion, collapse and underground hazard included in CGL. . HEREUNDER. ON -CALL PROFESSIONAL ENGINEERING SERVICES AGREEMENT AND ALL TASK WORK ORDWR- 60-DAYS NOTICE OF CANCELLATION OR NON -RENEWAL PER ATTACHED FORM IH-030206081201316.00) APPG�MENT BY WAI CERTIFICATE HOLDER CANCELLATION f SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MONROE COUNTY - BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: JUDITH S. CLARKE, PE, DIRECTOR OF ENG SVCS ACCORDANCE WITH THE POLICY PROVISIONS. 1100 SIMONTON STREET, #216 KEY WEST FL 33040 AUTHORIZED REPRESENTATIVE 4241L R. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ACORO0 AC� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 110/18/2016 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 Brown & Brown Insurance - Clearwater 83 Park Place Blvd., Suite 101 Clearwater FL 33757-2456 CONT_NAMEVicky Vick Van Wormer PHONE n XC. N 727 442-7695 E-MAIL -- vvanwormer@bbpinellas.com INSURERS AFFORDING COVERAGE NAIC # INSURER A:Admiral Insurance Company 24856 INSURED INSURER B:The Travelers IndemnityCompany Of 25666 Kisinger Campo & Assoc. Corp. INSURERC:The Charter Oak Fire Insurance Comp 25615 Campo & Associates, PLLC, KCCS, Inc. 201 N. Franklin Street, Ste. 400 INSURER D :Travelers Casualty and Surety Coma 19038 INSURER E : Tampa FL 33602 INSURER F CnVFRAnFR rFRTIFIr ATF NIIMRFR• 976017792 RFVIC1r1N 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. INSR LTR I TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS C X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE XI OCCUR 630-8254A604 A D B I 9/1/2016 K MAN 9/1/2017 ENT EACH OCCURRENCE $1,000,000 DAMA PREM SES Ea occur ence $300,000 X MED EXP (Any one person) $10,000 Contractual BY X XCU Liability PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 GEN'L DATE7 POLICY F7X ECT LOC WAIVER N YES--- PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: B AUTOMOBILE LIABILITY 8108254A604 9/1/2016 9/1/2017 BINED Ea accident L L I $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO AUTOS OWNED SCHEDULED BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAB X OCCUR CUP8254A604 9/1/2016 9/1/2017 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N N I A UB2G641560 10/3/2016 10/3/2017 X PER X OTH- STATUTE ER U.S.L.H. E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYE $500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below ! E.L. DISEASE - POLICY LIMIT 1 $500,000 A Professional Liability E000002720503 11/2/2016 11/2/2017 Per Claim 5,000,000 Claims Made Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability. Explosion, collapse and underground hazard included in CGL. . ON -CALL PROFESSIONAL ENGINEERING SERVICES AGREEMENT AND ALL TASK WORK ORDERS AUTHORIZED HEREUNDER. 60-DAYS NOTICE OF CANCELLATION OR NON -RENEWAL PER ATTACHED FORM IH-03020608. (KCA PROJECT #1201316.00) L9 iw I L"L\I a i hJ 11111"Oil 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MONROE COUNTY - BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: JUDITH S. CLARKE, PE, DIRECTOR OF ENG SVCS ACCORDANCE WITH THE POLICY PROVISIONS. 1100 SIMONTON STREET, #216 KEY WEST FL 33040 AUTHORIZED REPRESENTATIVE 1C�/_� . V"4'� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AlCoRV® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 8/29/2017 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 endorsemen s . PRODUCER Brown & Brown Insurance - Clearwater 83 Park Place Blvd., Suite 101 Clearwater FL 33757-2456 COACT NAME* Vick Van Wormer PN(AIONE 727_450-7018 F"X 727-450-7083 E-MAIL . vvanwormer@bbpinellas.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Admiral Insurance Company 24856 INSUREn INSURER B :The Travelers Indemnity Company of America 2566E INSURER C :The Charter Oak Fire Insurance Company 25615 Kisinger Campo & Assoc. Corp. INSURER D :Travelers Casualty and Surety Company 19038 Campo & Associates, PLLC, KCCS, Inc. 201 N. Franklin Street, Ste. 400 Tampa FL 33602 INSURER E : INSURER F rnvGRAr-cc rFRTIFIrATE NUURFR• 1060582912 REVISION NUMBER: vTHIS 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 INSURANCEADDLSUBR INSD MD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DD/YYYY LIMITS C X COMMERCIAL GENERAL LIABILITY 630-8254A604 9/1/2017 9/1/2018 EACH OCCURRENCE $1,000,000 CLAIMSRENTED -MADE �X OCCUR DAMAGE ToEa occurrence) PREM IS $300,000 X MED EXP (Any one person) $10,000 Contractual X XCU Liability PERSONAL SADVINJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 POLICY � JE � LOG $ OTHER: B AUTOMOBILE LIABILITY 8108254A604 9/1/2017 9/1/2018 COMBINED Ea accident $1,000,000 BODILYINJURY(Perperson) $ ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOSHIRED NON -OWNED AUTOS ONLY X AUTOS ONLY IX PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAB X OCCUR CUP8254A604 9/1/2017 9/1/2018 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DIED X I RETENTION $10,000 $ D .WORKERS CpMPEN34TIC�N AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICERIMEMBER EXCLUDED? N (Mandatory In NH) N/A l:E2G64156O 10/3/2017 1^,13/2^vig ^ PFR X DTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEIf L$50O,000 E..SE - POLICY LIMIT yes, describe underDESCRIPTION OF OPERATIONS below A Professional lability Claims Made E000002720503 11/2/2016 11/2/2017 Per Claim 5,000,000 Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability. Explosion, collapse and underground hazard included in CGL. IZED HEREUNDER. 60-DAYS NOTICE OF CANCELLATION OR NON -RENEWAL PER ATTACHED FORMCT #1201316.00) ON -CALL PROFESSIONAL ENGINEERING SERVICES AGREEMENT AND ALL TASKWW�;c EMENT CERTIFICATE HULUhK I+ANt,CLLPI I IUN MONROE COUNTY - BOCC ATTN: JUDITH S. CLARKE, PE, DIRECTOR OF ENG SVCS 1100 SIMONTON STREET, #216 KEY WEST FL 33040 G.L ' 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 _ 440. 7C S'E-NTTATIVVE, R. W;/' ACORD 25 (2016/03) U 1985-ZU15 ACUKU GUKFUKA I IUN. All rlgnis reserveo. The ACORD name and logo are registered marks of ACORD AC'" D CERTIFICATE OF LIABILITY INSURANCE DATE(MMMD/YYYY) 110/31/2014 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 endorsements . PRODUCER Brown & Brown Insurance - Clearwater P O Box 2456 CONTACT NAME, Sara Walcz kiewicz PHONE 727 461-6044 FAT( 727 442-7695 E-MAIL . swalczykiewicz@bbpinellas.com Clearwater FL 33757-2456 INSURERS AFFORDING COVERAGE NAIC INSURER A: Hartford Fire Insurance CO. 19682 INSURED Kisinger Campo & Assoc. Corp. KCCS, Inc. INSURER B: Hartford Casualty Insurance Co 29424 INSURER C :Admiral Insurance Company 24856 INSURER D : Campo & Associates, PLLC 201 N. Franklin Street, Ste. 400 Tampa FL 33602 INSURER E : INSURER F : COVERAGES CERTIFICATE NIIMRER- 1B74770047 r, wrc. — .0 .. r«V1Q1Vn numoErt: 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 INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/Yl'YY LIMITS B X COMMERCIAL GENERAL LIABILITY Y 21UUNAG7547 /1/2014 /1/2015 EACH OCCURRENCE $1,000,000 �X DAMAGE TO RENTED NO CLAIMS -MADE OCCUR PREMISES Ea $100,000 X MED EXP (Any one person) $10,000 Contractual XCU Liability PERSONAL & ADV INJURY $1,000,000 X AGGREGATE LIMIT APPLIES PER: 1K GENERAL AGGREGATE $2,000,000 GEN'L PRODUCTS - COMP/OP AGG $2,000,000 POLICY JECT 0 LOC OTHER: B AUTOMOBILE LIABILITY Y 21UENNE3246 /1/2014 /1/2015 Ea accident $1,000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ JX AUTOS AUTOS HIRED AUTOS X AUT SWNED PROPERTY DAMAGE $ Per accident $ B X UMBRELLA LIAB XJ OCCUR Y 21XHUAG7607 /1/2014 /1/2015 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $4,000,000 DIED IX I RETENTION $10.000 $ q WORKERS COMPENSATION 21WBNW1033 10/3l2014 10/3/2015 PER OTH- X AND EMPLOYERS' LIABILITY Y / N STATUTE ER E.L. EACH ACCIDENT $500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED, ❑N N / A E.L. DISEASE - EA EMPLOYE $500,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS below C Professional Liability Claims Made E000002720501 1/2/2014 11/2/2015 Per Claim 5,000,000 Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space Is required) Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability. Explosion, collapse and underground hazard included in CGL. . ENGINEERING DESIGN & PERMITTING SERVICES FOR CARD SOUND BRIDGE REPAIR PROJECT LOCATED IN MONROE COUNTY, FL. 60-DAYS NOTICE OF CANCELLATION OR NON -RENEWAL PER ATTACHED FORM IH-03020608. (KCA PROJECT #1201302.00) V GEMENT PYM to- MONROE COUNTY - BOCC ATTN: JUDITH S. CLARKE, FpE-_DJfEf1T Tf EALG SVCS 06 • Ildd (L. AU 1100 SIMONTON STREET KEY WEST FL 33040 080338 80J 031 ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. IORIZED REPRESENTATIVE 440.. JR. V(� CV 1835-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD `il--V��, 8/27/2014 7/20CERTIFICATE OF LIABILITY INSURANCE M/DD/YYYr) 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(- 0- PRODUCER 3rown & Brown Insurance - Clearwater O Box 2456 'learwater FL 33757-2456 INSURED Kisinger Campo & Assoc. Corp. KCCS, Inc. Campo & Associates, PLLC 201 N. Franklin Street, Ste. 400 Tampa FL 33602 Deborah Gale 1,727 461-6044 FAX hot 727 442-7695 Igale@DDpineiias.com (AIC INSURERS AFFORDING COVERAGE NAIC Hartford Fire Insurance Co. 19682 Hartford Casualty Insurance Co 29424 Continental Casualtv Co. gnaaz THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREDcNAMED 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. tR LTR B X TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR contractual ��""'�` INSD Y WVD POLICY NUMBER 21UUNAG7547 BY K BV — WONER ��/V�GrI POLICY EFF MM/DDIYYYY /1/2014 AQEME POLICY EXP MM/DD/YYYY /1/2015 LIMITS EACH OCCURRENCE $11000,00( X X GEN'L DAMAGE TO RENTED PREMISES Ea occurrence $100,000 XCU Liability MED F�(P (Any one person) $10,000 AGGREGATE LIMIT APPLIES PER: POLICY � PRO- LOC OTHER: PERSONAL & ADV INJURY $1,000,OOC GENERAL AGGREGATE $2,000,00C �r �. PRODUCTS - COMP/OP AGG $2,000,OOC A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS x NON -OWNED AUTOS Y 21UENNE3246 /1/2014 /1/2015 $ Ea accident $1,000,00() X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAS EXCESS LIAR X OccUR ,., .,..� ....,� Y 21XHUAG7607 /1/2014 /1/2015 EACH OCCURRENCE $4,000,000 A IWORKERS COMPENSATION 21 WBNW 1033 0/3/2014 10/3/2015 J( PER OTH- $ AND EMPLOYERS' LIABILITY Y / N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑N N / A E.L. EACH ACCIDENT $500,000 (Mandatory In NH) H yes, describe under E.L. DISEASE - EA EMPLOYE $500,000 DESCRIPTION OF OPERATIONS below C E.L. DISEASE -POLICY LIMIT 1 $500,000 Professional Liability OkEH288295813 11/2/2013 11/2/2014 Per Claim 2,000,000 Claims Made Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability. Explosion, collapse and underground hazard included in CGL. . ON -CALL PROFESSIONAL ENGINEERING SERVICES AGREEMENT AND ALL TASK WORK ORDERS AUTHORIZED HEREUNDER. SO -DAYS NOTICE OF CANCELLATION OR NON -RENEWAL PER ATTACHED FORM IH-03020608. (KCA PROJECT #1201316.00) TE LLA SHOULD ANY OF THE ABOVE DESCRIBED•POL�3ICIES BE'CANCELLED BEFORE MONROE COUNTY - BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: JUDITH S. CLARKE, PE, DIRECTOR OF ENG ACCORDANCE WITH THE POLICY PROVISIONS. SVCS AN ON 1100 SIMONTON STREET, #216 AUTHORIZED REPRESENTATIVE KEY WEST FL 33040 080338 u0i 03113 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ACOROa C40 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 110/31/2014 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 endorsements . PRODUCER Brown & Brown Insurance - Clearwater P O Box 2456 Clearwater FL 33757-2456 CONTACT Sara Walcz kiewicz Fax PHONE . 727 461-6044 . 727 442-7695 E-MAIL . swalczykiewicz@bbpinellas.com INSURERS AFFORDING COVERAGE NAIC A INSURER A: Hartford Fire Insurance Co. 19682 INSURED INSURER B: Hartford Casualty Insurance Co 29424 Kisinger Campo & Assoc. Corp. INSURER C :Admiral Insurance Company 24856 KCCS, Inc. Campo & Associates, PLLC INSURER D INSURER E : 201 N. Franklin Street, Ste. 400 INSURER F : Tampa FL 33602 COVERAGES CERTIFICATE NUMBER. 363048704 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 DDLSUBR INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY Y 21UUNAG7547 /1/2014 /1/2015 EACH OCCURRENCE $1,000,000 CLAIMS -MADE Fx I OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $100,000 X MED EXP (Any one person) $10,000 Contractual X XCU Liability PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY 7 JPECOT- LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: B AUTOMOBILE LIABILITY Y 21UENNE3246 /1/2014 11/2015 EaacciNED SINGLE LIMIT dant $1,000,000 X BODILY INJURY (Per person) $en ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) ) $ XIAUTOS HIRED AUTOS X NON -OWNED PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAB X OCCUR Y 21XHUAG7607 /1/2014 /1/2015 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DED X I RETENTION $10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N N I A 21WBNW1033 10/3/2014 10/3/2015 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - FA EMPLOYE $500,000 (Mandatory In NH) If yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $500,000 C Professional Liability E000002720501 11/2/2014 11/2/2015 Per Claim 5,000,000 Claims Made Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability. Explosion, collapse and underground hazard included in CGL. . ON -CALL PROFESSIONAL ENGINEERING SERVICES AGREEMENT AND ALL TASK WORK ORDERS AUTHORIZED HEREUNDER. 60-DAYS NOTICE OF CANCELLATION OR NON -RENEWAL PER ATTACHED FORM IH-03020608. (KCA PROJECT #1201316.00) BA "0 GEMENT DA ' 3 '813 1i MONROE COUNTY - BOCC SVCS JUDITH S. CLARKE, P6,e.JE�QR t EI S 6 1100 SIMONTON STREET, #216 a L A(J� KEY WEST FL 33040 080338 803 0311 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ORIZED REPRESENTATIVE 4240. lR. Vf� @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 11/2/2015 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 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTANAME, Sara Walcz kiewicz Brown & Brown Insurance - Clearwater PHONE FAX 727 442-7695 P O Box 2456 Clearwater FL 33757-2456 E-MAIL swalczykiewicz@bbpinellas.com INSURERS AFFORDING COVERAGE NAIC # INSURER A:Admlral Insurance Company 24856 INSURED INSURER B :Charter Oak Fire Insurance Co. 25615 Kisinger Campo & Assoc. Corp. INSURER C :Travelers Indemnity of America 25666 KCCS, Inc. Campo & Associates, PLLC INSURER D :Travelers Property Cslty Ins 36161 1 INSURER E: Travelers Casualty and Surety 19038 201 N. Franklin Street, Ste. 400 1 INSURER F Tampa FL 33602 CnVFRArFR CERTIFICATE NIIMRPR• 358768640 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. TYPE OF INSURANCE ADDLSUBR IN D WVD POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYYX LIMITS COMMERCIAL GENERAL LIABILITY Y 810-8254A604 9/1/2015 9/1/2016 EACH OCCURRENCE $1,000,000 rLTSR CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $100,000 X MED EXP (Any one person) $10,000 Contractual • XCU Liability PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY a JECT LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: C AUTOMOBILE LIABILITY Y 8102G365561 9/1/2015 9/1/2016 Ea accident LIMIT $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO AUTOS OWNED SCHEDULED X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ D X UMBRELLA LIAB X OCCUR Y CUP2G361734 9/1/2015 9/1/2016 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DED X I RETENTION$10,000 $ E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A UB213641560 10/3/2015 10/3/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEd $500,000 E.L. DISEASE - POLICY LIMIT 1 $500,000 If yes, describe under DESCRIPTION OF OPERATIONS below A Professional Liability Claims Made E000002720501 11/2/2015 11/2/2016 Per Claim 5,000,000 Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability. Explosion, collapse and underground hazard included in CGL. . ON -CALL PROFESSIONAL ENGINEERING SERVICES AGREEMENT AND ALL TASK WORK ORDERS AUTHORIZED HEREUNDER. 60-DAYS NOTICE OF CANCELLATION OR NON -RENEWAL PER ATTACHED FORM IH-03020608. (KCA PR T #1201316.00) APPR VE MEM DAE ULK I II-IUA I t MULULK MONROE COUNTY - BOC ATTN: JUDITH S. CLARKE, SVCS 1100 SIMONTON STREET, KEY WEST FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE C THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN _ G PT(f IIQ(.pRDANCE WITH THE POLICY PROVISIONS. PE, DIRECTOR OF ENG ]IUG #216 660j38 80_4 a AJJ��RIE�ESEN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD l ® ACERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 11/2/2015 v THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Brown & Brown Insurance - Clearwater CONTACT NAME: Sara Walcz kiewicz PHONE FAX 727 442-7695 P O Box 2456 Clearwater FL 33757-2456 E-MAIL swalczykiewicz@bbpinellas.com INSURERS AFFORDING COVERAGE NAIC A INSURER A :Admiral Insurance Company 24856 INSURED Kisinger Campo & Assoc. Corp. KCCS, Inc. INSURER B :Travelers Indemnity of America 25666 INSURER C :Travelers Casuaq and Surety 19038 INSURER D :Charter Oak Fire Insurance Co. 25615 INSURER E : Campo & Associates, PLLC 201 N. Franklin Street, Ste 400 Tampa FL 33602 INSURER F : COVERAGES GtKIIFIUAIt NUlvltstr[: 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 D X TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR Contractual Liab ADDLrgm INSD WVD POLICY NUMBER 810-8254A604 POLICY EFF MM/DD/YYYY 9/1/2015 POLICY EXP MMIDDIYYYY 9/1/2016 LIMITS EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person) $10,000 X PERSONAL & ADV INJURY $1,000,000 X GEN'L XCU Liability GENERAL AGGREGATE $2,000,000 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY PRO- JECT LOC POTHER: $ B AUTOMOBILE LIABILITY ANY AUTO ALLNED SCHEDULED NUTOS D HIRED AUTOS rAUTOS Ix 8102G365561 9/1/2015 9/1/2016 Ea accident)$1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ B UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE CUP2G361734 9/1/2015 9/1/2016 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 rd X I STATUTE I OERH $ C N / A UB2G641560 10/3/2015 10/3/2016 DED X I RETENTION$10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYE $500,000 E.L. DISEASE - POLICY LIMIT $500,000 A Professional Liability Claims Made N E000002720501 11/2/2015 11/2/2016 Per Claim 5,000,000 Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certificate Holder is an additional insured with respect to general liability ,auto liability and umbrella liability. Endorsements available upon Underground hazard included in CGL. request. Waiver of Subrogation applies to general liability and workers compensation & employers liability. Explo*DNAGf]&NT Project: Engineering Design and Permitting Services for Emergency Repairs to No Name Key Bridge. A�PPRO 60 Days notice of cancellation or non -renewal per attached IH0302 0608.W V I., "kiH of �O&IOW FICA I t Monroe County BOCC NOW 6_ AON SI Attn: Ms Judith S Clarke, Dir of Engineering 1100 Simonton Street 06003'd 80A 0311 Key West FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ORIZED REPRESENTATIVE 4140. ;e. "i;Ir .. ....... ...... wr•�mm nnnnrno AT•r1W All A, kfc rcc—arl ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD V ACC)R v A CERTIFICATE OF LIABILITY INSURANCE YY) DATE (MMIDDIYY 11/2/2015 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 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)CONTA. PRODUCER Brown & Brown Insurance - Clearwater NAME: Sara Walcz kiewicz PHONE FAX 727 442-7695 P O Box 2456 Clearwater FL 33757-2456 E-MAIL . swalczykiewicz@bbpinellas.com INSURERS AFFORDING COVERAGE NAIC N INSURER A :Admiral Insurance Company 24856 INSURED INSURER B: Charter Oak Fire Insurance Co. 25615 INSURER C :Travelers Indemnity of America 25666 Kisinger Campo & Assoc. Corp. INSURERD:Travelers Property CsIty Ins 36161 KCCS, Inc. Campo & Associates, PLLC 201 N. Franklin Street, Ste. 400 INSURER E :Travelers Casualty and Surety 19038 INSURER F : Tampa FL 33602 rnv�onr�c r`I=RTIPIf-ATE All IMRFR• 360978816 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 INSURANCEADDLISUBIR IN D WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR Y 810-8254A604 9/1/2015 9/1/2016 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $100,000 X MED EXP (Any one person) $10,000 Contractual X XCULiability PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 POLICY PRO ❑ LOC JECT $ OTHER: C AUTOMOBILE LIABILITY Y 8102G365561 9/1/2015 9/1/2016 Ea accidenCOMBINEDt $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL AUTOS NED SCHEDULED -OWNED X HIRED AUTOS X NONUTS AUTOS PPeOacc 'ZI) DAMAGE $ D X UMBRELLA LIAB X OCCUR Y CUP2G361734 9/1/2015 9/1/2016 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETEN7ION$10,000 $ E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N / A U82G641560 10/3/2015 10/3/2016 ER T- X STATUTE ERH E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYE $500,000 E.L. DISEASE - POLICY LIMIT 1 $500,000 If yes, describe under DESCRIPTION OF OPERATIONS below A Professional Liability Claims Made E000002720501 11/2/2015 11/2/2016 Per Claim 5,000,000 Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability. Explosion, collapse and underground hazard included in CGL. . ENGINEERING DESIGN & PERMITTING SERVICES FOR CARD SOUND BRIDGE REPAIR PROJECT LOCATED IN MONROE COUNTY, FL. 60-DAYS NOTICE OF CANCELLATION OR NON -RENEWAL PER ATTACHED FORM IH-030206 JECT #1201302.00) gAA. PROVGIEMENT D l W GtKIII-II.AIt I'1VLLJtK -1 n MONROE COUNTY - BOCC �`Q ;7��O6�� ATTN: JUDITH S. CLARKE, PE, E Svcs 1100 SIMONTON STREET ilti`ojj a �O� �3 KEY WEST FL 3304E 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 -i Auto. k Slitd o:,r V lyifif-YVl4 AI.VKU I,VRF'V RAI IV ry. NII ngnls • ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD / 1 DATE (MMIDD/YYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE II 19/9/2015 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 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER NAME: CONTACT Sara WaICZ kiewicz Brown & Brown Insurance - Clearwater PHONE FAX 727 442-7695 P O Box 2456 E-MAy Clearwater FL 33757-2456 IL . swaiczykiewicz@bbpinellas.com p bb inellas.com INSURER A:AUInlras IIISUIOIIt:C t-1UIIIIJcIIIY INSURED INSURER B :Travelers Indemnity of America 25666 Kisinger Campo & Assoc. Corp. INSURERC:Travelers Casualty and Surety 19038 KCCS, Inc. INSURERD:Charter Oak Fire Insurance Co. 25615 Campo & Associates, PLLC 201 N. Franklin Street, Ste 400 INSURERE: Tampa FL 33602 1 INSURERF: '7e-I04e% AD novlcrnu u1IRMOCG• 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,SUMPOLICY INSD' WVD POLICY NUMBER EFF MM/DO/YYYY POUCY EXP MM/DDIYYYY LIMITS D x COMMERCIAL GENERAL LIABILITY 6302G361734 9/1/2015 9/1/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE I X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence 8100,000 X MED EXP (Any one person) $10,000 Contractual Liab X XCU Liability PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 POLICY � P COT- LOC $ OTHER B AUTOMOBILE LIABILITY 8102G365561 9/1/2015 9/1/2016 COMBINED SINGLE LIMI 1 Ea accident)$1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ 8WNED SCHEDULED AUTOS NON -OWNED NONWNED ALIXI PROPERTYDAMA E $ HIRED AUTOS X AUTOS F rarcid $ B UMBRELLA uAB X OCCUR CUP2G361734 9/1/2015 9/1/2016 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LABCLAIMS-MADE DIED X RETENTION $10,000 $ WORKERS COMPENSATION UB2G641560 10/3/2015 10/3/2016 PER OTH- X STATUTE ER 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? r N (Mandatory in NH) N / A E.L. DISEASE -POLICY LIMIT $500,000 If yes, describe under DESCRIPTION OF OPERATIONS below A Professional Liability N E000002720501 11/2/2014 11/2/2015 Per Claim 5,000,000 Claims Made Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Certificate Holder is an additional insured with respect to general liability ,auto liability and umbrella liability. Endorsements Available upon request. Waiver of Subrogation applies to general liability and workers compensation & employers liability. Explos' n, II & Underground hazard included in CGL. AP Project: Engineering Design and Permitting Services for Emergency Repairs to No Name Key Bridge. A PRO D _ GEMENT 60 Days notice of cancellation or non -renewal per attached IH0302 0608. W t�l CERTIFICATE HULDER Monroe County BOCC Attm Ms Judith S Clarke, Dir of Engineering 1100 Simonton Street Key West FL 33040 lr/11Y V C LLF1 I I V 1. V -. rn SHOULD ANY OF THE ABOVE DESCRIBED POLIfE CANOED MORE THE EXPIRATION DATE THEREOF, NOTICE BE D LIVE IN ACCORDANCE WITH THE POLICY PROVISIONS.._? N OC_: _ W �i AUTHORIZED REPRESENTATIVE T5 —0 -�C_ r _ © 1988-2014 ACORD CORPORATION. All rigats resirved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AC40R V CERTIFICATE OF LIABILITY INSURANCE DATE(M /DD/YYYY) 9/1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER NAME CT Sara Walcz kiewicz Brown & Brown Insurance - Clearwater PHONE FAX . 727 442-7695 P O Box 2456 -M EAIL . swalczykiewicz@bbpinellas.com Clearwater FL 33757-2456 INSURERS AFFORDING COVERAGE NAIC N INSURER A:AdmiralInsurance Company 24856 INSURED INSURERB:Charter Oak Fire Insurance Co. 25615 Kisinger Campo & Assoc. Corp. INSURER C :Travelers Indemnity of America 25666 KCCS, Inc. Campo & Associates, PLLC INSURER D :Travelers Property CsIty Ins 36161 INSURER E: Travelers Casualty and Surety 19038 201 N. Franklin Street, Ste. 400 INSURER F Tampa FL 33602 COVERAGES CERTIFICATE NUMBER: 1106750335 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 ADDLISUBIR INSD WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY Y 6302G361734 9/1/2015 9/1/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X� OCCUR E( RENTED PREMI PREMISESSEa occurrence) $100,000 X MED EXP (Any one person) $10,000 Contractual X XCU Liability PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY FX] JPE O LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: C AUTOMOBILE LIABILITY Y 8102G365561 9/1/2015 9/1/2016 Co BINED SINGLE LIMIT-- Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO AUTOSNED AUTOSULEDBODILY Ix INJURY (Per accident) $ NON-OWNED HIRED AUTOS LAUTOS PROPERTY DAMAGE Per accident $ D X UMBRELLA LIAB X OCCUR Y CUP2G361734 9/1/2015 9/1/2016 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DED X I RETENTION $10,000 $ E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N U62G641560 10/3/2015 10/3/2016 X PER OTH- STATUTE I ER E.L. EACH ACCIDENT $500,000 ANY PROPRIETOFb'PARTNER/EXECUTIVE ;��ry � OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYEd $500,000 I] (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $500,000 A Professional Liability E000002720501 11/2/2014 11/2/2015 Per Claim 5,000,000 Claims Made Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability. Explosion, collapse and underground hazard included in CGL. . ON -CALL PROFESSIONAL ENGINEERING SERVICES AGREEMENT AND ALL TASK WORK ORDERS AUTHORIZED HEREUNDER. 60-DAYS NOTICE OF CANCELLATION OR NON -RENEWAL PER ATTACHED FORM IH-03020608. (GA PRO PPRO 'ED14g1E01316.00) ENT BY CERTIFICATE HOLDER CANCELLATION r— SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MONROE COUNTY - BOCC ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: JUDITH S. CLARKE, PE, DIRECTOR OF ENG SVCS 1100 SIMONTON STREET, #216 AUTHORIZED REPRESENTATIVE ram' KEY WEST FL 33040 �. z o r c rn ©1988-2014 ACORD CORPOWON. A ght serve ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD I-)- N O W O 7:0 I® ACOQO v A CERTIFICATE OF LIABILITY INSURANCE TE (MM/DDIYYYY) DATE 9/1/2015 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 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . Brown & Brown Insurance - Clearwater CONTAPRODUCER NAME: Sara Walcz kiewicz PHONE FAX 727 442-7695 P O Box 2456 Clearwater FL 33757-2456 EAIL -M. swalczykiewicz@bbpinellas.com INSURERS AFFORDING COVERAGE NAIC N INSURERA:Admiral Insurance Company 24856 INSURED INSURERB:Charter Oak Fire Insurance Co. 25615 INSURER C :Travelers Indemnity of America 25666 Kisinger Campo & Assoc. Corp. INSURER D :Travelers Property CsIty Ins - INSURER E: Travelers Casualty and Surety 36161 — — -- 19038 KCCS, Inc. Campo & Associates, PLLC 201 N. Franklin Street, Ste. 400 INSURER F Tampa FL 33602 fin\/C�Al�C0 /`cOTICIPATC IUIInAmr-o 137g36197g RFVISIr)N NIIMRFR• vTHIS 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 INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS B x COMMERCIAL GENERAL LIABILITY Y 6302G361734 9/1/2015 9/1/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑X OCCUR DAMAGE TO PREMSES EaENTED occu ence $100,000 X IVIED EXP (Any one person) $10,000 Contractual X XCU Liability PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRODUCTS -COMP/OP AGG $2,000,000 POLICY ECT LOC OTHER: C AUTOMOBILE LIABILITY Y 8102G365561 9/1/2015 9/1/2016 coug$ Ea accident $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ AUTOS AWNED CHEDULED OUTOS %( HIRED AUTOS X NON -OWNED IAUTOS PROPER ciUentDAMAGE $ D X UMBRELLA LIAB X OCCUR Y CUP2G361734 9/1/2015 9/1/2016 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION $ 10,000 $ E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) �NIA UB2G641560 10/3/2015 10/3/2016 PER OTH- x I STATUTE ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEd $500,000 E.L. DISEASE - POLICY LIMIT 1 $500,000 If yes, describe under DESCRIPTION OF OPERATIONS below A Professional Liability Claims Made E000002720501 11/2/2014 11/2/2015 Per Claim 5,000,000 Aggregate 5,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability. Explosion, collapse and underground hazard included in CGL. . ENGINEERING DESIGN & PERMITTING SERVICES FOR CARD SOUND BRIDGE REPAIR PROJECT LOCATED IN MONROE COUNTY, FL. 60-DAYS NOTICE OF CANCELLATION OR NON -RENEWAL PER ATTACHED FORM IH-03020608. (KCA P CT #1201302.00) PROV D EMENi /L�TI GI/ATC unr mom CAMRFI I ATInN /" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BESANQULED BEFORE MONROE COUNTY - BOCC ATTN: JUDITH S. CLARKE, PE, DIRECTOR OF ENG THE EXPIRATION DATE THEREOF, b1DTICE ACCORDANCE WITH THE POLICY PROVIC%NS. WILt2BE %-^ (/) JZLIVERED IN i rn SVCS 1100 SIMONTON STREET KEY WEST FL 33040 AUTHORIZED REPRESENTATIVE P n t ��, ,�,y4,,,rly. o n "= W eq "r1 V IWOO-LU14 At UKU 1-V7Ur(AI IUrtrI1 F,!W's reberveu. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ;<C_ �s '� r— � d