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Certificate of Insurance '`'` CERTIFICATE OF LIABILITY INSURANCE I BATE (MM /OO /YYYY) 3 /1s/201s THIS CERTIFICATE IS ISSUE° AS A MATTER OF INFORMATION ONLY AN° CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE °OES NOT AFFIRMATIVELY OR NEGATIVELY AMEN °, E XTEND OR ALTER THE COVERAGE AFFORDE° BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE °OES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE° REPRESENTATIVE OR PRO°UCER, AND THE CERTIFICATE HOL °ER. IMPORTANT: If the certificate holder is an AODITIONAL INSURE°, the policy(ies) must be endorsed. If SUBROGATION IS WAIVE°, 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). PROBUCER CONTACT Hrenda Monroe NAM Regan 1r1611rar1Ce Ag PAHON F tl (305) 852 -3234 I (X);,- Nol. (305)052 -3703 90144 Overseas Hwy. E '"°P i 1F yt . lomonroe @reganinsoranoeinc. COTS INSURER(S) AFFOROING COVERAGE NATO # Tavernier FM. 33070 - INSURER A :C anoplus US =n surance 'no NS °RED INSURER B Jules T Beckwi tt R Trust 5/14/1992 INSURER C 12 Fireside Drive INSURER B: INSURER E : McMurr PA 1531 _ INSURER F ) COVERAGES CERTIFICATE NUM13ER:15 -16 GL REVISION NUMBER: THIS IS CERTIFY THAT THE POLICIES INSURANCE LISTED BELOW HAVE BEEN ISSUER T C THE IiJSiJREO NAMED ABOVE FOR THE POLICY PERIOD INDICATE E0 O. NOT TH EING ANV REQUIREMENT. REMENT, TERM OR CON EITION OF ANV CONTRACT OR OTHER OOCUM ENT WITH RESPECT TO WHICH THIS R CETIFICATE MAC , ISSU BE ISSUES OR MAY PERTAIN, THE INSURANCE AF FORE EE BY THE POLICIES OESCRIBEO HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANO CON OI TIONS OF SUCH POLICIES. LIMITS SHOWN MAV HAVE BEEN REEUCEO BY PAID CLAIMS 'L'M I TYPE OF INSURANCE AOOL SUER POLICY EFF POLICY EXP L ...SR W)IIl POLICY NUMBER (MM /pONYYYI (MM /BOKYYYI MITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ 100 , 0 A I CLAIMS -MADE I X I OCCUR X ■138018024011 3/21/2015 3/21/2016 MFO FXP (Any one parson) $ S, 000 PERSONAL 8 AOV INJURY $ 1_,000,000 GENERAL AGGREGATE $ 2 , 000 , 000 G ,E I EML AGGREGATE LIMIT APPLIES PER'. PRODUCTS - COMP /OP AGO $ included 2 S I POLICY I PF 0 I LOC $ AUTOMOBILE LIABILITY CO MBINEO SINGLE LIMIT (Ea idan0 $ ANY AUTO BODILY INJURY (Par parson) $ ALL OVNJEO SCHE UULEO BODILY INJURY (Para cidar, $ AUTOS AUTOS HIRED AUTOS NON -OWNED PROPERTY DAMAGE AUTOS (Par - P Eiden0 $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ OEO I I RETENTION $ $ WORKERS COMPENSATION I TORY ■ MITS I I O FR ANO EMPLOYERS' LIABILITY Y / N ANY PROPRIE TOR/PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? E.L. EACH ACCIDENT $ —_ I (Mandatory in NH) `� E.L. OISEASE - EA EMPLOYEE $ I O E SGRIPTION OF OPERATIONS below E . DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORU 101, A00Itlonal Remark. Scbadula, IT more apaca Is raqulrad) C ertificate 1 107Lder iS sYlown as an addi Insured par policy forms, concei ∎ns, l 81 , MXC1138iOOS - PPR• .. !� EMEM WAIV N/A - _. • e r�' �� CERTIFICATE HOLDER " -t •`` i CANCELLATION SHOULD ANY OF THE ABOVE OESCRIBEO POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE OEL } .�Lc ���µtt {-.� �� LL11 II�'� IVEREO IN MortrOe COUi'aty Board �i apo)R'llt - CSOfYlr Yts�SlZ,n ACCOROA NCE WITH THE POLICY PROVISIONS - 1100 Slmon.torn Street Kay West, FL 33040 _1 `, `1 � _ Es '.1 -1 1 0 —I s j AUTHORIZED REPRESENTATIVE U IJJ i.l JoYan C /FTHOM �� _ / �� ■ 25 (2010/05) © 1988 -2010 ACOR° CORPORATION. All rights reser,re C. INSG25 (zotoosLo, The ACORO name :ma logo are registered marks of ACORO ACO O® CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 3/21/2016 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 CONTACT Brenda Monroe NAME: Regan Insurance Agency PHONE Ext): (305) 852 -3234 SAC, No): (305) 852 -3703 INC. 90144 Overseas Hwy. A : bmonroe @reganinsuranceinc.com INSURER(S) AFFORDING COVERAGE NAIC # Tavernier FL 33070 INSURER A :L1oyd's of London INSURED INSURER B : Jules I Beckwitt Rev Trust 5/14/1992 INSURERC: c/o Charlene P. Helba, Trustee INSURERD: 120 Fireside Drive INSURER E : McMurray PA 15317 INSURER F : COVERAGES CERTIFICATE NUMBER:16 - 1 7 term REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF ' POLICY EXP 1 LIMITS LTR I TYPE OF INSURANCE MD WVD POLICY NUMBER (MM/DD/YYYYI (MM/DDIYYYYI i X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A _ CLAIMS -MADE X OCCUR PREMISES Ea occurrence) $ 100,000 X BOFTL22053 3/21/2016 3/21/2017 MED EXP (Any one person) ' $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 — ' , GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 - X - 1 POLICY .JEC7 PRODUCTS - COMP/OP AGG 1 LOC $ included OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED I I SCHEDULED BODILY INJURY (Per accident) $ AUTOS 1 'AUTOS NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS I ' AUTOS (Per accident) UMBRELLA LIAB OCCUR I EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE I AGGREGATE $ - -- - - T— $ DED RETENTION $ WORKERS COMPENSATION I PER I 1 OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE � ER 1 ANY PROPRIETOR /PARTNER /EXECUTIVE r — NIA I E.L. EACH ACCIDENT $ IOFFICER /MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under ' DESCRIPTION OF OPERATIONS below i E.L. DISEASE - POLICY LIMIT $ I DESCRIPTION OF OPERATIONS / LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is shown as an additional insured per policy forms, conditions, 1'u'tations and exclusions. / ' 3. 3. • t)Y : C,vtL CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County Commissione THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West, FL 33040 AUTHORIZED REPRESENTATIVE Joseph Roth /FTHOM c;?."(er`- .24E- /© 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)