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Certificate of Insurance ACCPRD CERTIFICATE OF LIABILITY INSURANCE 6/12/2015 D 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 NAME: Patricia Cholewa The James B. Oswald Company PHONE FAX 1100 Superior Avenue, Suite 1500 (A/C. moo. E):216- 839 -2807 (A/c, Not: Cleveland OH 44114 ADDRESS :PCholewa@oswaldcompanies.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Hartford Casualty Ins. Co. 29424 INSURED MBIK2 -1 INSURER B :XL Specialty Insurance Co. 37885 Scott C. Maloney R.A. INC. INSURER C : 3121 Bridge Avenue INSURER D : Cleveland OH 44113 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 389622912 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP W LIMITS LTR INSR VD POLICY NUMBER (MM /DD/YYYY) (MMIDDIYYYY) A GENERAL LIABILITY Y Y 45SBA107008 9/14/2014 3/14/2015 EACH OCCURRENCE $1,000,000 DAMAGE TO X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) ence) $1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 X Non - Contributory GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 PRO- 7 POLICY X FS T X LOC $ A AUTOMOBILE LIABILITY Y Y 45SBA107008 9/14/2014 3/14/2015 COMBINED SINGLE LIMIT 1,000,000 (Ea accident) _ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON -OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accident) X Al Primary $ A X UMBRELLA LIAB X OCCUR Y Y 45SBA107008 3/14/2014 3/14/2015 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $1,000,000 DED X RETENTION $10,000 Excludes Professional $ A WORKERS COMPENSATION 45SBA107008 3/14/2014 3/14/2015 WC STATU x OTH OH Stop Ga AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER F P ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 B Professional Liability N Y DPR9724443 6/12/2015 3/12/2016 Each Claim $3,000,000 Claims Made Aggregate $3,000,000 Retro Date: 9/1/2001 Pollution & Envir. Liab. Included DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the Nam- • sured by written contract or agreement. hh , i► AP•` . /41GEMENT tY WA N /A■ CERTIFICATE HOLDER CANCELLATION 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 ACCORDANCE WITH THE POLICY PROVISIONS. • 1100 Simonton Street Key West FL 33040 AUTHORIZED REPRESENTATIVE 404 ?aSCav C © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD „---• Acc•R® O DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE g/14/ DATE (MMI (MM/ 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). CONTACT PRODUCER -MA NAME: Patricia Cholewa - - — The James B. Oswald Company gG 6 t o KI c t ax . No. Exn:216- 839 -2807 FAX No): 1100 Superior Avenue, Suite 1500 to aP n DRESS :PCholewa@oswaldcompanies.com Cleveland OH eland OH 44114 FQ+� INSURER(S) AFFORDING COVERAGE NAIC # CI ,c Q, .'' :Hartford Casualty Ins. Co. 29424 INSURED MBIK2 -1 Sw INSURERB Specialty Insurance Co. 37885 Scott C. Maloney R.A. INC. .. ` , , INSURER C :Hartford Accident & Indemnity 22357 .— 3121 Bridge Avenue .,. ®mil' / INSURER D : Cleveland OH 44113 1‘ G 0- INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 173984384 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 LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) A GENERAL LIABILITY Y Y 45SBA107008 9/14/2015 9/14/2016 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $1,000,000 CLAIMS - MADE IX I OCCUR MED EXP (Any one person) $10,000 X Al Primary & PERSONAL&ADV $1,000,000 X Non - Contributory GENERAL AGGREGATE $2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 POLICY .IECT X PRO- X LOC COMBINED SIRGZFa LIMIT $ 0 AUTOMOBILE LIABILITY Y Y 45UECBH0542 9/14/2015 9/14/2016 (Ea accident) $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS _ AUTOS X HIRED AUTOS X AUTOS PROPERTY DAMAGE NON -OWNED (Per accident) $ $ X Al Primary A X UMBRELLA LIAB X OCCUR Y Y 45SBA107008 9/14/2015 9/14/2016 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $1,000,000 DED X RETENTION $10,000 Excludes Professional $ A W ORKERS COMPENSATION 4 5SBA107008 9/14/2015 9/14/2016 WC STATU- X ER OT OH Stop Gap AND EMPLOYERS' LIABILITY TORY LIMITS ANY PROPRIETOR/PARTNER /EXECUTIVE Y / N E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N I A E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 B Professional Liability N Y DPR9724443 6/12/2015 6/12/2016 Each Claim $3,000,000 Claims Made Aggregate $3,000,000 Retro Date: 9/1/2001 Pollution & Envir. Liab. Included DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the N. ed In' 'lt -..•y written contract or g GEMENT agreement. ANPR� .��. 3Y ',SW Ir , WAI R N/A ' Y' 3 © __ CERTIFICATE HOLDER CANCELLATION o t rn r al O SHOULD ANY OF THE ABOVE DESCRIBED PO S BE CAIELLEDIBEFORE THE EXPIRATION DATE THEREOF, NOTICES• WILL BE IN Monroe County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISION C I CJ1 -rJ 1100 Simonton Street r " Key West FL 33040 AUTHORIZED REPRESENTATIVE C” J^�' J W .. zi�1a C,a © 1988 -2010 ACORD CORPORATION. All ■ g hts reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD