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Certificate of Insurance S016682 DATE (MM /DD /YYYY) AC Co c CERTIFICATE OF LIABILITY INSURANCE 1/29/2016 THI .---- RTIFICATE 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 NAME: X Commercial Lines PHONE 888- 572 -2412 I (A/C, No): IA/C. No. Extl: Wells Fargo Insurance Services USA, Inc. E - MAI L DOR ESS: ADDRESS: certs trinet.COm 6100 Fairview Road INSURER(S) AFFORDING COVERAGE NAIC # Charlotte, NC 28210 INSURERA; Indemnity Insurance Company of North America 43575 INSURED INSURER B : Strategic Outsourcing, Inc. INSURER C: PO Box 241448 INSURER O: - INSURER E : Charlotte, NC 28224 INSURER F COVERAGES CERTIFICATE NUMBER: 10068585 REVISION NUMBER: See below PE THIS IS TO THAT THE NDCATED.CNOTWITHSTANDING ANY I REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCENT WITH RESPECT TO L WHICHT I HIS 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 SUER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 DAMAGE TO RENTED CLAIMS -MADE I OCCUR PREMISES (Ea occurrence) 5 MED EXP (Any one person) $ _PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEM. AGGREGATE LIMIT APPLIES PER: POLICY I I JE C 1 I WC PRODUCTS - COMP /OP AGG 5 OTHER: COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY (Ea accident) '' � BODILY INJURY (Per person) $ AppP ANY AUTO 4V- P:r ' AGSM NT — ALL OWNED SCHEDULED �� Or /1 , _ , ` accident) $ AUTOS _AUTOS (� BODILY INJURY (Per accident) lG.,/l PROPERTY NON -OWNED DA idr� , PE RRTY DAMAGE $ HIRED AUTOS AUTOS WAIVER `/A _ S.__ CC s"'r� l L'e (Per PRO $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ — EXCESS LIAR CLAIMS -MADE AGGREGATE 5 — $ DED RETENTION$ PER OTH- WORKERS COMPENSATION WLRC48767230 03/01/2016 03/01/2017 x I STATUTE I ER A AND EMPLOYERS' LIABILITY YI 1,000,000 E.L. EACH ACCIDEN I $ ANY PROPRIETOR /PARTNER/EXECUTIVE N / A 1,000,000 OFFICER /MEMBER EXCLUDED? I N I E.L. DISEA - E A EMPLOYEF $ If y Mandatory s in and 1,000,000 DE If ESs, C DESCRIPTION under N OF OPERATIONS below E .L. DISEASE - POLICY LIMIT $ SRIPI DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers' Compensation coverage is limited to employees leased to Key West Chamber of Commerce by Strategic Outsourcing, Inc. V 7 ., AiNno .- CERTIFICATE HOLDER 1 ?II . 4{14IH i1I CANCELLATION 7.7 MONROE COUNTY B NRRRRD nF COUNTY COMMISSIONERS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE �� THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 SIMONTON STR T j,Il 7 H ACCORDANCE WITH THE POLICY PROVISIONS. KEY WEST FL 33040 G C' TV rr 51 0/ j (,j /.)j" , 0,1 03 ltd AUTHORIZED REPRESENTATIVE 9(aAf 6"�iw._ The ACORD name and logo are registered marks of ACORD © 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01)