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Insurance
DALE (MMIDDYYYY) j C AC)RvCERTIFICATE OF AIRCRAFT INSURANCE 03/0&2016 THIS CERTIFICATE IS ISSUED AS A MA MATION WLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVE OR NEG��QL�,L, ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURA E DOES CONT T BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND E CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is a ADDITIONAL INSURED, the policy(ies must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, ce In policies y rggy re fflgndorseme A statement on this certilfic ate does not conf�ighNio the certifcate holder in lieu of such endorse s). M I bb LLUU , PRODUCER Pamsh- Neill & Assoc. Inc. P. O. Box 349 MONROE CONTACT NAME. :z.. m PHONE FAX -C Ea AtC, No T6IlI DRESS -� r Mount Vemon, OH, 43050 RISK MANA PRODUCER CUSTOMERIDNo. hLSURFD Cabanas Aerobatics, Inc.; Fred Cabanas and M8J= Flying dba Key INSURER(S) AFFORDING COVERAGE % �NAR°.�to. INSURER A U.S. SPECIALTY INSURANCE COMPANY Ln -, V0estBi Planes and Island Aero Tours 3 Parrott St KeyV%Ae-A FL, 33040 INSURER B - p INSURER C -„-Y -✓ INSURER D INSURER E INSURER F 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 ______'--."------ - ----- -•-------•--••—•- vr..�.n ,.,.r•.�a. ��a�mv�n. RCVIJIVPI IYVIt1OCrC: POLICY TYPE LINE OF BUSINESS SUBCODE - U ® COMMERCIAL ® AIRPLANE U HELICOPTER MIXED FLEET EXCESS QUOTA ADUSTRIPL MEASURE& SHARE NON OWNED ❑ LIABILITY HULL & LIABILITY � HULL ONLY ONLY AIRCRAFT INFORMATION ACORD 333, Aircraft Schedule attached YEAR MAKE MODEL SERIAL NUMBER REGISTRATION NUMBER 1941 PIPER J31--65 N38159 AIRCRAFT COVERAGES INSURE RLETTER ,.� POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE ADDITIONALINSURED7(Y/N) SUBROGATION WAIVED? (Y/N) SA001-09 03116 2016 03/16/2017 Y N V COVERAGE"' (y _ OPTIONS LIMIT APPLIES TO LIMIT APPLIES TO Iy. ,� ') � N ALL RISK GROUND AND FLIGI IT --- -- --- ` _ 40,000 -- -- - ___-- - $ 250 Ded. -Not in motion NRCRAFi1JLL � F ALL RISK GROUND ONLY x -• ❑ AGREED VALUE $ 2,500 Ded. - In motion • .�(D �• ® LIABILITY 1,000,000 EA OCC EA PER AIRCRAFE-11BILI" . L• tL. Y� 100,000 FA PASS AGGR Cv m INCLUDING CREW 5D00 MEDI-AL1:33i'MEN= FXCI UDING CRFW - , EA PER $ 10,000 EA OCC ❑ -- j (j_ CCC ,4ERAGE OPTIONS LIMIT - APR[ IFS TO APPLIESTO CODE DESCRIPTION H - -LIMIT UtbUKIPTION OF OPERATIONS / REMARKS (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is included as an Additional Insured. CERTIFICATE HOLDER CANCELLATION Monroe County Board of Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE 1100 Simonton Street EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE Key West, FL 33040 WITH THE POLICY PROVISIONS. UTHORIZED REPRESENTATIVE I © 2009 ACORD ACORD 21 (2009112) The ACORD name and logo are registered marks of ACORD (' AN ft ghts reserved. �N G��(E,