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Certificates of Insurance 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements,as specified in the County's Schedule of Insurance Requirements,be waived or modified on the following contract. Contractor: Fire Tech Repair Service, Inc. Contract for: Scheduled semi—annual inspections and preventative maintenance of fire rescue vehicles, annual pump tests and Arldcessof&ontraciorx for unscheduled maintenance and repair resulting from equipment failure or malfunction. Address of Contractor: P.O. Box 1570, Key Largo, FL 33037 Phone: (305) 451-4230/(305) 394—'1996 ref 1/(305) 191-16'12 cell Scope of Work: Stated above. l c�Tf� INcRKE�s o+ti'N TiE (ernPANY Policies Waiver Agreement dated 2/21/01 between BOG and Fire Tech Repair will apply to: Service, Inc. tor Taxing District 1, and all renewals. Agreement dated 2 /01 between BOCC and Fire Tech Repair Service, Inc axing District 6, and all renewals. Signature of Contractor: Approved c — Not Approved Risk Management , W 1 Date Z Z � 0 Z County Administrator appeal: Approved: Not Approved: Date: Board of County Commissioners appeal: Approved: Not Approved: Meeting Date: Administration Instruction #4709.3 102 Attachment B (Page 3 of 3) ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 5/24/2005 • PRODUCER (561) 998-1570 FAX (561)998-2447 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Mack Group, NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Inc.. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1900 NW Corporate Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 101 E Boca Raton FL 33431 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Nautilus Ins. Co. Fire Tech Repair Services, Inc. INSURERB: P. 0. Box 1570 INSURERC: INSURER D: _ Rey Largo FL 33037 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD_ TYPE OF INSURANCE _ - -_ POLICY NUMBER DATE(MMIDDIYY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 50,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS MADE X OCCUR NC436539 5/14/2005 5/14/2006 MEDEXP(Anyoneperson) $ 1,000 _ PERSONAL BADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 GE I POLICY f JECT fl LOC Ap�Brr ED Y RIS( M AGEMENT AUTOMOBILE LIABILITY BY ( COMBINED SINGLE LIMIT (Ea accident) ANY AUTO _ DATE v _® ALL OWNED AUTOS BODILY INJURY p� (Per person) $ SCHEDULED AUTOS WAIVER N/A 1( YES HIRED AUTOS Cita_ BODILY INJURY NON-OWNED AUTOS /;� (Per accident) c ✓ PROPERTY DAMAGE ////� ) \�/�' ,��//� (Per accident) GARAGE LIABILITY C/ ,/ u l !1 ( ' AUTO ONLY-EA ACCIDENT $ ANY AUTO l� V�-'e "� OTHER THAN EA ACC $ Lied AUTO ONLY: AGG $EXCESS/UMBRELLA LIABILITY ' EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ - ------ -- - ------ ---- --------- _ $-- -- ----- — WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE$ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Automobile Repair or Service � L• YN C Certificate Holder is an Additional Insured with respect to CGL coverage. CERTIFICATE HOLDER CANCELLATION (305)292-4558 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL BOARD OF COUNTY COMMISSIONERS 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT ITS EMPLOYEES AND OFFICIALS FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 1100 SIMONTON STREET KEY WEST„, FL 33040 INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Jay Mack/DC - .ACORD 25(2001/08) 0 ACORD CORPORATION 1988 INS025(0108).06 AMS VMP Mortgage Solutions,Inc.(800)327-0545 . Page 1 of 2 ' .,no ...�:r ,.., % -. ACORDn, CERTIFICATE OF LIABILITY INSURANCE • 5/24/Q ) PRODUCER (561) 998-1570 FAX (561)998-2447 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Mack Group, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1900 NW Corporate Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 101 E Boca Raton FL 33431 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Nautilus Ins. Co. _ Fire Tech Repair Services, Inc. INSURERB: . P. 0. Box 1570 INSURERC: INSURER D: _ Key Largo FL 33037 INSURER E: COVERAGES • 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'LINSRD TYPE OF INSURANCE POLICY NUMBER� POLICY (MM DDIYY) POLICY MIIDD/YY EXPIRATION - LIMITS LTR INSRD ( ( ) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AMAG ENTED X COMMERCIAL GENERAL LIABILITY PREM PREMISES TEa occurrence) $ 50,000 •A CLAIMS MADE X OCCUR NC436539 5/14/2005 5/14/2006 MEDEXP(Anyoneperson) $ 1,000 • PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 CI POLICY n JECT n LOC APP ED Y RISi(M cNAGEMENT AUTOMOBILE LIABILITY B1r ��-���� • COMBINED SINGLE LIMIT $ ANY AUTO (! 1 (Ea accident) ALL OWNED AUTOS DATE .®��'�a '.... 5 BODILY INJURY YES_ SCHEDULED AUTOS WAIVER N/A .1( (Per person) $ HIRED AUTOS BODILY INJURY (Per accident) $ NON-OWNED AUTOS / l� —J PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY C/ ,� `\ _. _� AUTO ONLY-EA ACCIDENT $ ANY AUTO v ,611 OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY ti......J4- EACH OCCURRENCE $ —I OCCUR CLAIMS MADE • AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- O - EMPLOYERS' TH LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE$ If yes,describe under SPECIAL PROVISIONS below .E.L DISEASE-POLICY LIMIT $ OTHER • DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Automobile Repair or Service Certificate Holder is an Additional Insured with respect to CGL coverage. CERTIFICATE HOLDER CANCELLATION (305)292-4558 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL BOARD OF COUNTY COMMISSIONERS 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT ITS EMPLOYEES AND OFFICIALS FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 1100 SIMONTON STREET KEY WEST, , FL 33040 INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE • Jay Mack/DC ACORD 25(2001/08) ©ACORD CORPORATION 1988 INS025(0108).06 AMS VMP Mortgage Solutions,Inc.(800)327-0545 Page 1 of 2 • .t"O W C E RT I F I CA-__ 'E OF LIABILITY I N S U R/3.'„ E OP ID LR DATE(MM1DD/YYYY) .FIRET-2 09/11/09 PRODUCER THIS CERTIFICATE IS ISSUED.AS A MATTER OF INFORMATION Herbig Insurance Group LG ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Chase Herbig HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 890 East SR 434 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Longwood FL 32750 Phone: 407-834-4444 Fax:407-834-6071 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: NW Mutual Fire Insurance Co. 23779 INSURER B: Fire Tech Repair Services Robert Burley INSURER C: PO Box 1570 INSURERD: Key Largo FL 33037 I INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSK AUU'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ UAMAI,t I O RtN I LU COMMERCIAL GENERAL LIABILITY - PREMISES(Ea occurence) $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 7 POLICY PRO n LOC JECT I AUTOMOBILE LIABILITY A X ANY AUTO 77BA4798833001 05/24/09 05/24/10 COMBINED SINGLE LIMIT $ 300 000 CO cident) , ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) y> PROPERTY DAMAGE $ ( Tom/ (Per accident) GARAGE LIABILITY % \�•--'"' —_W AUTO ONLY-EA ACCIDENT $ ANY AUTO 9c+�i 1 '', —u "''w^ EA ACC $ = - OTHER THAN �,I j' AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $V OCCUR CLAIMS MADE �. AGGREGATE $ $ DEDUCTIBLE ^ $ RETENTION $ $ WORKERS COMPENSATION j `/ TORY_LIMITS OER AND EMPLOYERS'LIABILITY - - - -- - of }ji - --- -- -ANY PROPRIETOR/PARTNER/EXECUTIV� C l�J .L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? I ` � (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Monroe County Board of County Commissioner is included as an additional insured as requiredby written contract with the named insured. C.... .- ,. l� / /tiGt.-7,7 C 2 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Monroe County Board of County IMPOSE NO OBLIGATION OR LIABILI ANY KIND UPON THE INSURER,ITS AGENTS OR Commisioner REPRESENTATIVES. �s"�5 �' Attn: Billy Pruitt 1100 Simonton St AUTHORIZED REPRESEN 1dGE /f d` Key West FL 33040 Chase Herbig ACORD 25(2009/01) . ©1988-2009 ACODRPORA,I AIL rights reserved. The ACORD name and logo are registered marks of/CORD ° y.. �` CERTIF" :.:ATE OF LIABILITY INS ir�ANCE DATE(MMIDDIYYYY) 8/18/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR N R THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CMSTC'p W NTRACT ETEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE H E 1 �J IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) mist be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain polic es may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). Al l( 2 ? MO PRODUCER CONTACT Katherilkeuc e Bkl NAME: y Mack, Mack & Waltz Insurance Group, Inc. PHONEHC Ext). ¢954)F40-6225 FAX No):(954)640-6226 1211 S Military Trail MONROE .im- �.s.kbuckley@mackinsurance.com RISK MAI, +'c Suite 100 CUSTOMER ID#Q0013689 Deerfield Beach FL 33442 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Northfield INSURER B: Fire Tech Repair Services, Inc INSURERC: P. 0. Box 1570 INSURER D: INSURER E: Key Largo FL 33037 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1081823633 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 LIMITS LTR INSR WVD POLICY NUMBER (MMIDDIYYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 50 000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ , A CLAIMS-MADE X OCCUR WS077078 6/16/2010 6/16/2011 MEDEXP(Anyoneperson) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 . GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 X POLICY PRO- JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS ";,;F:a" -- - BODILY INJURY(Per accident) $ SCHEDULED AUTOS 5't+ PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS ��� `.��— �•- $ 4,4 t''"'u.'-' $ u/ UMBRELLA LIAB OCCUR i,,q„t,,,,:t', i0.`a P`,.'-V' EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ - DEDUCTIBLE --- $ RETENTION $ Q/�+, QQQ `�/� �J $ WORKERS COMPENSATION CC fje:( WC STATU- OTH- AND EMPLOYERS'LIABILITY STATU- TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N ttl2f E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Automobile Repair or Service Certificate Holder is an Additional Insured with respect to CGL coverage. CERTIFICATE HOLDER CANCELLATION (305)289-6013 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County ACCORDANCE WITH THE POLICY PROVISIONS. Board of County Commissioners Its Employees and Officials AUTHORIZED REPRESENTATIVE 1100 Simonton Street Key Wed F'L 33040 C.L: Jay Mack/KATIE . ACORD 25(2009/09) -- - ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200909) The ACORD name and logo are registered marks of ACORD A��vim® CERTIFk;ATE OF LIABILITY INSI,KANCE 5/7/2012' 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 C IMPORTANT: If the certificate holder is an ADD TIONAL wesBEaramies, muse be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain pclicies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER JA AY 2�Q�EACT Kath 3rine Buckley Mack, Mack & Waltz Insurance Gro1,p, In ! (MC.No.Extt: (9 i4)640-6225 FAX No):(954)640-6226 1211 S Military Trail AIL ADDRESS:kbuc :ley@mackinsurance.com Suite 100 I 11PWROECO'JN1Y INSURER(S)AFFORDING COVERAGE NAIC# Deerfield Beach FL 33442 _- ^wsuRER-er-Nor'thfield INSURED INSURER B: Fire Tech Repair Services, Inc INSURER C: P. 0. Box 1570 INSURER D: INSURER E: Key Largo FL 33037 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1211125852 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 LIMITS LTR INSR WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 50,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR X WS115957 6/16/2011 6/16/2012 MED EXP(Any one person) $ 1,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 • POLICY n Pe 0 n L. $ AUTOMOBILE LIABILITY B PPR COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO D 7. '/j BODILY INJURY(Per person) $ ALL OWNED SCHEDULED WAIVER N/A_is. YES_ BODILY INJURY(Per accident) $ AUTOS AUTOS [� A HIRED AUTOS NON-OWNED V) r CA-CA, PROPERTY DAMAGE AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE - AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) • Automobile Repair or Service Certificate Holder is an Additional Insured with respect to CGL coverage. � c : I CERTIFICATE HOLDER CANCELLATION (305)289-6013 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissioners Its Employees and Officials AUTHORIZED REPRESENTATIVE 1100 Simonton Street Key West, FL 33040 ��. � Jay Mack/FLORA ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r9mnns\ni Tho At':(1R11 name,nrt Innn aro ronietororl m,rIe of arrio l OP ID: DR ACORD" DATE(MMIDDmYY) CERTIFICATE OF LIABILITY INSURANCE 05/16/12 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 CT 407-834-4444 NAME: HIG A E FAX Chase Herbige Longwood 407-834-6071 (A/C,No,No,Eat): (A/C,No): 890 East SR 434 E-MAIL Longwood,FL 32750 PRODUCER Chase Herbig CUSTOMER ID#:FIRET-2 INSURER(S)AFFORDING COVERAGE NAIC# INSURED Fire Tech Repair Services INSURER A:Nationwide Ins.Co.of America 25453 Robert Burley INSURER B: PO Box 1570 Key Largo, FL 33037 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 (MMIDDIYYYY) (MMIDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ PRO POLICY LOC � JECT OC AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT $ 300,000 A ANY AUTO ACPBAZ5914930099 05/12/12 05/24/13 (Ea accident) BODILY INJURY(Per person) $ - ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS HI'f kO E RI GEMEM $ BY A UMBRELLA LIAB OCCUR WAI .46 EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE . AGGREGATE $ DEDUCTIBLE Cc.'k $ RETENTION $ $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETORJPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN County of Monroe ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management 1100 Simonton St AUTHORIZED REPRESENTATIVE Key West, FL 33040 C G ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD AC�® DATE(MMIDDIYYYY) `� CERTIFICATE OF LIABILITY INSURANCE 10/18/2012 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 Vanessa Souvenir NAME: Mack, Mack & Waltz Insurance Group, Inc. CNN L- Extt: (954)640-6225 FAX No):(954)640-6226 1211 S Military Trail AAIL DDRESS:vsouvenir@mackinsurance.com _ Suite 100 INSURER(S)AFFORDING COVERAGE NAIC# Deerfield Beach FL 33442 INSURER A Northf ield INSURED INSURER B: Fire Tech Repair Services, Inc INSURERC: P. 0. Box 1570 INSURERD: INSURER E: Key Largo FL 33037 INSURER F: COVERAGES CERTIFICATE NUMBER:CL12101627048 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 W - POLICY EFF POLICY EXP LIMITS LTR INSR VD POLICY NUMBER (MMIDDIYYYY) (MMIDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 50,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR X WS153335 6/16/2012 6/16/2013 MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 —X—I POLICY II jEC II T LOC ` $ AUTOMOBILE LIABILITY AP V NAG COMBINED SINGLE LIMIT _ (Ea accident) • $ BY — ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED W BODILY INJURY(Per accident) $ _ AUTOS AUTOS 0 NON-OWNED veto PROPERTY DAMAGE HIRED AUTOS _ AUTOS v' 0 ' r (Per accident) $ _ cc.. .A it, -w llLb,r. $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Automobile Repair or Service Certificate Holder is an Additional Insured with respect to CGL coverage. CERTIFICATE HOLDER CANCELLATION (305)289-6013 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County ACCORDANCE WITH THE POLICY PROVISIONS. Board of County Commissioners Its Employees and Officials AUTHORIZED REPRESENTATIVE 1100 Simonton Street Key West, FL 33040 —�._� � � �/ Jay Mack/VANESS =7 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(7111nnst m Tho A(`f1Rrl names and Irwin ara ranicfararl mardre of Af`(1Rrl FIRET-2 OP ID:SJ A CP' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 07/11/2013 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 Phone:407-830-7827 NAAME CT 880 East SR 434ommerclal Fax:407-260-0216 (Arc"No.Ext): FAX No): Longwood,FL 32750 E-MAIL ADDRESS: Chase Herbig INSURER(S)AFFORDING COVERAGE NAIC It INSURER A:Nationwide Ins.Co.of America 25453 INSURED Fire Tech Repair Services INSURERB: Robert Burley PO Box 1570 INSURER C Key Largo, FL 33037 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 SUER POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MMIDDIYYYY) (MM!DDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY n PEO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 300,000 (Ea accident) $ A ANY AUTO X ACPBAZ5924930099 05/24/2013 05/24/2014 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X NON-OWNED PROPERTY DAMAGE HIRED AUTOS $ AUTOS (Per accident) vEMENT UMBRELLA LIAB OCCUR BY PR I /�Y/�" ( � L EACH,OCCURRENCE $ EXCESS LIAB CLAIMS-MADE DA ``•Yn AGGREGATE $ WAIVER /A ^ /1 DED RETENTION$ "' I L ,1 Li ". ^t WORKERS COMPENSATION 'J''�Vl. D. r)L— WC STATU- OTH- AND EMPLOYERS'LIABILITY Y!N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE N!A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN County of Monroe ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management 1100 Simonton St AUTHORIZED REPRESENTATIVE Key West, FL 33040 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2910/05). The ACORD name and logo are registered marks of ACORD CG: (r_ • L ACOR1] DATE(MMIDDIj%YYY)r : CERTIFICATE OF- LIABILITY INSURANCE 7/19/2;01.3 TIUS:CERTIFICATE IS.ISSUED ASiAMATTER OF INFORMATION ONLY_ AND CONFERS No:`RIGHTS UPON`THE CERTIFICATE HOLDERS THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY`.AMENDi. 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,,ANDTHE,CERTIFICATE•:HOLDER . IMPORTANT:._lithe certificate holder Is anADDITIONAL INSURED,the policy(let)must be•endorsed If;SUBROGATION IS:WAIVED,,subJect:to the terms and condIt erne,of the policy;certaln,poilcies,may regulre an endorsement,A statement eif this Certificate does not•confer rights to the' certificate holder In.lieu of;such'endorsement(s). . - ' . CONTACT . . PRODUCER : -. - - .. - : " Joseph;D-. ... _ • . AMILl- 954)581-7740 • - FAX (954)584-987S."" Rick Gibbs P.P ,. =assurance Agency PHo(AIC NO•Ekt): (AC,NO):; 1000. S; State Road 7 oet r ckglbbs .a.con . ... .. . ' , ".. INSURER(S)AFFORDING—COVERAGE: ' -. .NAICi*.,. " Plantation ;ET ;33317 . " . ".. ". INSURER�A.All� R15$�:�h1IR7ae5 � .. .. • . . INSURED •.. INSl1REfi8: " Fire Tech.: Repair: Services:; Inc ' lrisuizERc; :P.-'0.- $OX- 1570:.. ..._ ... INSURER D: .. :INSURERS.: • Key Largo FL ,33037 INSURERF<: • COVERAGES CERTIFICATE:NUMBER:CL1-362801143 REVISION NUMBER;• THIS IS TO'CERTIFY THAT THE POLICIES OF'INSURANCELISTED BELOW HAVE BEEN,;ISSUED TO THEINSURED'NAMED:ABOVE;FOR,TNE`POLICY PERIOD . INDICATED NOTWgHSTANDINO ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH-RESPECT TO WHICH:THIS • CERTIFICATE'MAY BE:ISSUED OR MAY PERTAIN,-THE'INSURANCEAFFORDED.BY THE POLICIES:DESCRIBED-HEREIN IS SUBJECT TO ALL:THE'TERMS,- EXCLUSIONS.AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS: . . .., INSR - ADOL SUER- - - POLICY EFF, .POLICY EXP. - - LTR'" TYPE OF INSURANCE - . INSR WVD .POLICY NUMBER . - (MMIDDIYYYY) (MMIDDIYYYY). -- - , - .LIMITS- . -. GENERAL LIABILITY . - ' -EACH;OCGURRENCE.. $ - 1,;D0.0f„OO:O •X COMMERCIAL GENERAL LIABILITY PREMISES(Ea RENTED, $ 50,000 A. CLAIMS-MADE, X OCCUR . WS172082 6/28/201;3 6f 28/2014 Iv1ED 7(P.(Any one persori). $ 1,000 .. •.. ... 7PERSONAL&.ADV INJURY" $ 1:„.000'r;000 • - GENERALIAG.GREGATE - $ 2',.000.i000 - �,GEN'LgGG.REGATELIMIT APPLIEPER.: . -. PRODUCTS;-COMPIOP.AGG: $ • 1,•DOOy_000 ' X I POLICY n'JECT I I LOC AUTOMOBILE LIABILITY . AP R K .. �. . ... .(a a8NEDt!WGLE LIMIT $- DA �Qr_Cte l' BODILY INJURY(Per person) $' ANY AUTO. BY O (/j V p ). — ALL OWNED r—SCHEDULED'• 1_ .BODILY INJURY(Per accident) $ _ AUTOS - _ AUTOS. WAIVER A,p YE i (,(; I' NON-OIMVED� / - 1. -e, , ,PROP.ERTY DAMAGE HIRED.AUTQS $ AUTOS - -(Per accident) -UMBRELLA-LIAR _ OCCUR FJ1CH OCCURRENCE $ • 'EXCESSLIAB' • CLAIMS-MADE AGGREGATE $ • DED RETENTION$ $ WORKERS COMPENSATION - W%:STATU- OTH AND EMPLOYERS'LIABILITY' Y.hN. TORY LIMITS. ER _ .:ANY PROPRIETORIPARTNERIEXECUTIVE .. -E L EACH ACCIDENT . $ OFFICER/MEMBER EXCLUDED? n N/A ,.(Mandatory in NH):.•... .. . E.L.DISEASE--EA EMPLOYEE $ If yes;describe under' DESCRIPTION OF OPERATIONS beloVi EL.DISEASE-POLICY-LIMIT $ • DESCRIPT,ION'OF OPERATIONS 1LOCATIONSIVEHICLES(Attach ACORD101;AdditIonal'Rematks"Schedule;if more space:Is required), . .. The policy holde `'is listed.. as an "additional insured with respect to CGL coderagea CERTIFICATE HOLDER 'CANCELLATION. SHOULD ANY OF.THE ABOVE DESCRIBED POLICIES.BE CANCELLED BEFORE • THE EXPIRATION DATE THEREOF,. NOTICE WILL BE,_DELIVERED; IN; • ACCORDANCE;WITH,THE POLICY=PROVISIONS • Monroe: County BOCC' . i100 Simonton St; - Suite 268 AUTHORIZED REPRESENTATIVE Key West, 'FL 33040 . Rick Gibbs%CARJAR - =-, '� -<-- >•,'' • -ACORD 25(2010105) O 1988-2010 ACORD CORPORATION.:All-rights reserved. INS02So(oos(2 )oI; The.ACORDname and logo:are-registered marksof ACORD • Aco® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) `..�� 7/21/2 014 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 Regina Alsina NAME: g Rick Gibbs, P.A. Insurance Agency AONE lCC.No.Ext): (954)581-7740 FAiC A ,No):(959)584-9875 1000 S. State Road 7 ADDR EMAILESS:dena@rickgibbspa.com dena@rick ibb a.com INSURER(S AFFORDING COVERAGE NAIC# Plantation • FL 33317 INSURER AAll Risk. Limites INSURED INSURER B: Fire Tech Repair Services, Inc INSURER C: P. O. Box 1570 INSURERD: INSURER E: Key Largo, . FL 33037 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1362801143 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. LIMITS LTR • - INSR WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) GENERAL LIABILITY . EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 50 000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE n OCCUR WS172082 6/28/2019 6/28/2015 MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 37 POLICY n JECT n LOC • $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO - BODILY INJURY(Per person) $ — ALL OWNED SCHEDULED • BODILY INJURY(Per accident) $ AUTOS _ AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS _ AUTOS (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION `",� VAC STATU- OTH- AND EMPLOYERS'LIABILITY YIN PRO BY, �'",AGEMENT TORY LIMITS ER ANY OFFICER/ BER EXCLUDED?PROPRIETOR/PARTNER/EXECUTIVE I I NIA DAM ' 2 •j4 V - 't/'�!Q/,/p�L E.L.EACH ACCIDENT $ (Mandatory in NH) • WAIVER N/A YES,_,- e n q�( w E.L.DISEASE-EA EMPLOYEE S. If yes,describe under C DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ HoV �rui DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) The policy holder is listed as an additional insured with respect to CGL coverage. 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. 1100 Simonton St - - Suite 268 AUTHORIZED REPRESENTATIVE Key West, FL' 33040 Rick Gibbs/CARJAR ''` ACORD 25(2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD • • �..�. .. FIRET-2 OP ID: SJ A 1C4C,RE7 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 07/22/2014 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 endorsement(s). PRODUCER CONTACT Sylvia A.Johnson CIC,CPIW NAME: HIG Insurance Commercial PHONE 407-830-7827 FAX 880 East SR 434 (A/c.No.Ext): (A/c,No):407-260-0216 Longwood,FL 32750 E-MAIL Sy Ivia ADDRESS: hhig•com g Chase Herbig INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Nationwide Ins.Co.of America 25453 INSURED Fire Tech Repair Services,Inc INSURER B Robert Burley PO Box 1570 INSURER C: Key Largo,FL 33037 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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• ADM SUBR POLICY EFF POLICY EXP LIMITS LTRINSR WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ +• I - PERSONAL&ADVINJURY $ • GENERAL AGGREGATE• $ GEN'L AGGREGATE LIMIT APPLIES PER: _PRODUCTS-COMP/OP AGG $ —I POLICY jT 7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 300,000 (Ea accident) $ A ANY AUTO X ACPBAZ5934930099 05/24/2014 05/24/2015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS X AUTOS HIRED AUTOS X NON-0WNED PROPERTY DAMAGE $ AUTOS (PER ACCIDENT) $ UMBRELLA LIAB _ OCCUR • EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY OFFICER/MEMBER EXCLUDED PROPRIETOR/PARTNER/EXECUTIVE N I A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) County of Monroe, Risk Management is named as additional insured. AY PRO EMMY 01 :Cg✓tL WAIVER /A S— C C: )�/}(- CERTIFICATE HOLDER CANCELLATION COOFMON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN County of Monroe ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management 1100 Simonton Street AUTHORIZED REPRESENTATIVE • Key West,FL 33040 / J, ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD