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Certificate of Insurance
ACORV CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 06/20/2016 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 endorsements . PRODUCER Kelly White & Associates Insurance, LLC P.O. Box 350909 Jacksonville FL 32235 CONTACT HOUSE NAM PHONE 904-880-8881 (FAXNC No ADD E : kelly@kwhiteinsurance.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Colony Insurance Company INSURED Keys Contracting Services Inc 935 107th Street Gulf Marathon FL 33050 INSURER B : Travelers Property & Casualty Company INSURER C : INSURER D : Commerce & Industry 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 LTR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF IMMIDDIYYYYI POLICY EXP fMM1OD1YYYY1LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE $ 1.0w,0w EIT p I GE To RENT occurrencel $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 A 103 GL 0013693-00 04/20/2016 04/20/2017 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY iEc LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ rl OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ 1 OOO,OOO BODILY INJURY (Per person) $ X ANY AUTO B ALL OWNED SCHEDULED AUTOS AUTOS BA-21-1556465 06/06/2016 06/06/2017 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Paccident) $ NON -OWNED HIRED AUTOS AUTOS Personal Injury $ 10,000 UMBRELLA LIAB EACH OCCURRENCE $ ROCCUR HCLAIMS-MADE AGGREGATE $ EXCESS LIAR DED RETENTION $ $ D RKERS COMPENSATION ND EMPLOYERS' LIABILITY PROPRIETOR/PARTNERIEXECUTIVE Y/ N FFICER/MEMBER EXCLUDED? �Y Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC13673871 06/20/2016 06/20/2017 TH X pTAT T X ER Includes USL&H E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ 1,000,000 $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000, 000 r J -n 0 T DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) i1 r �• 1— cry::K 'Tl Oc: w CFRTIFICATF 1In1 nF:P CAaIRFI I ATInIJ ?:. dt: : "' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 500 Whitehead St. AUTHORIZED REPRESENTATIVE Key West FL 33040 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD