Loading...
Certificates of Insurance Client#:1458462 GAFOOD DATE(MM/DDlYYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 3/13/2019 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMTACT Margo L.Kyser,CIC,CISR,AIS USI Insurance Services LLC PHONE 260-435-4238 FAX 866-702-7119 (A/C,No,Ext): (A/C,No): 9910 Dupont Circle Dr. East Ao RESS: margo.kyser@usi.com Suite 120 INSURER(S)AFFORDING COVERAGE NAIC# Fort Wayne,IN 46825 INSURER A:Hartford CasualtyInsurance Com anY 29424 INSURED INSURER B:Federal Insurance Company 20281 G.A.Food Services of Pinellas 12262 INSURER C:Pennsylvania Manufacturers Assoc.Ins. County Inc. INSURER D:Hartford Fire Insurance Company 19682 12200 32nd Ct.,North INSURER E: Saint Petersburg, FL 33716 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. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER ADM SUBR POLICY EFF POLICY EXP LIMITS (MM/DD/YYYY)EFF (MOLIC/YEXP A X COMMERCIAL GENERAL LIABILITY X X 36UENZV6433 03/15/2019 03/15/2020 EACH OCCURRENCE $1,000,000 D CLAIMS-MADE X OCCUR PREMISES(E a occurrence) $300,000 AP VE GEMENT MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: DAT GENERAL AGGREGATE $3,000,000 PRO- WAIVE M POLICY JECT X LOC PRODUCTS-COMP/OP AGG $2,000,000 - - OTHER: --- -- — $ - - - D AUTOMOBILE LIABILITY X X 36UENZV5917 03/15/2019 03/15/2020(E0a aBcdeDtSINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) _ X$1,000 Comp X $1,000 Coll. $ B X UMBRELLA LIAB X OCCUR 79892909 03/15/2019 03/15/2020 EACH OCCURRENCE $15,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $15,000,000 DED X RETENTION$0 $ C WORKERS COMPENSATION X 2019750298901 03/15/2019 03/15/2020 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 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 Crime 82508244 03/15/2019 03/15/2020 $500,000 Employee Dishonesty w/$2,500 Ded DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County BOCC is included as an additional insured as it relates to the General and Automobile Liability in accordance with the policy terms and conditions. Bayshore Manor is named as an additional insured as it relates to General Liability and Automobile Liability in accordance with the policy terms and conditions. CERTIFICATE HOLDER CANCELLATION Monroe CountyBOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St,2nd Floor Key West,FL 33040 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S25189183/M25187638 . PVRZP GAFOOD Client#: 1458462 ACORD,. CERTIFICATE OF LIABILITY INSURANCE YYYY) 3/13DATE (M/2018 MIDDIMIDDI 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Insurance Services LLC NAME: Margo L. Kyser, CIC, ACSR, AIS PHONE 260-435=4238 FAX 866-702-7119 A/C, No, Ext : A/C, No 9910 Dupont Circle Dr. East E-MAIL ser mar o.k usi.com ADDRESS: g Y Suite 120 Fort Wayne, IN 46825 INSURER(S) AFFORDING COVERAGE NAIC# Hartford Fire Insurance Company INSURER A : P Y 19682 INSURED G.A. Food Services of Pinellas County Inc. 12200 32nd Ct., North Saint Petersburg, FL 33716 INSURER B : Federal Insurance Company 20281 INSURER C :Pennsylvania Manufacturers Assoc. Ins. 12262 INSURER D suFed erallnranceCo. 20281 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 CONTRACTOR 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. LTRR TYPE OF INSURANCE NSRADDLSUBR WVD POLICY NUMBER MM/DDNYYY MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X X 36UENZV6433 3/15/2018 03/15/2019 EACH OCCURRENCE $1 00U 000 CLAIMS -MADE 7 OCCUR PREMISES Ea occur ence 000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 PRO - POLICY JECT X LOC PRODUCTS - COMP/OPAGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY X X 36UENZV5917 3/15/2018 03/15/2019 cideniSINGLE LIMIT Ea ccBINED $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY _ $ X $1,000 Comp. I X 1$1,000 Coll. B X UMBRELLA LIAB X OCCUR X 79892909 3/15/2018 03/15/2019 EACH OCCURRENCE s15,000,000 AGGREGATE s15,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITYTuT, ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? F`N] N / A X 2018800298901 3/15/2018 03/15/2019 X STR OTH- ER E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE s500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT s500,000 D Crime 82508244 1111/2018 01/10/2019 $500,000 Employee Dishonesty W/$2,500 Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Bid-SSD Food Services & Meal Catering For Monroe Co Nutrition Program Monroe County Board of County Commissioners is included as an additional insured as it relates to the General and Automobile Liability i accordance with the policy terms and conditions. PR E Y AGENAENT SP WAIVER /A ES- e e Monroe County BOCC 1100 Simonton Street, Room 1-213 Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) 1 of 1 #S22684159/M22683391 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DRBZP Client#: 1458462 GAFOOD ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 4/03/2018 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER US[ Insurance Services LLC 9910 Dupont Circle Dr. East Suite 120 CONTACT Margo L. Kyser, CIC, ACSR, AIS PHONE 260-435-4238 FAX 866-702-7119 A/C, No, Ext : A/C, No E-MAIL margo.ser usi.com ADDRESS: g y INSURER(S) AFFORDING COVERAGE NAIC# Fort Wayne, IN 46825 INSURERA: Hartford Fire lasuraaeeCompany 19682 INSURED G.A. Food Services of Pinellas County Inc. 12200 32nd Ct., North Saint Petersburg, FL 33716 INSURER B : Federal Insurance Company 20281 INSURER C : Pennsylvania Manufacturers Assoc. Ins. 12262 INSURER D Federal Insurance Co. 20281 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 CONTRACTOR 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X X 36UENZV6433 3/15/2018 03/15/2019 EACH OCCURRENCE S1,000,000 CLAIMS -MADE � OCCUR PREMISES ERENTED r nte $300,000 MED EXP (Any one person) S 5,000 PERSONAL & ADV INJURY S1,000,000 LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE s3,000,000 nPRO- POLICY IJECT X LOC r,OTHER: PRODUCTS-COMP/OPAGG s2,000,000 S A AUTOMOBILE LIABILITY X X 36UENZV5917 3/15/2018 03/15/2019 COMBINED SINGLE LIMIT Ea accident S1,000,000 BODILY INJURY (Per person) S X ANY AUTO BODILY INJURY (Per accident) S OWNED SCHEDULED AUTOS ONLY _ _ AUTOS X HIRED NOiv-JWidED AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE Per accident S S X $1,000 Comp. X $1,000 C011. B X UMBRELLA LIAR IV OCCUR X 79892909 3/15/2018 03/15/2019 EACH OCCURRENCE s15,000,000 AGGREGATE s15,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ S C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) N I A X 2018800298901 3/15/2018 03/15/2019 X STATUTE ERH E.L. EACH ACCIDENT s500,000 E.L. DISEASE - EA EMPLOYEE s500,000 E.L. DISEASE - POLICY LIMIT S500,000 If yes, describe under DESCRIPTION OF OPERATIONS below D Crime 82508244 1/10/2018 01/10/2019 $500,000 Employee Dishonesty w/$2,500 Ded DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Monroe County BOCC is included as an additional insured as it relates to the General and Automobile Liability in accordance with the policy terms and conditions. Bayshore Manor APP V I. AGEMENT ,Q 1 �.p.n/ � WAIVER /A_`: r` �Il�r tsi CERTIFICATE HOLDER CANCELLATION I f I vn E>A115N Monroe Count BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management ACCORDANCE WITH THE POLICY - PROVISIONS. 1100 Simonton St, 2nd Floor Key West FL 33040 AUTHORIZED REPRESENTATIVE GC, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S22848962/M22683391 LXVZP Client#: 1458462 GAFOOD ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1/03/2018 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Insurance Services LLC CONTACT Margo L. Kyser, CIC, ACSR, AIS PHONE 260-435-4238 FAX 866-702-7119 E A Lo, Ext : A/C, No 9910 Dupont Circle Dr. East p Suite 120 Fort Wayne, IN 46825 ADDRESS: margo.kyser@usi.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Fire Insurance Company 23035 INSURED G.A. Food Services of Pinellas County Inc. 12200 32nd Ct., North Saint Petersburg, FL 33716 INSURER B : Liberty Insurance Corporation 42404 INSURER C : Pennsylvania Manufacturers Assoc. Ins. 12262 INSURER D : Liberty Insurance Underwriters, Inc. 19917 INSURERE: 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 CONTRACTOR 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 ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X X TB2Z91458863017 3/15/2017 03/15/2018 EACH OCCURRENCE $1,000,000 CLAIMS -MADE ® OCCUR PREMISES (Ea occurrence)s300,000 MED EXP (Any one person) $5,000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 PRO - POLICY JECT LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: • AUTOMOBILE LIABILITY X X AS2Z91458863027 3/15/2017 03/15/2018 COMBINED INGLE LIMIT Ea accidentS $1,000,000 ANY AUTO X BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident S X HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY X $ $1,000 Camp. X $1,000 Coll. B X UMBRELLA LIAB OCCUR X TH7Z91458863037 3/15/2017 03/15/2018 EACH OCCURRENCE $5 000 000 N AGGREGATE s5,000,000 F1EXCESS LIAR CLAIMS -MADE DED I X RETENTION $1 O 000 Prod/Comp O $5,000,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) N / A X 2018750298901 1/01/2018 03/15/2018 X 71 PER OTH- T U E E E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE s500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT s500,000 D Excess Liability 100019892702 3/15/2017 03/15/2018 $10,000,000 Ea Occur $10,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Bid-SSD Food Services & Meal Catering For Monroe Co Nutrition Program Monroe County Board of County Commissioners is included as an additional insured as it relates to the General and Automobile Liability in accordance with the policy terms and conditions. APPRUED AGEMENr BY 41V 1►jr, WAIVER NIA.,YES Itl:IC♦f112LyG\Ia:Lei 4Ua: yt10Lyae4_IIILei 0 1:izf—W 9 W1W:C.IAMaI Monroe County BOCC 1100 Simonton Street, Room 1-213 Key West, FL 33040 L SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE W\ ACORD 25 (2016/03) 1 of 1 #S22267809/M22257946 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DRBZP 10412 A �O�Q9 AIll CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) I 3/14/2017 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 have ADDITIONAL INSURED provisions or 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 CONTACT Lisa Kibbey Commercial Lines - (813) 639-3000 __ PHONE FAX No. Extl: 813 639 3000 fA� No : 855-299-7117 Wells Fargo Insurance Services USA, Inc. ADDRESS: clw.certre uest wellsfar o.com ADDRESS: q � 9 2502 N. Rocky Point Drive, Suite 400 INSURER(S) AFFORDING COVERAGE NAIC # Tampa, FL 33607 INSURER A: Liberty Mutual Insurance Co. 23043 INSURED INSURERB: Liberty Mutual Fire Insurance CO 23035 G. A. Food Services of Pinellas County, Inc. INSURERC: Liberty Insurance Corporation 42404 DBA G.A. Food Service Inc INSURER 13: Manufacturers Alliance Insurance Company 36897 12200 32nd Court, North INSURER E : Liberty Insurance Underwriters, Inc. 19917 St. Petersburg, FL 33716 INSURERF: COVERAGES CERTIFICATE NUMBER: 1lbbU7U9 REVISION NUMBER- See below 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 OF INSURANCE L ADDTYPE UBR POLICY NUMBER POLICY EFF MMM Y POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [?�] OCCUR TB2Z91458863017 03/15/2017 03/15/2018 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occulce3 $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY ❑ PRO � LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY AS2Z91458863027 03/15/2017 03/15/2018 COfe.MBINdrrntSINGLELIMIT g 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) S x PROPERTY DAMAGE (Per accident) g HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY x Comp/Coll Deductible $ HCPD - ACV x $1,000 C x UMBRELLALJAB xd OCCUR TH7-Z91-458863-037 03/15/2017 03/15/2018 EACH OCCURRENCE S 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION$ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AN VPROPRIETO RIPARTN E R/E XEC UTIV E OFFICERIMEMBEREXCLUDED7 Y. (Mandatory in NH) NIA 201775 0298901 01/01/2017 01/01/2018 PER OTH- x STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE. EA EMPLOYEE $ 500,000 If yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 Excess Liability 1000198927-02 03115=17 03/15/2018 $10,000,000 each occurrence LE $10,000,000 aggregate DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Co issi included as an RE: Bid-SSD Food Services & Meal Catering For Monroe Cc Nutrition Program Monroe County BoaLDATAE additional insured as it relates to the General and Automobile Liability in accordance with the policy ndi ' ISK M Ml NT �w, ad� �1.k 1"WAI YES --- 11' r r CERTIFICATE HOLDER CANCELLATION Monroe County BOCC 1100 Simonton Street, Room I-213 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Key West FL 33040 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD 01988-2015 ACORD CORPORATION. All rights reserved. ACORD x(201w,) i1111uri1111111w1111111111111nm1111111111uar11111irha ...4/D05W02 10412 AC p ® DATE (MMIDDIYYYY) ORO CERTIFICATE OF LIABILITY INSURANCE 12/28/2016 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. I IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 L is a Kibbe NAME: y Commercial Lines - (813) 639 -3000 PHONE Fax — — tA/C�� .Extk. 813- 639 -3000 liNc, H 855 - 299 =7117 Wells Fargo Insurance Services USA, Inc. E o.com c lw.certre uest wellsfar ADDRESS: 4 g 2502 N. Rocky Point Drive, Suite 400 INSURER S AFFORDING COVERAGE NAIC # Tampa, FL 33607 INSURERA: Liberty Mutual Insurance Co. 23043 INSURED INSURER B: Liberty Mutual Fire Insurance CO 23035 _ G. A. Food Services of Pinellas County, Inc. INSURER C: Liberty Insurance Corporation 42404 DBA G.A. Food Service Inc INSURER D: Manufacturers Alliance Insurance Company 36897 12200 32nd Court, North INSURER E_ Liberty Insurance Underwriters, Inc. L 19917 St. Petersburg, FL 33716 INSURERF: COVERAGES CERTIFICATE NUMBER: 11240497 REVISION NUMBER: See below 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 ADD W UBR POLICY EFF POLICY EXP LIMITS • LTR INSD VD POLICY NUMBER (MM/DD/YYYY) (MMIDDIYYYY) X COMMERCIAL GENERAL LIABILITY 1,000,000 A _— TB2Z91458863 03/15/2016 03/15/2017 EACH OCCURRENCE $ __— CLAIMS -MADE X OCCUR PREMISES (Ea occurrence1 $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & AOV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ 3,000,000 x_ I POLICY L J E T l J LOC PRODUCTS - COMP /OP AGG $ 2,00Q000 1 OTHER: — - - -- — $ B AUTOMOBILE LIABILITY AS2Z91458863 03/15/2016 03/15/2017 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED X NON -OWNED PROPERTY DAMAGE _ AUTOS ONLY AUTOS ONLY (Per accident) $ X I X HCPD - ACV X $1,000 Comp /Coll Deductible $ C X UMBRELLA LIAB X OCCUR TH7 - 458863 - 036 03/15/2016 03/15/2017 EACH OCCURRENCE _ $ 5,000,000 • EXCESS LIAB CLAIMS MADE AGGREGATE $ 5,000,000 I DED X RETENTION $ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 201775 0298901 01 /01 /201 01/01/2018 X STATUTE ER 500,000 ANYPROPRIETORIPARTNER /EXECUTIVE Y / N E.L. EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? Y N / A — (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 E Excess Liability 1000198927 - 01 03/15/2016 03/15/2017 sio,000,000 each occurrence 10,000,000 aggregate DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE:RE: BAYSHORE MANOR MONROE COUNTY BOCC Is included as an additional insured as it relates to the General and Autos o1 " Liability in accordance with the policy terms and conditions. PPRO / D B T = ..(al ci HEFT _- , /► / „ WAIV N/' - 11 C C t-I Lt.) c: TI isI -i1- CERTIFICATE HOLDER CANCELLATION MONROE COUNTY BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RISK MANAGEMENT ACCORDANCE WITH THE POLICY PROVISIONS. 1100 SIMONTON ST, 2ND FLOOR KEY WEST FL 33040 AUTHORIZED REPRESENTATIVE 9 (401 - ,— I The ACORD name and logo are registered marks of ACORD © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) V I •CYe03A2e10002e9/02/02/0/0/0/0' 10412 AC(7RC7►`° CERTIFICATE O F LIABILITY I NS U RAN C E DATE (MMIDD/YYYY) 3/8/2013 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(les) 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 Lisa Hollingsworth Commercial Lines - (813) 639-3000 PHONE EX : g13-636-5476 ac No): 813-636-7192 EMAIL i cw.certre llo.com uest wesfar ADDRESS: 4 @ g Wells Fargo Insurance Services USA, Inc. INSURERS AFFORDING COVERAGE NAIC N 2502 N. Rocky Point Drive, Suite 400 INSURER A : Liberty Insurance Corporation 42404 Tampa, FL 33607 INSURED INSURER B : Wausau Underwriters Insurance Company 26042 G. A. Food Service of Pinellas County, Inc. INSURER C : North River Insurance Company 21105 DBA G.A. Food Service Inc INSURER D : Manufacturers Alliance Insurance Company 36897 12200 32nd Court, North INSURER E : INSURER F : St. Petersburg, FL 33716 COVERAGES CERTIFICATE NUMBER: 5717258 REVISION NUMBER: See below 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DO POLICY EXP MMIDD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR TB7Z91458863013 03/15/2013 03/15/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 PRO LOC -XI POLICY D JECT $ B AUTOMOBILE LIABILITY ASJZ91458863-023 03/15/2013 03/15/2014 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X NON -OWNED HIRED AUTOS X AUTOS Comp/Coll Deductible $ $1,000 x HCPD - $70K X $1,000 C X UMBRELLA LIAB x OCCUR 5811014259 03/15/2013 03/15/2014 EACH OCCURRENCE $ 15.000,000 AGGREGATE $ 15.000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ 0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDE; ❑Y (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 201375-0298901 A� ICY DA 01/01/2013 n�R r7G11r1G1�s 01/01/2014 L X WC STA'T- OTH- E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 E.L. DISEASE - POLICY LIMIT 500,000 $vym' it �• DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE:RE: BAYSHORE MANOR CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED RE GENERAL LIABILITY & AUTO LIABILITY IF REQUIRED BY WRITTEN CONTRACT CERTIFICATE HOLDER CANCELLATION MONROE COUNTY BOCC I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE RISK MANAGEMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1100 SIMONTON ST, 2ND FLOOR KEY WEST FL 33040 /3� b1V� AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 10412 Ac CERTIFICATE OF LIABILITY INSURANCE DATE /DD /YYYY) 4 161.0.- -- 12/28/2016 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 have ADDITIONAL INSURED provisions or 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 N ACT Lisa Kibbey Commercial Lines - (813) 639 -3000 PHONE — — -- FAX - --- --_ LA/CApLfx.U.L_ 813-639-3000 — — — (ac N 299 7117 Wells Fargo Insurance Services USA, Inc. E - MAIL o.com f l c w.certre uest welisar ADDRESS: q Q 9 ` 2502 N. Rocky Point Drive, Suite 400 — — — — — INSUREKS) AFFORDING COVERAGE NAIL # Tampa, FL 33607 INSURER Liberty Mutual Insurance Co. 23043 _ INSURED INSURER B: Liberty Mutual Fire Insurance Co _23035 _ G. A. Food Services of Pinellas County, Inc. INSURERC: Liberty Insurance Corporation 42404 _ DBA G.A. Food Service Inc INSURER D: Manufacturers Alliance Insurance Company 36897 12200 32nd Court, North INSURERE: Liberty Insurance Underwriters, Inc. 19917___ St. Petersburg, FL 33716 INSURER F : COVERAGES CERTIFICATE NUMBER: 11240498 REVISION NUMBER: See below 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DO/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A TB2Z91458863 03/15/2016 03/15/2017 - DAMAGE TO RENTED CLAIMS -MADE ^ J OCCUR PREMISES (Ea occurrence) $ 300,000 MED EXP (Any one person) $ 5,000 _ PERSONAL 8 ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY Li I SM : L J LOC PRODUCTS_ COMP /OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY AS2Z91458863 03/15/2016 03/15/2017 . COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY (Per person) $ OWNED u SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS X HIRED x NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) X HCPD - ACV X $1,000 Comp /Coll Deductible $ C x UMBRELLALIAB X OCCUR TH7 - 458863 - 036 03/15/2016 03/15/2017 EACH OCCURRENCE S 5,000,000 EXCESS LIAR 5,000,000 C LAIMS -MADE AGGREGATE $ DED X , RETENTION $ 10,000 $ D WORKERS COMPENSATION YIN 201775 0298901 01/01/2017 01/01/2018 x STATUTE 1 AND EMPLOYERS' LIABILITY 500,000 ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? Y N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under 500,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ E Excess Liability 1000198927 - 01 03/15/2016 03/15/2017 $10,000,000 each occurrence 10,000,000 aggregate I I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: Bid -SSD Food Services & Meal Catering For Monroe Co Nutrition Program Monroe County Board of County Commissioners is included as an additional insured as it relates to the General and Automobile Liability in accordance with the policy terms and condi ns. 40/ ∎.- AGEMENT I 7 /��� L DAT MCNII'Z z • V WAIV'R N/ S.__ CC' (. / Q a ��l.�.w. -u - J4.444__ k )1)- hq•-tro CERTIFICATE HOLDER CANCELLATION Monroe County BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street, Room 1-213 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Key West FL 33040 AUTHORIZED REPRESENTATIVE 9 ,,,1,... The ACORD name and logo are registered marks of ACORD ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2018!03) (II1IIII II I IIIIIIIIIIIIIIIIIIIII I III) III I II I IIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIII 'CYBO3A28/000290/02/02/0/0/0/0'