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HomeMy WebLinkAboutCertificate of Insurance , 0 Recejv DATE (MM/DD/YYYY) A`� o CERTIFICATE OF LIABILITY INSURANCE (� 8/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TH CER F HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGEA BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSLJ1W fl R(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 NAME: CONTACT Angel zzYarbrough Keys Insurance Services PHONE (305) -0494 FAX 1ALCJI.Q._ 4: (A/C,No) (305)743 -0582 EMAIL 5800 Overseas Hwy ADDRESS: a Y g Y arbrou h@ke ainsurance.com P.O. Box 500280 INSURER(S)AFFORDINGCOVERAGE NAIC# Marathon FL 33050 INSURER A :Granada Insurance Company 16870 INSURED INSURER B:West Surety Anthony Culver, DBA: Culver's Cleaning Company INSURERC: PO BOX 500333 INSURERD: INSURER E : Marathon FL 33050 -0761 INSURERF: COVERAGES CERTIFICATE NUMBER:2016 -2017 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE ING/1 WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A CLAIMS -MADE X OCCUR PREMISES (Ea occurrence) $ 100,000 X 0185FL00038609 8/23/2016 8/23/2017 MEDEXP(Anyoneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- - PRODUCTS COMP /OP ApC $ .7.1 JECT LOC 2,000,000 OTHER: . $ AUTOMOBILE LIABILITY COMBINE[NGLE LIMIT (Ea accident= 70/ $ m ANY AUTO BODILY INJWIPer perso $ ALL OWNED SCHEDULED BODILY INJ r accid AUTOS AUTOS �� etHJ$ HIRED AUTOS NON-OWNED PROPERTY bg 6GE C3 $ ° . AUTOS (Per accident �_ • in UMBRELLA LIAB OCCUR EACH OCCUR EXCESS LIAB CLAIMS -MADE AGGREGATE -r.' .$ 1 r'"' .... DED RETENTION $ 0' , WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABIUTY Y / N STATUTE 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 I E.L. DISEASE - POLICY LIMIT $ B Bond 68634853 7/30/2016 7/30/2017 Employee Dishonesty $10,000 DESCRIPTION OF OPERATIONS / LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 1 APP i E ' t' GEMENT s • I, - 0445:C#44,-- WAIVE N/ • l — CL: 4-4 l CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West, FL 33040 AUTHORIZED REPRESENTATIVE Q " Grimi Betancourt /LR :: ..-1-E- 7 ---.. - -- "� © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)