COI Expires 06/28/2017ACORI]` CERTIFICATE OF LIABILITY INSURANCE
FDA"`
29J2016
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 pollcy(iesj must be endorsed. If SUBROGATION IS WAIVED, subject to
the terns 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
NAME:
Harden and Associates
501 Riverside Avenue, Suite 1000
Jacksonville FL 32202
PHONE FAX
-3785 AIC No
WE tip, 904-634-110
E-MAIL
INSURERS AFFORDING COVERAGE
NAIL 9
INSURER A:Charter-Oak-Mire-Insurance Co
INSURED REYNO-1
INSURER B.Travelers Indemnity Company
INSURER C :
RS&H, Inc.
10748 DeerWOod Park Blvd S
Jacksonville FL 3225E
INSURER D :Phoenix Insurance Company
of -London ---
[tNSURERE-.Llnydr,
INSURER F :
COVERAGES CERTIFICATE NUMBER: 729213952
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
LTR IN POUCYNUMBER
POLICY EFF POLICY EXPuMISS
MMfD MMn)DNYYY
A G__E""NERALLIABIUTY
6304711N755
6128,2016 6421112017 EACH OCCURRENCE
$1,000,000
X COMMERCIAL GENERAL LIABILITY
PR �11 a. 4_ �
S 2000,000 -
CLAIMS•MA XOCCUR
MEO EXP }
510 000
PERSONAL & ADV INJURY
51,000 000
GENE RALAGGREGATE
SZ000000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUGTS • COMPIOP AGO
S2.000 000
POLICY ' X PRO L
$
9 AUTOMOBILE UABILrrY
8104621 MG01
6/2812016 6 {2812017 e a den!
1 000 000
X ANY AUTO
BODILY INJURY (Per n)
S
ALLOW SCHEDULED
AUTOS AUTOS
_........�.�,..._,...�__
BODILY INJURY (Per accident)
.„„........._..�.__.
$
X„ X NON -OWNED
PROPERTY DAMAGE
HIRED AUTOS
Comp/Coll Deductible
$1,0001$1,000
C X UMBRELLAUAB X I OCCUR CUP471IN755
6/2812016 612812017 EACH OCCURRENCE $10,000,000
_ ._.
EXCESS UAB CLAIMS -MADE
AGGREGATE S10,000,000
DED X T IETENTION $10 000
S
C WORKERS COMPENSATION PJUB91SK337416
12111201E 121V2017 X T WC STATU= (JTH»
D AND EMPLOYERS'LIABILJTY YIN PVYCNUS538BB307
121112016 1211d2017 MaYAJ
ANY PROPRIETO ARTNERIEXECUTIVE
N
E.L.. EACH Agg1DENT Si,000 000
--..�
OFFICERIMEMBER EXCLUDED7 'NIA
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYE $1,000,000
describe urder
DIt ESCRIPTION OF OPERATIONS bekm
E.L. DISEASE _ POLICY LIMIT 51'000,000
E Professional Liability DR1600805
612812016 612812017 Per Claim $5,000,000
E with Contractors Pollution Liab, DR1600807
612612016 612MO17 $5,000,000
Claims Made: 111142 Retro Date
(Aggregate
i RatenBon $50,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAttach ACORD 101, Additional Remarks Schedule, if more space Is required)
RE: C I Services for Various Monroe County Roadway and Drainage Improvements Projects
Holder shall be Additional Insured where required by
contract for GL and to Liabil`t .
AP
BY MENT
A
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Monroe County, a Political Subdivision
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
1100 Simonton St., Roam 2-216
ACCORDANCE WITH THE POLICY PROVISIONS.
Key West FL 33040
-
AUTHORIZED REPRESENTATIVE
01988-2010 ACORD CORPORATION. All rights reserved.
ACORD 26 (2010105) The ACORD name and logo are
registered marks of ACORD