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COI w/Various Expirations 2017A� R17® CERTIFICATE OF LIABILITY DATE(MMIDWYYY, _ fLlTY INSURANCE 03/07/2017 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 be endorsed. If SUBROGATION IS WANED, 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 endorseme nt(s). PRODUCER THOMAS LEDWIDGE INSURANCE AGENCY SiateFarm 6177 MIAMI LAKES DRIVE E �+ MIAMI LAKES, FL 33014 S —__--- __ INSURED OAC ACTION CONSTRUCTION-CORP - 10260 - 11980 SW 144 Ct. Suite 101 MIAMI FL 33186-6266 ME NA° LOURDES MENDOZA ` PHONE 305 822-2424 PAX $22-255a E r.1AIi - - t1,VC F�o5 ADDRESS: LOURDES@LEDWIDGEAGENCY.COM INSURERS) AFFORDING COVERAGE INSURER A State Farm Mutual Automobile insurance Company -- - INSURERB: INSURERC: NAIC X 25178 INSURER D INSURER E : COVERAGES CERTFFI THIS IS TO CERTIFY THAT THE POLICIES OF INDICATED. NOTWITHSTANDING ANY REQUIF CERTIFICATE MAY BE ISSUED OR MAY PER EXCLUSIONS AND CONDITIONS OF SUCH POLI 7R4SR ---_ --WjN _TTYPE OF INSURANCE r�so COMMERCIAL GENERAL LIABILITY 1 CLAIMS -MADE D OCCUR GEN'L AGGREGATE LIMIT APPLIES PERPRO- POLICY E ECT El LOC OTHER: A AUTOMOBILE LIABILITY Y AUTO '�,L FANY ] ALL OWNED X -,- SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS !—j+ UMBRELLA LIAB OCCUR EXCESS L. AND EMPLOYERS' LIABILITY Y ! N ANY PROPRIETOR/PARTNERrEXECUTIVE OFFICER/MEMBEREXCLUDED7 ❑ NIA (Mandatory In NH) . TF MI IMRFD• -" REVISION NUMBER: RANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIWTS EACH OCCURRENCE $ MED EXP (Any one person) y i PERSONAL & ADV INJURY $ .. — ._, -- -- GENERAL AGGREGATE b _---_ PRODUCTS - COMP/OP AGG $ C87 0587- E22-59 G17 1524-007-59A j 11122/2016 03/07/2017 05/22l2017 COMBINED SINGLE LIMIT $ Ea acrid 09/07/2017 BODILY INJURY (Per person) $ 1,000,000 C87 0586-E22-59 11/22/2016 : 05/22/2017 _BODILY INJURY (Per accident) $ — 1,000,000 G171523-CO7-59A 03/07/2017 PROPERTY DAMAGE--- 09/07/2017 P_'_ nt 1,000,000 _ EACH OCCURRENCE $ AGGREGATE $ E.L. EACH ACCIDENT _ $ E.L. DISEASE - EA EMPLOYE b E.L. DISEASE - Pnl iCv i uerT c DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, AddWo" Remarks Schedule, may be attached If more space is required) 14 FORD F150 PICKUP VIN:IFTFWICF7EFA90329 16 FORD F150 PICKUP VIN: 1FTMF1C83GKD92199 16 FORD F150 PICKUP VINAFTMF1C88GKD62163 14 FORD F150 PICKUP VIN: 1 FTMF1 CM7EFB57405 Key West Airport Customs Terminal Project ` CGCO61561 ;BYX PP E GEMENT WAIVER N/A -10� ERTIFICATE HOLDER CANCELLATION Monroe County Board Of County Commissioners 1100 SiMOnton Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Key West, FL 33040 ACCORDANCE VVITH THE POUTION DATE C Yp PROVISIONS. WILL 8E DELIVERED IN ACORD 25 2014101 01988-2014 AC ( 1) The ACORD name and logo are registered marks of ACORD G� 1001486 132849.9 02-04-2014 CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DO/YY Y) 03/07/2017 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 arl ADDITIONAL INSURED, the policy(ies) must be endorsed- H 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 --LOURDES MENDOZA THOMAS LEDWIDGE INSURANCE AGENCY PNONE -- 305-822_2424 Fax Statt'Farin 6177 MIAMI LAKES DRIVE E E MAIL — — �No):3o5 a22-255s MIAMI LAKES, FL 33014 ADDRESS. Margie@LedwidgeAgency.com .______-, [NSURER(S)AFFORDINGCOVERAGE j NA1C # INSURED _ INSURER A State Farm Mutual AutOITIO1Nle Insurance COmpany 25178 OAC ACTION CONSTRUCTION CORP 10260 — _. 11980, 144A CT. Suite 101 _INSURERS: INSURER C : ----�--.--_--- MIAMI FL 33186-6266 --- ----- _. _ INSURER D - INSURER E : COVERAGES INSURER F : 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 PAlD CLAIMS. .TR ' TYPE OF IMSURANCE POLICY NUMBER M� Y EFF M MI �Y Exp -- --- -- -- . COMMERCUIL GENERAL LUIBILITY ' ' LIMITS CLAIMS -MADE OCCUR I EACH OCCURRENCE $ L__ � I � PREMISES fEa occ'unence) $ j J MED EXP fAnY one Person) j $ — GEN'L AGGREGATE LIMIT APPLIES PER ! PERSONINJURY AL B ADV INJ LM!SON— $ POLICY JECT F1 LOC I , I I GENERAL AGGREGATE .._.___._ S -- IH OTHER; PRODUCTSOPAG -COMPIG S A AUTOMOBILE uAaw-Ty Y N j 447 7958-E22 59F — 11/22/2016 j OS/2212017 -- LIMIT $ ANY AUTOMBItJdEeSINGLE ALL OYVNED X—I SCHEDULED AUTOS AUTOS I wNED ' ', 689 4492-E22-59F 927 4908-E22-59D i 11/22/2016 105/22J2017 BODILY INJURY (Per person) I I 90OILY INJURY (Per ! 11/22/2016 a t 000.000 HIREDAUTOS AUTOSUTOS I j 05/22/2017 accident) $ 1,000,000 ___-' 9454338-E22-59C PRQPERTY DAMAGE 11122/2016 OU22/2017 Perac�dentZ — $ 1,000,000 `-----.— UMBRELLA LUIB I OCCUR $ EXCESS LIAR 1 CLAIMS -MADE EACH OCCURRENCE EACH __—,-- $ DED RETENTION $ i AGGREGATE $---- -- II WORKERS COMPENSATK)N -- $ jANDEMPLOYERS'LWBILnY Y N TH- STATUTE IZANY PROPMETOR/PARTNER/EXECU7IVE BERNH) EXCLUDED? ❑� N ! A • EROFFICE _-- _ (Mandatory In j tMandatory in NH} i E.L. EACH ACCIDENT $ Ifyes, describe under DESCRIPTION OF OPERATIONS below I E L_DISEASE - EA E F--�EMPLOYE _ $ _ ---- E.L. DISEASE -POLICY LIMIT .— $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Rem wka Schedule, may be a0taciled N more space is required) 2008 CHEVROLET C1500 VIN: 2GCEC13J281158461 2013 CADILLAC SRX SPORT WG VIN: 3GCEC13J 8/158461 2014 ACURA MDX SPORT WG VIN: 5FRYD3H47EB019569 2011 FORD F250 SO PICKUP VIN: I FT7W2BT1 BEB52505 Key West Airport Customs Project CGC061561 4-APPP kA7--&— Monroe NAGEMENT 'ERTIFICATE HOLDER CANCELLATION County Board of County Commissioners 1100 Simonton Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Key West, FL 33040 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. / - AU RIZED REPRESENTATIVE - 1 ACORD 25 (2014/01) ©1988-2014 AC C RA ION- All rights resew The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014 .4`cooR"® CERTIFICATE OF LIABILITY INSURANCEDATE(M D" 03/07/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEP, 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 borN IS WAIVED, subject to the terms and conditions of the policy, certain policies may e endsed. If SUBROGATIOrequire an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 'i�. NAME: URDES MEND07A THOMAS LEDWIDGE INSURANCE AGENCY PHONE— StateFarm 6177 MIAMI LAKES DRIVE: E 7ADDR L .Exu:.305 822-2424 FAX 305-822-2558 • MIAMI LAKES, FL 33014 ESS: Margie@LedwidgeAgency.com - — ----- INSURER(S) AFFORDING COVERAGE N� 4 _State Farm Mutual Automobile insurance Company 25178 INSURED OAC ACTION CONSTRUCTION CORP ((10260) ERA:11980 SW 144A CT. Suite 101 ER B. — — MIAMI FL 33186-6266 INSURER C INSURER D : _ —... INSURER E CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED REVISION INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR ABOVEE FOR THE POLICY CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, EXCLUSIONS PERIOD CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISL THE INSURANCE AFFORDED BY THE POLICIES AND CONDITIONS OF SUCH POLICIES. DESCRIBED HEREIN IS SUBJECT TO AL THE TERMS, LIMITS SHOWN MAY HAVE BEEN REDUCED BY LTR TYPE OF INSURANCE D UBR PAID CLAIMS. COMMERCIAL GENERAL LIABILITY POLICY NUMBER M Y EFF POLICY E7CP --`----- ---_ - _ M LIMITS � I CLAIMS -MADE OCCUR ! [] I EACH OCCURRENCE $ j E TO-RL T -0 DA1 AZ, _-.- —. --- i PREMISES (Ea occunwicel S --- ---- ---- ! MED EXP (Any one person) $ — GEN'L AGGREGATE LIMIT APPLIES PER: ( POLICY JE Q ❑ LOC I PERSONAL & ADV I NJURY I $ _ GENERAL AGGREGATE _ I $ r OTHER: PRODUCTS-COMP/OPpGG $ —. A AUTOMOBILE LIABILITY Y '.N $ • — ____ ANY AUTO COMBINED SI LE LIMIT $ Ea accident) ALL OWNED X SCHEDULED AUTOS i _ G17 1522 0759 BODILY INJURY — 0 .- 03107/2017 11/07/2017 (Per person) $ 1,000,000 AUTOS HIRED AUTOS NON-0WNEO AUTOS I -----._..— --- BODILY INJURY (Per accident) $ 1,000,000 --�— _ PROPERTY DAMAGE $---1,000,000 _ Per aaadentj UMBRELLA LIAR _ - OCCUR $ -------__.. EXCESS LIAB C LAIMS-MADE ,EACH OCCURRENCE $ --_- � ...--- AGGREGATE $ _ AND EMPLOYERS- LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y 1 N OFFICER/MEMBER EXCLUDED? �I N I A (Mandatory in NH) II•1 E.L. EACH ACCIDENT _ $ E-L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT $ 948-1859-22-59A 02/22/2017I08122l2017 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACOFtD 101, Additional Remarks Sgredule, ma 16 FORD F150 Pickup VIN:1FTEW1CFXGFB22008 y be attached iF more space is required) Key West Airport Customs Project � CGCO61561 gA1PPI ED�RENENT WAIVER N/A >0YES CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners 1100 Simonton Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Key West, FL 33040 THE EMRAT'ON DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AU D REPRESENTATIVE • r', ACORD 25 (2014/01) ©1988-2014 ACOR C R RATION. A11 rights rase The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014 A� o® CERTIFICATE OF LIABILITY INSURANCE DATE 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 WANED, 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 THOMAS LEDWIDGE INSURANCE AGENCY State arm 6177 MIAMI LAKES DRIVE E MIAMI LAKES, FL 33014 NAME: LOURDES MENDOZA M-2 .305-822-2424 Pac No _305-822-2558 E-MAIL LOURDES@LedwidgeAgency.com INSURER(s)AFFORDING COVERAGE AICS INSURERA:State Farm Mutual Automobile Insurance Company +--t25178 INSURED OAC ACTION CONSTRUCTION CORP (10260) _ 11980 SW 144 Ct. Suite 101 MIAMI FL 33186-6266 INSURERB: BISURERC: 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 LTR TYPE OF INSURANCE JUM U D POLICY NUMBER MMU K:Y EPF MS POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence) ccurrence $ MED EXP (Any one person) $ & ADV INJURY $ AGGREGATE LIMIT APPLIES PER: POLICY JE l]T LOC _PERSONAL GENERAL AGGREGATE $ GEN'L PRODUCTS - COMA/OP AGG $ $ OTHER: A AUTOMOBILE LIABILITY Y N C87 0586-E22-59 A 05/2212017 11/22%2017 COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ 1,000,000 ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS C87 0587-E22-59A G17 1524 -007 -59 G171522-007-59 05/22/2017 03/07/2017 03/07/2017 11/22/2017 09/07/2017 09/07/2017 BODILY INJURY (Per accident) $ 1,000,000 PROPERTY DAMAGE Per accident $ 1,000,000 $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYCEWMEETOR/PXCLUDEDXECVr1VE OFFICERlMEMBER EXCLUDED? � N 1 A PER OTH- STATUTE ER E.l.EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under E.L. DISEASE -POLICY LIMIT --- $ DESCRIPTION OF OPERATIONS below Comp & Coll $500 deductible DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached it more space is required) 14 FORD F150 PICKUP VIN: 1FTFW1CF7EFA90329 14 FORD F150 PICKUP VIN: 1FTMF1C EFB57405 14 FORD F150 PICKUP VIN: 1FTMF1C88GKD621631 16 Ford F150 PICK UP VIN: 1FTEWICF G BWAS Key West Airport Customs Terminal Project B P VE EMENT CGCG61561—DATE W ..� HOLDER Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West, FI 33040 ACCORDANCE WITH THE POLICY PROVISIONS. / A THORIZED REPRESE ATIVE C. L 01988-2014 ACOR O TlI N. All righ resery ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04- q� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDNM) 05/24/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER THOMAS LEDWIDGE INSURANCE AGENCY Statefafm 6177 MIAMI LAKES DRIVE E ` MIAMI LAKES, FL 33014 - CAME:ONTACT LOURDES MENDOZA N PHONE 305-822-2424 ac Na :305 822-2558 AD^ ADDRESS, Lourdes@Ledwidgeagency.com INSURER(5), AFFORDING COVERAGE NAIL$ INSURER A State Farm Mutual Automobile Insurance Company 25178 INSURED OAC ACTION CONSTRUCTION CORP (10260) 11980 SW 144 Ct. Suite 101 MIAMI FL 33186-6266 INSURERB: 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. LNSRR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY yy MM/0POIJY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR f AMAO PREMISES Ea bccunence $ MED EXP (Any one person) Is —_-- i PERSONAL & ADV INJURY $ AGGREGATE LIMIT APPLIES PER: POLICY ❑ PO -JET LOC GENERAL AGGREGATE GEN'L $ PRODUCTS - COMP/OP AGG $ $ OTHER: A AUTOMOBILE LIABILITY Y N 447 7958-E22-59F 05/22/2017 11/22/2017 COMBIN D SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ 1,000,000 ANY AUTO ALL OWNED T SCHEDULED AUTOS ^ AUTOS NON -OWNED HIRED AUTOS 689 4492-E22-59F 927 4908-E22-59D 945 4338-E22.59C 05/22/2017 05/22/2017 05/22/2017 11/22/2017 11122/2017 11/22/2017 BODILY INJURY (Per accident) $ 1,000,000 PROPERTYaccident) Pe ERtDAMAGE $ 1,000,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTIONS $ WORKERS COMPENSATION S' AND EMPLOYERLIABILITY Y r N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? N! A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S (Mandatory In NH) I s, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ Comp & Call 500 deducbble DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 2008 CHEVROLET C1500 VIN: 2GCEC13J281158461 2014 ACURA MDX SPORT WG VIN: 5FRYD3H47EB019569 2013 CADILLAC SRX SPORT WG VIN: 3GYFNDE39DS597275 2011 FORD F250 SD PICKUP VIN: 1 FTTW2BT1 BEB52505 Key West Airport Customs Project CGCO61561 APP K M E 7 DATE WAI N/A- ;, CANCELLATION Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key west, FI 33040 ACCORDANCE WITH THE POLICY PROVISIONS. AUIHORIZED REPRESE ATIVE G cam' 10 1�dj 01988-2014 AC D C ORATION. All nghts resew ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014 A� !�'�r CERTIFICATE OF LIABILITY INSURANCE D05/2 /20`117 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 WANED, 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 THOMAS LEDWIDGE INSURANCE AGENCY Statefar►n 6177 MIAMI LAKES DRIVE E MIAMI LAKES, FL 33014 CONTAC NAME:T LOURDES MENDOZA PHONE 3oS-822-2424 Ne .305 822-2558 ADDRESS: LOURDES@LedwidgeAgency.com INSURER(S) AFFORDING COVERAGE NAtC it INSURER A State Farm Mutual Automobile Insurance Company 25178 INSURED OAC ACTION CONSTRUCTION CORP (10260) 11980 SW 144 Ct. Suite 101 MIAMI FL 33186-6266 INSURER B: INSURERC: 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. LLTTR TYPE OF INSURANCE ADD SUB POLICY NUMBER M1W � MOL � LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ _ AMA T RENTED PREMISES Ea occugg ce� $ MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ AGGREGATE LIMIT APPLIES PER: POLICY PET ❑ LOC GENERALAGGREGATE $ GEN•L j PRODUCTS- COMP/OP AGG $ $ OTHER: A AUTOMOBILE LIABILITY Y N G 171523 C07 59 03/07/2017 09/07/2017 COMBINED SINGLE LIMi Me accident $ BODILY INJURY (Per person) $ 1,000.000 ANY AUTO OWNEDX SCHEDULED ALL AUTOS AUTOS BODILY INJURY (Per accident) $ 1=400 HIRED AUTOS AUTOSNON-OWNED AUTOS PROPERTY DAMAGE Peracddent $ 1,000,000 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N / A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, descr�e under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT I $ ENOL 948 1859 E22 59B 05122/2017 11/22/2017 Comp & CoH TobW Ueduclible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedute, may he attached it more space is rep " d) 16 FORD F150 Pickup VIN: IFTEWICFXGFB22009 APP B ISK N� Key West Airport Customs Project BA CGC061561 W N A Monroe County Board of County Commisioners 1100 Simonton Street Key West, FIL 33040 1 � w 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 RREPRETIVE 4ww7dVv(6 01988-2014 ACORD rights .,.,.,�.., %,v r J I ne s+t.vKu name ana logo are reglsterea marKS of AGURD 1001486 132849"9 02-04-2014 ,AcoR" EVIDENCE OF PROPERTY INSURANCE DATE(MMIDD/YYYY) `... 06/30/2017 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY A ONN Ex : (305)265-0112 COMPANY Entrust Insurance 1431 Ponce De Leon Blvd Certain Underwriters at Lloyd's of London Coral Gables 265-0101 FL 33134 I CODE: I SUB CODE: I INSURED OAC Action Construction Corporation 11980 SW 144 Court Suite 101 Miami VKUYtKIT INI-UKMAIIUN LOCATION/DESCRIPTION 3491 S. Roosevelt Blvd Key West, FI 33040 LOAN NUMBER EFFECTIVE DATE EXPIRATION DATE 06/30/2017 10/01 /2017 FL 33186 1 THIS REPLACES PRIOR EVIDENCE DATED: POLICY NUMBER CSN0000291 CONTINUED UNTIL TERMINATED IF CHECKED 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 EVIDENCE OF PROPERTY INSURANCE 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. /`/1\/C0A!_-C Id1Uf'%011A71l1L1 ,,.-.,,, , ., ...,,.I A- I COVERAGE / PERILS / FORMS AMOUNT OF INSURANCE DEDUCTIBLE Builders Risk Wind -Only Coverage Form Renovations and Improvements $1,000,000 $100,000 All Covered Property at all Locations $1,000,000 $100,000 Flood Zone VE 10 Coverage Form $1,000,000 $100,000 Mr-MMMMO tIFIGIUCIIng J eGlai I.OnQIUOnS Project Name: Key West International Airport Customs Facility Phase 11 Additional Insured: Monroe County Board of County Commissioners 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. AnnIT10NA1 INTFRFST NAME AND ADDRESS X ADDITIONAL INSURED LENDER'S LOSS PAYABLE Ll LOSS PAYEE MORTGAGEE Monroe County Board of County Commissioners LOAN # 1100 Simonton Street, #2-284 Key West, FjL 33040 AUTHORIZED REPRESENTATIVE At;UKU L/ (LU1ti/U3) 91993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE (MM/DD/YYYY) AC61ZV EVIDENCE OF PROPERTY INSURANCE lft� 1 06/30/2017 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY A O N .NEExc. (305)265-0112 COMPANY Entrust Insurance 1431 Ponce De Leon Blvd American Zurich Insurance Company Coral Gables FL 33134 n /c No: (305)265-0101 1 ADDRESS: Info@agencyentrust.com CODE: I SUB CODE: INSURED OAC Action Construction Corporation 11980 SW 144 Court Suite 101 Miami LOCATION/DESCRIPTION 3491 S. Roosevelt Blvd Key West, FI 33040 LOAN NUMBER EFFECTIVE DATE EXPIRATION DATE 06/30/2017 10/01 /2017 FL 33186 THIS REPLACES PRIOR EVIDENCE DATED: POLICY NUMBER E R09099617 CONTINUED UNTIL TERMINATED IF CHECKED 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 EVIDENCE OF PROPERTY INSURANCE 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. /`l11,1C0A!_C 1KICf%0R1ATIf1KI , w, „— .- n—m nrn,., COVERAGE I PERILS I FORMS AMOUNT OF INSURANCE DEDUCTIBLE Builders Risk Coverage Form $5,000 Renovations and Improvements $1,000,000 Ex -Wind All Covered Property at all Locations $1,000,000 Ex -Flood KtMAKKS tincivaing 5 eClal GOnaItIOnS Project Name: Key West International Airport Customs Facility Phase II Additional Insured: Monroe County Board of County Commissioners AP V ENT BY WA R N A CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AnnITIANAI INTFRFSiT NAME AND ADDRESS X ADDITIONAL INSURED LENDER'S LOSS PAYABLE Ll LOSS PAYEE MORTGAGEE LOAN # Monroe County Board of County Commissioners 1100 Simonton Street, #2-284 AUTHORIZED REPRESENTATIVE Key West, FL 33940 r AU(JKo 27 (z016103) ©1993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AZ " CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/DD/YYYY) 10/18/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT IJAMP. LOURDES MENDOZA THOMAS LEDWIDGE INSURANCE AGENCY StafeFarin 6177 MIAMI LAKES DRIVE E 06 MIAMI LAKES, FL 33014 tNsuRED _ —OAC ACTION CONSTRUCTION CORP (1026 11980 SW 144 Ct. Suite 101 MIAMI FL 33186-6266 COVFRAnFS r-oorlclnar� . "'—" o tl;sU0-dZZ-z4z4 ;mac No):305-822-2558 ADDRESS! LOURDES@LedwidgeAgency.com INSURER($) AFFORDING COVERAGE NAIL # INSURER A :State Farm Mutual Automobile Insurance Company 25178 INSURER B : -_ — _ _ -- ---- - D: _ _ - - - -- - -- - ICC V IJIVN rvUIVIt5t11: 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 EFF I POLICY EXP - --_'-- POLICY NUMBER DNYYY DIYYYY LIMITS COMMERCIAL GENER-AL�UABIUTY CLAIMS -MADE I OCCUR � EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea oeourrenog) - $ MED EXP (Arty one person) $ -- � -- ----- PERSONAL & ADV INJURY S I GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ECT LOC ! OTHER: GENERAL AGGREGATE - ! PRODUCTS - COMP/OP AGG ' S _ S -- --' � S A AUTOMOBILE j ' LIABILITY ANY AUTO _ AUTOS ALL OWNED SCHEDULED X AUTOS AUTOS HIRED AUTOS NON-OWNEDPROPERTY AUTS Y N ( G771523 C07 59 109iuT/2017 03l071201$ i COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ 1,00o,000 BODILY INJURY (Per accident) $ 1,000,000 DAMAGE-' Per accident $ 1,000,000 UMBRELLA LIAB 1 OCCUR EXCESS LIAB ClAIPo15-MADE ;EACH OCCURRENCE S AGGREGATE _ . DED RETENTION S - I S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER7EXECU?IVE OFFICERIMEMBER EXCLUDED? (Mandatory in and If yes, describe under N / A STATUTE ERH E.L. EACH ACCIDENT -- $ E.L. DISEASE - EA EMPLOYE -- ___..._..-..---_ $ E.L. DISEASE - POLICY LIMIT $ I DESCRIPTION OF OPERATIONS below !ENOL 9481859 E22 598 05/2212017 ! 11/22/2017 i Comp S Coll $500 deductlMe DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 16 FORD F150 Pickup VIN: 1FTEWlCFXGFB22009 APP V RIS GEMENT Key West Airport Customs Project B CGC061561 WAN /A Y n�orrren..� . -- - — l.A1VGtLLA I IVN Monroe County Board of County Commisioners 1100 Simonton Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Key West, FL 33040 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. A ORIZED REPREq(t!J��T1YE � V"t ©1988-2014 ACORD CO ORATION. All rights resery ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2 4 fi c���Ztcli+vl.(� ,ac R CERTIFICATE OF LIABILITY INSURANCE FD 18/2011 10l8/27 107 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 CON ACT LOURDES MENDOZA NAME: _ THOMAS LEDWIDGE INSURANCE AGENCY PHONE JAM-Mg305-822-2424 �305 822-2558 StateFarin 6177 MIAMI LAKES DRIVE E E,tLI: - rarC "°' E-MAIL ADDREss: LOURDES@LedwidgeAgency.com MIAMI LAKES, FL 33014 - - INSURERS) AFFORDING COVERAGE NAUC if _ INSURER A:State Farm Mutual Automobile Insurance Company 25178 INSURED OAC ACTION CONSTRUCTION CORD (10260) - ----- INSURER B : 11980 SW 144 Ct- Suite 101- INSURER C MIAMI FL 33186-6266 - E: COVERAGES rcOTICIf%Arc K11M. e. 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 A L j SUBR; ` POLICY NUMBER POLICY EFF M/ODIYYW POLICY fXP MMLIC -- LIMITS COMMERCIAL GENERAL LIABILITY `----�—� CLAIMS -MADE EACH OCCURRENCE DAMA E TO RENTED PREMISES'Ea occurrence i- - OCCUR I $ 4 I MED EXP (Any one person) $ ------ --- _ PERSONA_ & ADV INJURY -_ $ I { 1EN1 AGGREGATE LIMIT APPLIES PER: PRO- ' GENERAL AGGREGATE --- S ( j - PRODUCTS - COMP/OP AGG - —-- S POLICY JECT t_ LOC OTHER: $ A ! AUTOMOBILE LIABILRY Y N C117 05864E22-59 A 05/2212017 11/22/2017 COMBINED SINGLE LIMIT--$ �j Ea accdent BODILY INJURY (Per person) $ 1,pp0,0pp -� --11 I ANY AUTO ALL OWNED X SCHEDULED Auros I Autos NON C87 0587-E22-59A G1 T 1524 -007 59 05=2017 09H)912017 ! 11/22/2017 03/0712018 BODILY INJURY (Per accident $ 1,000,OOQ -OWNED HIRED AUTOS X Autos PROPERTY DAMAGE ( I G17 1522-007-59 09107/2017 03/0712018 Per accident s 1.000.000 $ j I UMBRELLA LIAB I OCCUR EACHOCCUR_R_E_N_C_E_ S EXCESS LIAR CLAIMS -MADE ! AGGREGATE $ DED RETENTION $ _ _ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. E.L. EACH ACCIDENT _ $ ANY PROPRiETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED' ❑ N 1 A , (Mandatory in NH) { E.L. DISEASE - EA EMPLOYE S If yes, describe under DESCRIPTION OF OPERATIONS below _ _.__. E.L. DISEASE - POLICY LIMIT ! $ I Comp & Coll deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 14 FORD F150 PICKUP VIN: 1FTFW1CF7EFA90329 14 FORD F150 PICKUP VIN: I FTMF1 CM7EFB57405 14 FORD F150 PICKUP VIN: 1FTMF1C88GKD621631 16 Ford F150 PICK UP VIN: IFTEWICFXGFB22009 Key West Airport Customs Terminal Project 1 APP VE CGCO61561 BY NAGEMENT WA A GANGtLLA7 ION Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West, FI 33040 ACCORDANCE WITH THE POLICY PROVISIONS. A ORIZED REPRESENTATIVE 01988-2014 ACOft COR ORATION. All ribhts rese d. ACORD 25 (21P4101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02- - 14 GG' ACC)REP ® r ATE (MM/DDIYYYY) � EVIDENCE OF PROPERTY INSURANCE 10/19,2017 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PHONE . (305)265-0112 COMPANY Entrust Insurance 1431 Ponce De Leon Blvd American Zurich Insurance Company Coral Gables FL 33134 F4 c. Ne, (305) 265-0101 1 nnnwFss• Infooagencventrust.com 1 CODE: I SUB CODE: I INSURED OAC Action Construction Corporation 11980 SW 144 Court Suite 101 Miami F'KUMtK 1 T INI-UKMA I IUN LOCATIONID E SC RIPTI ON 3491 S. Roosevelt Blvd Key West, FI 33040 LOAN NUMBER POLICY NUMBER ER09099617 EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 10/01/2017 01/01/2018 TERM INATEDIFCHECKED FL 33186 THIS REPLACES PRIOR EVIDENCE DATED: 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 EVIDENCE OF PROPERTY INSURANCE 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. rnVFRAr_F INFORMATIAN DCDII C MCI IDCn Deci� DDnnn cocnini COVERAGE / PERILS / FORMS AMOUNT OF INSURANCE DEDUCTIBLE Builders Risk Coverage Form $5,000 Renovations and Improvements $1,000,000 Ex -Wind All Covered Property at all Locations $1,000,000 Ex -Flood KtMAKKS (incluaing special GOnaltionS Project Name: Key West International Airport Customs Facility Phase II Additional Insured: Monroe County Board of County Commissioners 4APP RIS EMENT A 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. AnniTInN1AI INTFRPRT NAME AND ADDRESS X ADDITIONAL INSURED LENDER'S LOSS PAYABLE LOSS PAYEE MORTGAGEE H LOAN # Monroe County Board of County Commissioners 1100 Simonton Street, #2-284 AUTHORIZED REPRESENTATIVE Key West, FL 33040 ACORD 27 (2016/03) 9)1993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD e-c-' WtiC.t� DATE(MMIDDIYYYY) . 6. O EVIDENCE OF PROPERTY INSURANCE f`� 10/19/2017 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PHONE (305)265-0112 COMPANY Entrust Insurance 1431 Ponce De Leon Blvd Certain Underwriters at Lloyd's of London Coral Gables 265-0101 FL 33134 I CODE: I SUB CODE: I INSURED OAC Action Construction Corporation 11980 SW 144 Court Suite 101 Miami PROPERTY INFORMATION LOCATIONIDE SC RI PTION 3491 S. Roosevelt Blvd Key West, FI 33040 LOAN NUMBER EFFECTIVE DATE EXPIRATION DATE 10/01/2017 01/01/2018 FL 33186 1 THIS REPLACES PRIOR EVIDENCE DATED: POLICY NUMBER CSN0000291 CONTINUED UNTIL TERMINATED IF CHECKED 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 EVIDENCE OF PROPERTY INSURANCE 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. ^^%#0nA/10 §L10^O\■AT1f1\1 nrn„ n ... n„nrn wn,n I I o w COVERAGE I PERILS I FORMS AMOUNT OF INSURANCE DEDUCTIBLE Builders Risk Wind -Only Coverage Form Renovations and Improvements $1,000,000 $100,000 All Covered Property at all Locations $1,000,000 $100,000 Flood Zone VE 10 Coverage Form $1,000,000 $100,000 Project Name: Key West International Airport Customs Facility Phase II Additional Insured: Monroe County Board of County Commissioners 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. ADDITIUNAL IN I 1=KL5I NAME AND ADDRESS X ADDITIONAL INSURED LENDER'S LOSS PAYABLE Ll LOSS PAYEE MORTGAGEE LOAN # Monroe County Board of County Commissioners 1100 Simonton Street, #2-284 Key West, FL 33040 AUTHORIZED REPRESENTATIVE ACORD 27 (2016/03) ©1993-2015 ACORD CORPORATION. All rights reserved. ' The ACORD name and logo are registered marks of ACORD A "R" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDo s ) 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 ICONTACT THOMAS LEDWIDGE INSURANCE AGENCY Statefarin 6177 MIAMI LAKES DRIVE E MIAMI LAKES, FL 33014 INSURED OAC ACTION CONSTRUCTION CORP (10260) 11980 SW 144 Ct. Suite 101 MIAMI FL 33186-6266 COVERAGES rI=PTIFIreTC h "UMCD. LOURDES MENDOZA 305 822-2424 FAX — ,A (A/C, No1:305-822-2558 s: LOURDES@LedwidgeAgency.com INSURER S AFFORDING COVERAGE NAIC # A .State Farm Mutual Automobile Insurance Company 25178 E: 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 SUfB POLICY NUMBER POLICY EFF r MMIDDIYYYY POLICY EXP DDIYYYY -`--- LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR I i EACH OCCURRENCE $ DAMAGE TO RENTET _ PREMISES (Ea occurrence_ $ MED EXP (Any one person) $ — ' PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY C I SCO T-1 i_OC GENERAL AGGREGATE ! S I I PRODUCTS --_ I-— - - 1 $ I OTHER: A AUTOMOBILE LIABILITY Y N ! G171523 C07 59 i 09/07/2017 03/07/2018 COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) S 1,000,000 ANY AUTO ! ! ALL OWNED X SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS . BODILY INJURY (Per accident) $ 1,000,000 PROPERTY DAMAGE Per aceidenR $ 1,000,000 UMBRELLA LIAH i OCCUR I ; EACH OCCURRENCE ? EXCESS UAB �_ I CLAIMS-MADE DED i r RETENTION $ ' i ! I AGGREGATE i$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERlEXECUTIVE OFFICERIMEMBER EXCLUDED) ❑ N I A ( ! PER i STATUTE I ERH E.L. EACH ACCIDENT $ .. E.L. DISEASE - EA EMPLOYE $ (Mandatory In andNH) If yes, describe under DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below `-E.L. ( 'ENOL i( I I I 9481859 E22 59B 05122/2017 Comp & Coll $500 deductible 11l22/2017 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if morn space is required) 16 FORD F150 Pickup VIN: 1FTEWlCFXGFB22009 Key West Airport Customs Project Y P D MENT CGCO61561 WAIVER a cM r t C nvwr-rc CANCELLATION Monroe County Board of County Commisioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West, FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. / A ORIZED REPREPTIVE ©1988-2014 ACORD CO ORATION. All rights resery ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2 4 '4C__ J?Uv CERTIFICATE OF LIABILITY INSURANCE `►� DATE(MM/DD/YYYY) 10/18/2017 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 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 THOMAS LEDWIDGE INSURANCE AGENCY SPetefcTatd# 6177 MIAMI LAKES DRIVE E MIAMI LAKES, FL 33014 _ INSURED OAC ACTION CONSTRUCTION CORP (10260) 980 SW 144 Ct. Suite 101 MIAMI FL 33186-6266 CONTACTLOURDES MENDO_ZA ME: NAME: PHONE 305 822-2424 F 305 822-2558 `(' tvc No) E-MAIL — ADD —RELOURDES SS: - @LedwldgeAgency.com - - INS URER{S) AFFORDING COVERAGE ----- �25IC18 INSURER A :State Fann Mutual AutOmOblle IrlsuranCe Company i------"--" INSURER 8 : h INSURER C : — INSURER D : INSURER E INSURER F : - 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 iADDL SUBR v- ---- -- POLICY NUMBERI POLICY E FF POLICYEXP MMIDDIYYYY) IMM/DDIYYYYI i LIMITS COMMERCIAL GENERAL LIABILITY i ! EACH OCCURRENCE DAMAGE TORCN-MIT MIS ES' occurrencel __ i CLAIMS -MADE �I OCCUR '�---'" ------ $ __ —!---------- _ j I MED EXP (Any one person) $ { PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER - GENERAL AGGREGATE (_ S __ �_-- POLICY E �_ LOC _ _ PRODUCTS - COMPIOP AGG S 'OTHER: A AUTOMOBILE LIABILITY Y N C87 0586-E22-59 A 05/2212017 11/22/2017 COMBINED SINGLE LIMIT $ Ea accide�- _ $ 1,000,000 ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS C87 0587-E22-59A G17 1524 -007 -59 05/22/2017 111/22/2017 I BODILY INJURY (Per person) - BODILY INJURY (Per accident) $ 1,000,000 �/ NON -OWNED HIRED AUTOS ^ 09/09/2017 03/07/2018 ( PROPERTY DAMAGE _ I AUTOS G171522-007-59 09/0712017 03/07/2018 Per accident $ 1.000,000 ___ I UMBRELLA LIAR OCCUR EACHOCCURRENCE____ S I -- !EXCESS L{AB CLAIMS -MADE - ------.. .....-__- AGGREGATE S DED RETENTION$ _ v $ i WORKERS COMPENSATION IPER OTH- AND EMPLOYERS' LIABILITY YIN N _ STATUTE ER EACH ACCIDENT _ S ANY PROPRIETORlPARTNER/EXECUTIVEL OFFICER/MEMBER EXCLUDED? ❑ N 1 A (Mandatory in If yes, describe under I `E.L.-- - DISEASE EA EMPLOYE -- _ S S 1 DESCRIPTION OF OPERATIONS below � E.L. DISEASE -POLICY LIMIT i i Comp & Coll 500 deductible DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mom space is required) 14 FORD F150 PICKUP VIN: 1FTFW1CF7EFA90329 14 FORD F150 PICKUP VIN: 1FTNIFICM7EFB57405 14 FORD F150 PICKUP VIN: 1FTMF1C88GKD621631 16 Ford F150 PICK UP VIN: 1FTEWICFXGFB22009 Key West Airport Customs Terminal Project 4APPE Yi GEMENT CGC061561/q Y S� ..I. nvwcra CANCELLATION / Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West, FI 33040 ACCORDANCE WITH THE POLICY PROVISIONS. r A ORIZED REPRESENTATIVE 01988-2014 ACOe COR ORATION. All rilfhts rese d ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02- DATE (MMIDD/YYYY1 ACOR" EVIDENCE OF PROPERTY INSURANCE 1`� 10/19/2017 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PIHONE (305) 265-0112 COMPANY Entrust Insurance 1431 Ponce De Leon Blvd Certain Underwriters at Lloyd's of London Coral Gables 265-0101 FL 33134 I CODE: I SUB CODE: I INSURED OAC Action Construction Corporation 11980 SW 144 Court Suite 101 Miami LOCATIONID E SC RIPTI ON 3491 S. Roosevelt Blvd Key West, FI 33040 LOAN NUMBER EFFECTIVE DATE EXPIRATION DATE 10/01/2017 01/01/2018 FL 33186 1 THIS REPLACES PRIOR EVIDENCE DATED: POLICY NUMBER CSN0000291 CONTINUED UNTIL TERMINATED IF CHECKED 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 EVIDENCE OF PROPERTY INSURANCE 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. 1%n1JC0AGC IAICADMATIAIJ 000cecirI I oonen I I cooriei COVERAGE / PERILS / FORMS AMOUNT OF INSURANCE DEDUCTIBLE Builders Risk Wind -Only Coverage Form Renovations and Improvements $1,000,000 $100,000 All Covered Property at all Locations $1,000,000 $100,000 Flood Zone VE 10 Coverage Form $1,000,000 $100,000 Project Name: Key West International Airport Customs Facility Phase II Additional Insured: Monroe County Board of County Commissioners CANCELLATION PPR*N/AY 6EMENi Y WAIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AnnITInMAI IMTFRFRT NAME AND ADDRESS X ADDITIONAL INSURED LENDER'S LOSS PAYABLE LOSS PAYEE MORTGAGEE H LOAN # Monroe County Board of County Commissioners 1100 Simonton Street, #2-284 AUTHORIZED REPRESENTATIVE Key West, AFL 33040 ACORD 27 (2016/03) ©1993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACC)PROr EVIDENCE OF PROPERTY INSURANCE DATE (MMIDDIYYYY) �� 10/19/2017 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PHONE COMPANY [Air u.. r"'. (305) 265-0112 Entrust Insurance 1431 Ponce De Leon Blvd American Zurich Insurance Company Coral Gables FL 33134 FAX No): (305) 265-0101 ADDRESS: Info@agencyentrust.com CODE: I SUB CODE: INSURED LOAN NUMBER POLICY NUMBER OAC Action Construction Corporation ER09099617 11980 SW 144 Court EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL Suite101 10/01/2017 01/01/2018 TERM INATEDIFCHECKED Miami FL 33186 THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATIONIDESC RIPTI ON 3491 S. Roosevelt Blvd Key West, FI 33040 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 EVIDENCE OF PROPERTY INSURANCE 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. rnVFRAAF mg:nPUATInm DCDII C MIZI IDFII I I RAQ11' I I ROnAl'1 I I CDF!`IAI COVERAGE I PERILS I FORMS AMOUNT OF INSURANCE DEDUCTIBLE Builders Risk Coverage Form $5,000 Renovations and Improvements $1,000,000 Ex -Wind All Covered Property at all Locations $1,000,000 Ex -Flood Project Name: Key West International Airport Customs Facility Phase II Additional Insured: Monroe County Board of County Commissioners APP VWIGEMENT YWA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST NAME AND ADDRESS Monroe County Board of County Commissioners 1100 Simonton Street, #2-284 Key West, FL 33040 i. GC. ADDITIONAL INSURED i I LENDER'S LOSS PAYABLE I 1 LOSS PAYEE IMORTGAGEE LOAN # AUTHORIZED REPRESENTATIVE ACORD 27 (2016/03) @ 1993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACCO ® • DATE (Mlt1IDD1YYYY) O CERTIFICATE OF LIAI3ILI'TY INSURANCE 11/08/2018 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 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 Thomas Ledwidge NAME: THOMAS LEDWIDGE INSURANCE AGENCY -PHONE .Ext): 822 -2424 aAc,No). 822 -2558 State n 6177 MIAMI LAKES DRIVE E A : Thomas ©LedwidgeAgency.com MIAMI LAKES, FL 33014 INSURER(S) AFFORDING COVERAGE NAIC # Ohs _ INSURERA :State Farm Mutual Automobile Insurance Company 25178 ' INSURED OAC ACTION CONSTRUCTION CORP (10260) INSURER B: 11980 SW"144 Ct. Suite 101 INSURERC: MIAMI FL 33186 -6266 INSURER D : INSURER E : I 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. I LTR TYPE OF INSURANCE IADDL SUBR POLICY EFF POLICY EXP INSD MD POLICY NUMBER IMMJDD/YYYY) (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ SAGE TO RENTED _ CLAIMS -MADE Cl OCCUR PREMISES (Ea occurrence) $ ' MED EXP (Any one person) S PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S PRO- j POLICY JECT I l LOC • PRODUCTS - COMP/OP AGG S OTHER: S A . (Ea a AUTOMOBILE UABILITY Y C87 0586- E22-59 A 11/22/2018 05/22/2019 COMccident) I J INGLE LIMIT $ ANY AUTO C87 0587- E22 -59A 11/22/2018 05122/2019 BODILY INJURY (Per person) S 1,000,000 ALL OWNED N SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S 1,000,000 NON -OWNED G17 -007 -59 09/07/2018 03/07/2019 PROPERTY DAMAGE HIRED AUTOS AUTOS G17 1522-007-59 09/0712018 03/07/2019 (Per accident) $ 1,000,000 $ UMBRELLA MB — OCCUR EACH OCCURRENCE $ I EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED I RETENTION $ . _ .. :10 g -Y RISK , . ' NAGE' $ WORKERS COMPENSATION 1��, PER OTH- AND EMPLOYERS' LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y BY ✓ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? t I N 1 A •� __ - (Mandatory in NH) DATE E.L. DISEASE - EA EMPLOYEE $ D yS CRIP describe OF OPERATIONS below TION under WAIVER NAIL__ YES__ E.L. DISEASE - POLICY LIMIT $ ES Comp & Coll $500 deductible DESCRIPTION OF OPERATIONS 1 LOCATIONS • VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) • 14 FORD F150 PICKUP VIN: 1FTFWICF7EFA90329 14 FORD F150 PICKUP VIN: 1FTMF1CM7EFB57405 16 FORD F150 PICKUP VIN: 1FTMFIC88GKD62163 16 Ford F150 PICKUP VIN: 1FTEWICFXGFB22009 CGC License #061561 - CERTIFICATE HOLDER CANCELLATION Additional Insured: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key FL 33040 AUTHORIZED REPRESENTATIVE G C ; 1 Ly�,tvwt C� c T om , ©1988- ACORD CO All right's reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02 - - 2014 AC ® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 11/08/20 8 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 NAME �ThOrT1aS Ledwldge THOMAS LEDWIDGE INSURANCE AGENCY (NC. E><fr 822 -2424 , Ne1, 3054322 -2558 state Farm 6177 MIAMI LAKES DRIVE E an : Thomas @LedwidgeAgency.com o _ MIAMI LAKES, FL 33014 INSURERS) AFFORDING COVERAGE NAIL # a INSURER State Farm Mutual Automobile Insurance Company 25178 INSURED OAC ACTION CONSTRUCTION CORP (10260) INSURERB: • 11980 SW 144 Ct. Suite 101 INSURER C: _ MIAMI FL 33186 -6266 INSURER D: INSURER E : I INSURER F : I 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. I C.7 R TYPE OF INSURANCE ADDLfSUBR POLICY EFF POLICY EXP 1NS0 WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) 5 PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY I JECT I LOC PRODUCTS - COMP /OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY Y C87 0586- E22-59 A 11/2212018 05/22/2019 COMBINED SINGLE LIMIT s (Ea accident) ANY AUTO C87 0587- E22 -59A 11/22/2018 05/22/2019 BODILY INJURY (Per person) $ 1,000,000 ALL OWNED SCHEDULED AUTOS X AUTOS G17 1524 -007 -59 09/07/2018 03/07/2019 BODILY INJURY (Per accident) S 1,000,000 NON -OWNED PROPERTY DAMAGE HIRED AUTOS — AUTOS G17 1522-007-59 09/07/2018 03/07/2019 (Per accident ) S 1,000,000 $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE APP' 0 i=D Y ISK A GEI�tEtdT AGGREGATE $ DED RETENTION$ Js $ WORKERS COMPENSATION 1 . . PER 1 1 OTH- i AND EMPLOYERS' LABILITY Y / N BY . �— STATUTE I 1 ER ANY PROPRIETOR/PARTNER/EXECUTIVE I N ! A D A E.L. EACH ACCIDENT 1 $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under WAIVER N/ DESCRIPTION OF OPERATIONS below E-L. DISEASE - POLICY LIMIT { $ Comp & Coll 5500 deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached If more space is required) 14 FORD F150 PICKUP VIN: 1FTFW1CF7EFA90329 14 FORD F150 PICKUP VIN: 1FTMFICM7EFB57405 16 FORD F150 PICKUP VIN: 1FTMF1C88GKD62163 16 Ford F150 PICK UP VIN: 1FTEWICFXGFB22009 CGC License #061561 ' CERTIFICATE HOLDER CANCELLATION Additional Insured: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key FL 33040 AUTHORIZED REPRESENTATIVE • G G m�I%wt✓lnitv{� +Tr" 01988- ACORD ORPORATiON. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02- 042014 ACC9Re t � ' DATE (MM(DD/YYY1) �./, CERTIFICATE OF L�����' INSURANCE 11/08/2018 .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 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 CONT CT Thomas Ledwidge THOMAS LEDWIDGE INSURANCE AGENCY (A/C. Ext) ;3 822 -2424 I No). -822 -2558 StateFarm 6177 MIAMI LAKES DRIVE E E-MAIL ADDRESS: momas @LedwidgeAgency.com MIAMI LAKES, FL 33014 INSURER(S) AFFORDING COVERAGE NAIC 11 INSURER : State Farm Mutual Automobile Insurance Company 25178 INSURED OAC ACTION CONSTRUCTION CORP (10260) INSURER B : 11980 SW 144 Ct. Suite 101 INSURER C: MIAMI FL 33186 -6266 INSURERD: INSURER E : I INSURER F : I COVERAGES I. CERTIFICATE NUMBER: 1 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 IN$D MD POLICY NUMBER (MM/DDIYYYY) (MMIDD/YYYY) OMITS C OMMERCIAL GENERAL UABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISES (Ea occurrence) S MED EXP (Any one person) $ PERSONAL & ADV INJURY _ $ _ GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- ! POLICY JECT , LOC PRODUCTS - COMP /OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY Y G17 1523 C07 59 09/07/2018 03/07/2019 COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO E94 2855- D26-59 10/26/2018 06/26/2019 BODILY INJURY (Per person) $ 1,000,000 — ALLOWNED -;,--e, AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ 1,000,000 X HIRED AUTOS NOTN -OOWNED S PROPERTY DAMAGE 1Peracddent) $ 1,000,000 AU $ UMBRELLA LIAB I_ _ OCCUR APP fir -�}�( FilS,NAGEMENT EACH OCCURRENCE $ — EXCESS LIAB j_ CLAIMS-MADE �Y � ` ( \ / � AGGREGATE S 1111 .__ -_- -_ -. _ DED RETENTION S. (. (1 O S WORKERS COMPENSATION 1 ` PER STATUTE ORH- AND EMPLOYERS' LIABILITY YIN �� j, , ER ANY PROPRIETOR/PARTNER/EXECUTIVE 1 VNAIVPR N /1(6 Y EL EACH ACCIDENT $ OFFICER/MEMBER FACLUDEDT N / A (Mandatory In NH) El. DISEASE - EA EMPLOYEE $ If yos, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ Comp & Coll $500 deductible , ENOL Y 9481859 E22 59B 11/22/2018 05/22/2019 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) • 16 FORD F150 Pickup VIN: 1FTMF1C83GKD92199 18 Ford F150 Pickup VIN: 1FTMFICB8JKC01847 CGC License #061561 CERTIFICATE HOLDER. CANCELLATION Additional Insured: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 AUTHORIZED REPRESENTATIVE V , © 1988-2014 ACORD C i PORATION. All rights reserved. ACORD 25 (2014/01) The.ACORD name and logo are registered marks of ACORD 1001486 132849.9 02 - 04 - 2014