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Certificates of Insurance AC® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 02/04/2019 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Eryn Zak NAME: Lassiter-Ware Insurance of Tampa Bay PHONE,Extl: (800)845-8437 FAX XX,No): (888)883-8680 1300 N.Westshore Blvd E-MAIL E nZ Iassiter-ware.com ADDRESS: ry Suite 110 INSURER(S)AFFORDING COVERAGE NAIC# Tampa FL 33607 INSURER A: Amerisure Insurance Company 19488 INSURED INSURERS: North River Insurance Company 21105 Air Mechanical&Service Corp. INSURER C: Scottsdale Insurance Company 41297 4311 W.Ida St. INSURER D: • INSURER E: Tampa FL 33614-7665 INSURER F: COVERAGES CERTIFICATE NUMBER: 19-20 Master 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 SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDIYYYY) (MMIDD/YYYY) LIMITS XI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 300,000 X CONTRACTUAL LIABILITY MED EXP(Any one person) $ 10,000 A X XCU INCLUDED CPP20950420401 01/01/2019 01/01/2020 PERSONAL&ADVINJURY $ 1,000,000_ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X RO LOC 0000PRODUCTS-COMP/OPAGG $ 20 _OTHER: Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ - A OWNED SCHEDULED CA20950410402 01/01/2019 01/01/2020 BODILY INJURY(Per accident) $ AUTOS ONLY _AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) PIP-BASIC $ 10,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAB CLAIMS-MADE 5811111027 01/01/2019 01/01/2020 AGGREGATE $ 10,000,000 DED X RETENTION$ 0 $ WORKERS COMPENSATION X STA UTE OTH- ER AND EMPLOYERS'LIABILITY Y/N 1,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A WC21077280101 01/01/2019 01/01/2020 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED. (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ CLAIM LIMIT $2,000,000 CONTRACTOR'S POLLUTION C CONTRACTOR'S PROFESSIONAL VRS0003681 01/01/2019 01/01/2020 GENERAL AGGREGATE $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Re:Central Air Conditioning Maintenance and Repair,Middle Keys,Monroe County,FL. When required by written contract or agreement,Monroe County Board of County Commissioners,is included as an additional insured with regard to General Liability,Auto Liability,and Umbrella Liability. The attached certificate notes are a part of this certificate of insuranceAPP B GEMENT BY (�` WAIVER /A S �/"— "' YW CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 2798 Overseas Highway Suite 300 AUTHORIZED REPRESENTATIVE Marathon FL 33050 -i,c I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS Air Mechanical & Service Corp. Certificate Notes for Policy Term 1/1/19 to 1/1/2020 General Liability: 1. Blanket Additional Insureds when required by written contract including Ongoing Operations and Products & Completed Operations per Form CG7048 (10/15) . 2. Blanket Additional Insured Form #CG7048 (10/15) will convert to Form #CG2010 (11/85) when specifically required by written contract. 3. Blanket Waiver of Subrogation when required by written contract per Form CG7289 (04/17) . 4. Primary & Non-Contributory when required by written contract per Form CG7048 (10/15) . 5. General Aggregate Limit Applies Per Project per Form # CG7289 (04/17) . Automobile Liability: 1. Blanket Additional Insureds when required by written contract Per Form #CA7171 (05/08) . 2. Blanket Waiver of Subrogation when required by written contract Per Form #CA7171 (05/08) . 3. Automobile is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Workers' Compensation: 1. Blanket Waiver of Subrogation when required by. written contract, Form #WC000313. 2. Workers' Compensation provides coverage for the Workers' Compensation benefits of the State where the project is located. 3. Worker's Compensation is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Umbrella: 1. General Liability, Automobile and Employers Liability are listed in the underlying schedule on the Umbrella policy. 2. Follow form to the underlying, Additional Insured by written contract, Primary & Non-Contributory wording, and Waiver of Subrogation. General Information: 1. The General Liability, Automobile and Umbrella policies all contain a Severability of Interest Provision. 2. The General Liability policy contains no specific residential exclusions and is subject to ISO Form CG0001 (04/13) 3. The certificate notes shown above reference the following policies: CPP20950420401, CA20950410402, WC21077280101 and 5811111027 ALL COVERAGE IS SUBJECT TO THE POLICY TERMS, CONDITIONS AND EXCLUSIONS. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/20/2017 THIS CERTIFICATE IS I$SI.JED 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 INSVRER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certifies date hofdor is an ADDITIONAL SURED, the policy(ies) must be endorsed. If SUBROGATIQN IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confor rights to the certificate holder in Iiou of such ondorsoment(s). PRODUaER Lassiter -Ware Insurance of Jacksonville 1300 N Westshore Blvd Suite 110 Tampa FL 33607 CONTACT Eryn Zak PHONE (800)845-8437 � FAX (8080)BB3-0680 anDHess 1:rynZ@latgeit r cvare.com INSURER (S) AFFORDING COVERAGE NAIL 0 INSURERA Amerisure Insurance Company 19488 INSURED Aix' Mechanical & Service Corp. 2700 Ave of The Americas Englewood FL 34244 INSURERS Amerisure Partners Insurance 11050 INSURERC:The North River Insurance Co 21105 INSURERD:Scottsdale Insurance Cc 41297 INSURER E : 1 INSURERF: COVERAGES CERTIFICATE NUMBER:18/19 Master ' REVISION NUMBER: 1 h IS' 10'0 CERTIFY THAT THE POLICIES pF INSURANCE LISTED BELOW IiAVG BEEN ISSUED TO THE INSURED__ , - ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFI°ORDED 13Y 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 ApDl: INS14 $UBR' WVD _ POLICY NUMBER POLICV EFF M IDDIY POLICY EXP MMIDD/Y YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY ^J CLAIMS -MADE Dil OCCUR PP2095042 1/1/2018 1/1/2019 'b A0 r Ii9FITL-1) PRE MI ES (Ea occurrence) $ 300,000 MEDEXP_(Any one person) $ 10,000 PERSONAL & ADV INJURY $ 11000,000 X Contractural Liability X XCU Included GENERALAGGREGATE $ 2,000,000 GEN'LAGGREGATELIMIT APPLIES PER: PRODUCTS - COMIYOPAGG $ 2,.000,000 $ �T _.._ POLICY X PRO LOC AUTOMOBILE LIABILITY C MBI EU SINGL=LIMIT' E $ 1, 000, 000 X $ _ BODILY INJURY (Por person) $ B ..X ANY AUTO ALL OWNED SCHEDULED AUTOS S AUTOS HIRED AUTOS _ AUTOS CA2095041 1/1/2018 1/1/2019 BODILY INJURY (Par accident) $ PROPERTY DAMAGE' Peracc11 a tZ $G $ X $10,000 PIP X UMBREULALIAB N OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 3.0,000,000 L, EXCESSLIAB CLAIMS -MADE TJ2095043 1/1/2018 1/1/2019 DED I X I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE Of°FILER/MEMBER EXCLUDED? (Mandatory In Nil) N I A VC2095044 1/1/2018 1/1/2019 X WC ST'A'fU 077 PR E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYE $ 11000,000 If yes, describe under DESCRIPTION OF OPERATIONS below _ _ _ ^^ �1/1/2018 E.L. DISEASE - POLICY LIMIT S 3. 0_0 0 , 00 0 D Contractors Pollution RS0003102 1/1/2019 Claim Limit 1,000,000 Contractors Professional ClaimsAggrogato 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: Central A/C Maintenance & Repairs for'Middle Keys Facilities, Monroe,County, Florida. Monroe County Board of County Commissioners is named as Additional Insured with.respect to General Liability, Automobile Liability and Umbrella Liability when required by wri en contract. APPR /E B NAC7EM- BY DA -__ CERTIFICATE HOLDER CANCELLATION steryou-alice@monroecounty SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, -NOTICE WILL BE DELIVERED IN Monroe County Board of County Conkmissione ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street "AUTHORIZED REPRESENTATIVE Gato Bldg, Room 2-213 Key West FL 33040 G'. Lou Mariany/BETSYC ACORD 25 (2010/05) INS02819mmns) m ©1988-2010 ACORD CORPORATION. All rights reserved. Tho Ar:r1Ri1 name and Inn^ area ranicfararl marlra ^f Ar r)pn COMMENTS/REMARKS Air Mechanical & Service Corp.. Certificate Notes for Policy 'Perm 1/1/18 to 1/1/19 General Liability: 1. Blanket Additional Insureds when required by written contract including Ongoing Operations and Products & Completed Operations per Form C07048 (10/15). 2. Blanket Additional insured Form #CG7048 (10/15) will convert to Form #CG2010 (11/85) when specifically required by written contract. 3. Blanket Waiver of Subrogation when required by written contract per Form C07049 (11//09). 4. Primary & Non -Contributory when required by written contract per b'oz.m CG7048 (10/15). 5. General Aggregate Limit Applies Per Project per Form It C0,7049 (11/09). Automobile Liability: 1. Blanket Additional Insureds when required by written contract Per Form #CA7171 (05/08). 2. Blanket Waiver of Subrogation when required by written contract PerForm.)kCA7177.._--- (05/08) . 3. Automobile is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Workers' Compensation: 1. Blanket Waiver of Subrogation when required by written contract, Form #WC000313. 2. Workers' Compensation provides coverage for the Workers' Compensation benefits of the State where the project is located. 3. Worker's Compensation is a statutory coverage mandated by State Law. As such, coverage is'primary and non-contributory. Umbrella: 1. General Liability, Automobile and Employers Liability are listed in the underlying schedule on the Umbrella policy. 2. Follow form to the underlying, Additional Insured by written contract, Primary & Non -Contributory wording, and Waiver of Subrogation. General Information: 1. The General Liability, Automobile and Umbrella policies all contain a Severability of Interest. Provision. 2. The, General Liability policy contains no specific residential exclusions and is subject to ISO Form CG0001 (04/13) 3. The certificate notes shown above reference the following policies: CPP2095042, CA2095041, WC2095044 and 5811099003 ALL COVERAGE IS SUBJECT TO TIME POLICY TERMS, CONDITIONS AND EXCLUSIONS. I OFREMARK __ _ COPYRIGHT 20.00, AMS SERVICES INC. ' 7 ® DATE (MMIDD/YYYY) A� ° CERTIFICATE OF LIABILITY INSURANCE 12/21/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT Betsy Crawford PRODUCER NAME; Lassiter -Ware Insurance of Jacksonville IA PH IC. N o. Fxtl: (800) 845 - 8437 1 rc. No): (888)883 -8680 8659 Baypine Rd ao DR ware.com Suite 100 INSURER(S) AFFORDING COVERAGE _ NAIC 8 Jacksonville FL 32256 INsuRERAnerisure Insurance Company 19488 INSURED INSURERB:Amerisure Partners Insurance 11050 Air Mechanical & Service Corp. INSURERC: 2700 Ave of The Americas INSURERD: INSURER E : Englewood FL 34244 INSURERF: COVERAGES CERTIFICATE NUMBER:1 / Master 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. IL ADDL SUER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE NPR WNn POLICY NUMBER (MM /OD/YYYYI IMM(DD/YYYY) GENERALLIABIUTY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ A CLAIMS -MADE © OCCUR CPP2095042 1/1/2017 1/1/2018 MED EXP (Any one person) S 10,000 • X Contractural Liability PERSONAL 8, ADV INJURY $ 1,000,000 X XCU Included GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2 , 0 0 0 , 0 0 0 I X — 1 POLICY ' IFf fl LOC E T AUTOMOBILE LIABILITY (Ea COMBINED SINGLE LIMIT accident) $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ B ALL OWNED SCHEDULED CA2095041 1 /1/2017 1/1/2018 BODILY INJURY (Per accident) $ X AUTOS AUTOS PROPERTY DAMAGE X HIRED AUTOS x UTOS A ED (Per accident) $ — X $10,000 PIP UNisuredMotorists $ 20,000 X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESSUAB C LAIMS -MADE C U2095043 1/1/2017 1/1/2018 AGGREGATE ^ S 5,000,000 A 1 DED 1 X 1 RETENTION$ 10,000 $ WORKERS COMPENSATION X 1 1 Tt7RY I A U S I I T ER AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y/N E.L. EACH ACCIDENT $ 500,000 OFFICERIMEMBEREXCLUDED? n N / A WC2095044 12/31/201612/31 /2017 E.L. DISEASE - EA EMPLOYEES 500,000 A (Mandatory In NH) If ye ESC s, de R IPTION OF O sa ibe under PERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 D DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) RE: Central A/C Maintenance & Repairs for Middle Keys Facilities, Monroe County, Florida. Monroe County Board of County Commissioners is named as Additional Insured with respect to General Liability, Automobile Liability and Lhnbrella Liability when required by writ • en con �o . / e l/ tit/W4 APP 1eVEllt ` ' NA GENM ef• 1 w; (p � l i WAI . 1/A i-7- `� CERTIFICATE HOLDER CANCELLATION 4 � a/ — 4 - 1 , ( s t eryou al i ce@monroecounty SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissione 1100 Simonton Street , AUTHORIZED REPRESENTATIVE Gato Bldg, Room 2 -213 Key West , FL 33040 CC: Vi1"..rat Kirk Bramlett /BETSYC ACORD 25 (2010/05) @ 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005) 01 The ACORD name and logo are registered marks of ACORD COMMENTS /REMARKS Air Mechanical & Service Corp.. Certificate Notes for Policy Term 12/31/16- 12/31/17(WC) and 1/1/17 to 1/1/18 General Liability: 1. Blanket Additional Insureds when required by written contract including Ongoing Operations and Products & Completed Operations per Form CG7048 (10/15). 2. Blanket Additional Insured Form #CG7048 (10/15) will convert to Form #CG2010 (11/85) when specifically required by written contract. 3. Blanket Waiver of Subrogation when required by written contract per Form CG7049 (11//09). 4. Primary & Non - Contributory when required by written contract per Form CG7048 (10/15). 5. General Aggregate Limit Applies Per Project per Form # CG7049 (11/09). Automobile Liability: 1. Blanket Additional Insureds when required by written contract Per Form #CA7171 (05/08). 2. Blanket Waiver of Subrogation when required by written contract Per Form #CA7171 (05/08) . 3. Automobile is a statutory coverage mandated by State Law. As such, coverage is primary and non- contributory. Workers' Compensation: 1. Blanket Waiver of Subrogation when required by written contract, Form #WC000313. 2. Workers' Compensation provides coverage for the Workers' Compensation benefits of the State where the project is located. 3. Worker's Compensation is a statutory coverage mandated by State Law. As such, coverage is primary and non - contributory. Umbrella: 1. General Liability, Automobile and Employers Liability are listed in the underlying schedule on the Umbrella policy. 2. The Umbrella policy contains its own terms and conditions, however, the following endorsements have been added: a. Umbrella Policy per Project Aggregate per form CU7212 (08/07). b. Primary & Non Contributory when required by written contract per form CU7467 (08/10). 3. Transfer of Rights of Recovery if prior to loss. General Information: 1. The General Liability, Automobile and Umbrella policies all contain a Severability of Interest Provision. 2. The General Liability policy contains no specific residential exclusions and is subject to ISO Form CG0001 (04/13) 3. The certificate notes shown above reference the following policies: CPP2095042, CA2095041, WC2095044 and CU2095043 ALL COVERAGE IS SUBJECT TO THE POLICY TERMS, CONDITIONS AND EXCLUSIONS. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. ACOROa � CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 12/16/2015 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 Lassiter -Ware Insurance of Jacksonville 8375 Dix Ellis Trail Suite 105 Jacksonville FL 32256 CONTACT Bets Crawford NAME: y PHONE ($00) $45-8437 A/C No: (888)883-6680 EAI -ML .Betsyc@lassiter-ware.com INSURERS AFFORDING COVERAGE NAIC # INSURER AAmerisure Insurance Company 19488 INSURED Air Mechanical & Service Corp. 2700 Ave of The Americas Englewood FL 34244 INSURER BAmerlsure Partners Insurance 11050 INSURER C: INSURERD: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:16-17 Master 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 A I CLAIMS -MADE Fx-] OCCUR CPP2095042 1/1/2016 /1/2017 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 X Contractural Liability X XCU Included GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS A2095041 1/1/2016 /1/2017 X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ X NON -OWNED HIRED AUTOS AUTOS X UNisured Motorists $ 20,000 $10,000 PIP X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE CU2095043 /1/2016 /1/2017 DIED I X I RETENTION $ 10,000 $ WORKERS COMPENSATION OTH- X WC STATUTORY S AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500,000 A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/'4 C2095044 2/31/2015 2/31/2016 E.L. DISEASE - EA EMPLOYEd $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Central A/C Maintenance & Repairs for Middle Keys Facilities, Monroe County, Florida. Monroe County Board of County Commissioners is named as Additional Insured with respect to General Liability, Automobile Liability and Umbrella Liability when required by wri tenKNIAC6 C ppRp EMEM,,.W � WAIVER N/A YES _ GC 41r -Q CERTIFICATE HOLDER ii" :i 'h.1NI10j 30JNDW ANCEL TION i C_­' 14-1.1 steryou-alice@monroecounty SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of 8ao1Vtrit�Coaull"R1F* TIZ l i1 i Ill 77!lUUI. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Gato Bldg, Room 2-213 y Key West , FL 33040 tJd1}.J�� ��,� j� 031 Kirk Bramlett/BETSYC= ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS Air Mechanical & Service Corp.. Certificate Notes for Policy Term 12/31/15-12/31/16(WC) and 1/1/16 to 1/1/17 General Liability: 1. Blanket Additional Insureds when required by written contract including Ongoing Operations and Products & Completed Operations per Form CG7048 (09/13). 2. Blanket Additional Insured Form #CG7048 (09/13) will convert to Form #CG2010 (11/85) when specifically required by written contract. 3. Blanket Waiver of Subrogation when required by written contract per Form CG7049 (11//09). 4. Primary & Non -Contributory when required by written contract per Form CG7048 (09/13). 5. General Aggregate Limit Applies Per Project per Form # CG7049 (11/09). Automobile Liability: 1. Blanket Additional Insureds when required by written contract Per Form #CA7171 (05/08). 2. Blanket Waiver of Subrogation when required by written contract Per Form 4CA7171 (05/08). 3. Automobile is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Workers' Compensation: 1. Blanket Waiver of Subrogation when required by written contract, Form #WC000313. 2. Workers' Compensation provides coverage for the Workers' Compensation benefits of the State where the project is located. 3. Worker's Compensation is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Umbrella: 1. General Liability, Automobile and Employers Liability are listed in the underlying schedule on the Umbrella policy. 2. The Umbrella policy contains its own terms and conditions, however, the following endorsements have been added: a. Umbrella Policy per Project Aggregate per form CU7212 (08/07). b. Primary & Non Contributory when required by written contract per form CU7467 (08/10). 3. Transfer of Rights of Recovery if prior to loss. General Information: 1. The General Liability, Automobile and Umbrella policies all contain a Severability of Interest Provision. 2. The General Liability policy contains no specific residential exclusions and is subject to ISO Form C00001 (04/13) 3. The certificate notes shown above reference the following policies: CPP2095042, CA2095041, WC2095044 and CU2095043 ALL COVERAGE IS SUBJECT TO THE POLICY TERMS, CONDITIONS AND EXCLUSIONS. ',QNF10:i 304tNGW ' 1 '8I3 'Win 81 :C Nd I I NVP 9101 ""C'J38 80J 031113 I OFREMARK COPYRIGHT 2000, AMS SERVICES INC. I 7 A` "RV CERTIFICATE OF LIABILITY INSURANCE 12/16/2o5' 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 Lassiter -Ware Insurance of Jacksonville 8375 Dix Ellis Trail 105 Jacksonville FL 32256 CONTACT Bets Crawford NAME: y PHONE (800) 845-8437 FAX AAC No: (888)883-8680 E-MAIL ,Betsyc@lassiter-ware.com ADDRESSuite INSURERS AFFORDING COVERAGE NAIC # INSURER AAmerisure Insurance Company 19488 INSURED Air Mechanical 6 Service Corp. 2700 Ave of The Americas Englewood FL 34244 INSURER B:Amerisure Partners Insurance 11050 INSURERC: INSURERD: INSURER E : INSURER F : rrnvGveccc rFRTIFIrATG NIIMRFR•16-17 Master RFVIRION Nt1MRFRr 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 POLICYEFF IYYYY POLICY /YYW LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMA E TO RENTED PREMISES Ea or $ 300,000 MED EXP (Any one person) $ 10,000 A 7 CLAIMS -MADE a OCCUR CPP2095042 /1/2016 /1/2017 PERSONAL BADVINJURY $ 1,000,000 X Contractural Liability X XCU Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 11000,000 BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON-OHIRED AUTOS X AUTOSWNED 1XX A2095041 1/1/2016 /1/2017 BODILYINJURY(Peraccident) $ PeerPERTY acidentDAMAGE $ I UNisured Motorists $ 20,000 $10,000 PIP I X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 IN AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE CU2095043 /1/2016 /1/2017 DIED I X I RETENTION $ 10,000 $ WORKERS COMPENSATION X I WC STATU- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L. EACH ACCIDENT $ 500,000 A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA C2095044 2/31/2015 2/31/2016 E.L. DISEASE- EA EMPLOYEE $ 500,000 E.L. DISEASE -POLICY LIMIT $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Central A/C Maintenance s Repairs for Middle Keys Facilities, Monroe County, Florida. Monroe County Board of County Commissioners is named as Additional Insured with respect to General Liability, Automobile Liability and Umbrella Liability when required by wri ten ct. ppRp NAGEMENV-f/-G L " WAIVER N/AYES_ GC.^Ft�it CEKIIFICAIE HULUEK i 13 A nIIUJ _1UtlNt1W GANGtLLAIIUry 44L VC -­/-^-- steryou-alice@inonroecounty Monroe County Board of8 ioTG t11dCo1 1 1i1r 71U(. 1100 Simonton Street l7!U(. Gato Bldg, Room 2-213 Key West , FL 33040 iid1L �t� ��� a3�i� 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 Bramlett/BETSYC —}—�___Q I ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS Air Mechanical & Service Corp.. Certificate Notes for Policy Term 12/31/15-12/31/16(WC) and 1/l/16 to 1/1/17 General Liability: 1. Blanket Additional Insureds when required by written contract including Ongoing Operations and Products & Completed Operations per Form CG7048 (09/13). 2. Blanket Additional Insured Form #CG7048 (09/13) will convert to Form #CG2010 (11/85) when specifically required by written contract. 3. Blanket Waiver of Subrogation when required by written contract per Form CG7049 (11//09). 4. Primary & Non -Contributory when required by written contract per Form CG7048 (09/13). 5. General Aggregate Limit Applies Per Project per Form # CG7049 (11/09). Automobile Liability: 1. Blanket Additional Insureds when required by written contract Per Form #CA7171 (05/08). 2. Blanket Waiver of Subrogation when required by written contract Per Form 4CA7171 (05/08). 3. Automobile is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Workers' Compensation: 1. Blanket Waiver of Subrogation when required by written contract, Form #WC000313. 2. Workers' Compensation provides coverage for the Workers' Compensation benefits of the State where the project is located. 3. Worker's Compensation is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Umbrella: 1. General Liability, Automobile and Employers Liability are listed in the underlying schedule on the Umbrella policy. 2. The Umbrella policy contains its own terms and conditions, however, the following endorsements have been added: a. Umbrella Policy per Project Aggregate per form CU7212 (08/07). b. Primary & Non Contributory when required by written contract per form CU7467 (08/10). 3. Transfer of Rights of Recovery if prior to loss. General Information: 1. The General Liability, Automobile and Umbrella policies all contain a Severability of Interest Provision. 2. The General Liability policy contains no specific residential exclusions and is subject to ISO Form C00001 (04/13) 3. The certificate notes shown above reference the following policies: CPP2095042, CA2095041, WC2095044 and CU2095043 ALL COVERAGE IS SUBJECT TO THE POLICY TERMS, CONDITIONS AND EXCLUSIONS. VIA AIN110j 304NOW ' 1 '813 'kiln NVr 9iot 80.E 03111zi OFREMARK COPYRIGHT 2000, AMS SERVICES INC. E! 7 '4CC)R a CERTIFICATE OF LIABILITY INSURANCE 12ii6i2I 5) 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 Lassiter -Ware Insurance of Jacksonville 8375 Dix Ellis Trail Suite 105 Jacksonville FL 32256 CONTACT Bets Crawford NAME: y PHONE AIC.. (800)845-8437 FAX No: (888)883-8680 E-MAIL .Betsyc@lassiter-ware.com INSURERS AFFORDING COVERAGE NAIC # INSURER AAmerisure Insurance Company 19488 INSURED Air Mechanical & Service Corp. 2700 Ave of The Americas Englewood FL 34244 INSURER B: merisure Partners Insurance 11050 INSURERC: INSURERD: INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:16-17 Master 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 ADDL UBR POLICY NUMBER POLICY EFF MM DDIYYYY POLICY EXP MM DD/YYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X CPP2095042 /1/2016 /1/2017 TED PREMISES Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 X Contractural Liability X XCU Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2 , OOO , OOO POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X A2095041 /1/2016 /1/2017 X gODILYINJURY(Peraccident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS E AUTOS X UNisured Motorists $ 20,000 $10,000 PIP X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE CU2095043 /1/2016 /1/2017 DED X RETENTION $ 10,000 $ A WORKERS COMPENSATION EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH)El N/A C2095044 2/31/2015 2/31/2016 X WC STATU- OE TORY LIMITS E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below I I I E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: RFP-30-0-2015 MW, Medical Examiner's Office Chiller Replacement, Crawl Rey, FL 1'Ex� �D EMENPAV'� C g WAIV A ES l ZI Z4 112 L9111 I = I:QU411R - i.r.01"Q0A_11IIs] 0 Monroe County Boa d of IFWntli' dkmft i one 1100 Simonton Str t �! Gato Bldg, Room 2t` 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 Bramlett/BETSYC ACORD 25 (2010/05) INS025 (201005).01 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS Air Mechanical & Service Corp.. Certificate Notes for Policy Term 12/31/15-12/31/16(WC) and 1/1/16 to 1/l/17 General Liability: 1. Blanket Additional Insureds when required by written contract including Ongoing Operations and Products & Completed Operations per Form CG7048 (09/13). 2. Blanket Additional Insured Form #CG7048 (09/13) will convert to Form #CG2010 (11/85) when specifically required by written contract. 3. Blanket Waiver of Subrogation when required by written contract per Form CG7049 (11//09). 4. Primary & Non -Contributory when required by written contract per Form CG7048 (09/13). 5. General Aggregate Limit Applies Per Project per Form # CG7049 (11/09). Automobile Liability: 1. Blanket Additional Insureds when required by written contract Per Form #CA7171 (05/08) 2. Blanket Waiver of Subrogation when required by written contract Per Form #CA7171 (05/08). 3. Automobile is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Workers' Compensation: 1. Blanket Waiver of Subrogation when required by written contract, Form #WC000313. 2. Workers' Compensation provides coverage for the Workers' Compensation benefits of the State where the project is located. 3. Worker's Compensation is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Umbrella: 1. General Liability, Automobile and Employers Liability are listed in the underlying schedule on the Umbrella policy. 2. The Umbrella policy contains its own terms and conditions, however, the following endorsements have been added: a. Umbrella Policy per Project Aggregate per form CU7212 (08/07). b. Primary & Non Contributory when required by written contract per form CU7467 (08/10). 3. Transfer of Rights of Recovery if prior to loss. General Information: 1. The General Liability, Automobile and Umbrella policies all contain a Severability of Interest Provision. 2. The General Liability policy contains no specific residential exclusions and is subject to ISO Form CG0001 (04/13) 3. The certificate notes shown above reference the following policies: CPP2095042, CA2095041, WC2095044 and CU2095043 ALL COVERAGE IS SUBJECT TO THE POLICY TERMS, CONDITIONS AND EXCLUSIONS. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. 0 AC'ORO � CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY ) 11/19/2015 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 Lassiter -Ware Insurance of Jacksonville 8375 Dix Ellis Trail Suite 105 Jacksonville FL 32256 CONTACT Barbara Benton NAME: PHONE AIC.No (800) 845-8437 1AIC No: (888)883-8680 EA-DAIL .BarbaraB@lassiter-ware.com INSURERS AFFORDING COVERAGE NAIC # INSURER AAmerisure Insurance Company 9488 INSURED Air Mechanical & Service Corp. 2700 Ave of The Americas Englewood FL 34244 INSURER B Amerisure Partners Insurance 11050 INSURER C : INSURERD: INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER:15-16 Master 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 I L UBR POLICY NUMBER MMIDDPICY/YYYY Y EXP MMIDD NYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE To RETED PREMISES Ea occurrence $ 300,000 A CLAIMS -MADE F_XI OCCUR CPP2095042 /1/2015 /1/2016 MED EXP (Any one person) $ 10,000 PERSONAL BADVINJURY $ 1,000,000 X Contractural Liability X XCU Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED X AUTOS AUTOS NON-OWNED X HIRED AUTOS rAUTOS CA2095041 /1/2015 /1/2016 BODILY INJURY (Per accident) $ POP ci TY DAMAGE $ UNisured Motorists $ 20,000 X $10,000 PIP X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE U2095043 /1/2015 /1/2016 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N E.L. EACH ACCIDENT $ 500,000 A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A C2095044 1/1/2015 /1/2016 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Central A/C Maintenance & Repairs for Middle Keys Facilities, Monroe County, Florida. Monroe County Board of County Commissioners is named as Additional Insured with respect to General Liability, Automobile Liability and Umbrella Liability when required by written contract. NAGEMENT DA Y i GERTIFIGAII- KULUEK V 1 _i A tl'i11U J Juu"+ - k ANLtLLAI IUN Tom' — _y'{ f LAC-- T_­ Monroe Count }�Bq fUtMi Smmissione 1100 Simontor4��Stffe2Y Gato Bldg, Room 2-213 -t Key West , FIj jApDjm' 8 0 A 03 113 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 Snow/RARRAR ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS02.5 rgmnnsi ni Tho Ar:n l name and Innn mm ronicfororl m—lea of Af npn DATE(MM/DD/YYYY) A ® CERTIFICATE OF LIABILITY INSURANCE 1 12/16/2015 116.1 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). CONTACT PRODUCER NAME: Betsy Crawford PHONE ($OO) $45-$437 A/C No: Lassiter -Ware Insurance of Jacksonville FAX (888)883-8680 E-MAIL gets c@lassiter-ware.com 8375 Dix E111S Trail ADDRESS: y INSURERS AFFORDING COVERAGE NAIC # Suite 105 Jacksonville FL 32256 INsuRERAAmerisure Insurance Com an 19488 INSURED INSURERB�nerisure Partners Insurance 11050 Air Mechanical & Service Corp. INSURERC: 2700 Ave of The Americas INSURERD: Englewood FL 34244 INSURERF: Master BELOW HAVE BEEN ISSUED TO THE INSURED REVISION NUMBER: NAMED ABOVE FOR THE POLICY PERIOD COVERAGES CERTIFICATENUMBER:16-17 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED ANY CONTRACT OR OTHER DOCUMENT WITH PESPECT TO WHICH THIS INDICATED NOTWITHSTANDING ANY REOU!RE^.SENT, TERM OR CONDITION OF DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED LIMITS SHOWN MAY HAVE BEEN BY THE POLICIES REDUCED BY PAID CLAIMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. POLICY EFF POLICY EXP LIMITS INSR TYPE OF INSURANCE B LICY NUMBER MM/DD/YYYY MM/DD/YYYY 1,0001000 LTR EACH OCCURRENCE $ GENERAL LIABILITY DAMA ET RENTED PREMISES (Ea occurrence $ 300,000 rPP2O9504 MED EXP (Any one person) $ 10,000 X COMMERCIAL GENERAL LIABILITY 1/1/2016 1/1/2017 A CLAIMS -MADE ❑X OCCUR 2 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 X Contractural Liability X XCU Included PRODUCTS-COMP/OPAGG $ 2,0001000 GENT AGGREGATE LIMIT APPLIES PER'. $ POLICY X PRO LOC COMBINED SINGLE LIMIT Ea accident 1,000,000 AUTOMOBILE LIABILITY BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED A2095041 1/1/2016 1/1/2017 gODILYINJURY(Peraccident) $ PROPERTY DAMAGE Per accident $ X AUTOS AUTOS X NON -OWNED X UNisured Motorists $ 20 000 HIRED AUTOS AUTOS X $10,000 PIP 1/1/2016 1/1/2017 EACH OCCURRENCE $ 5, 000,000 X UMBRELLA LIAB X OCCUR AGGREGATE $ 5,000,000 A EXCESS CLAIMS -MADE U2095043 DED X RETENTION $ 10, 00 X I WC STATU- OTH- WORKERS COMPENSATION "Ry LIMITS E.L. EACH ACCIDENT $ 500,000 AND EMPLOYERS' LIABILITY Y / N E.L. DISEASE - EA EMPLOYE $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDE[ N/A C2095044 1/1/2015 1/l/2016 EL DISEASE - POLICY LIMIT $ 500,00 0 A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below ' E T' U l�`fi� F�F°h E ,1 L c Y `MAI N A Y DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks for Middle Keys Schedule, if more space is required) Facilities, Monroe County, Florida. RE: Central A/C Maintenance & Repairs Board of County Commissioners is named as Additional Insured with respect to General Monroe County Liability and Umbrella Liability when required by written contract. Liability, Automobile 1.1 ,11 J 30 CELLATION CERTIFICATE HOLDER T) steryou-alice@monroecounty SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE IN THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED j} iiiam�s�i�e'� ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of Coun'C 1100 Simonton Street AUTHORIZED REPRESENTATIVE Gato Bldg, Room 2-213 , ,; rc;���� • Key West , FL 33040 f-1 Kirk Bramlett/BETSYC ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) n�mn l Innn ern rnnicfnrc,l mnr4c of el^nRn Th. eCnArl �nr INSn95romnnslni COMMENTS/REMARKS Air Mechanical & Service Corp.. Certificate Notes for Policy Term 12/31/15-12/31/16(WC) and 1/1/16 to 1/1/17 General Liability: 1. Blanket Additional Insureds when required by written contract including Ongoing Operations and Products & Completed Operations per Form CG7048 (09/13). 2. Blanket Additional Insured Form #CG7048 (09/13) will convert to Form #CG2010 (11/85) when specifically required by written contract. 3. Blanket Waiver of Subrogation when required by written contract per Form CG7049 (11//09). 4. Primary & Non -Contributory when required by written contract per Form CG7048 (09/13). 5. General Aggregate Limit Applies Per Project per Form # CG7049 (11/09). Automobile Liability: 1. Blanket Additional Insureds when required by written contract Per Form #CA7171 (05/08). 2. Blanket Waiver of Subrogation when required by written contract Per Form #CA7171 (05/08) . 3. Automobile is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Workers' Compensation: 1. Blanket Waiver of Subrogation when required by written contract, Form #WC000313. 2. Workers' Compensation provides coverage for the Workers' Compensation benefits of the State where the project is located. 3. Worker's Compensation is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Umbrella: 1. General Liability, Automobile and Employers Liability are listed in the underlying schedule on the Umbrella policy. 2. The Umbrella policy contains its own terms and conditions, however, the following endorsements have been added: a. Umbrella Policy per Project Aggregate per form CU7212 (08/07) b. Primary & Non Contributory when required by written contract per form CU7467 (08/10) 3. Transfer of Rights of Recovery if prior to loss. General Information: 1. The General Liability, Automobile and Umbrella policies all contain a Severability of Interest Provision. 2. The General Liability policy contains no specific residential exclusions and is subject to ISO Form CG0001 (04/13) 3. The certificate notes shown above reference the following policies: CPP2095042, CA2095041, WC2095044 and CU2095043 ALL COVERAGE IS SUBJECT TO THE POLICY TERMS, CONDITIONS AND EXCLUSIONS. COPYRIGHT 2000, AMS SERVICES INC. OFREMARK r L P AC4ORbr CERTIFICATE OF LIABILITY INSURANCEF11/19/2015DATE(MMIDD15L../ 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 Lassiter -Ware Insurance of Jacksonville 8375 Dix Ellis Trail Suite 105 Jacksonville FL 32256 CONTACT Barbara Benton NAME: WC0NE . (800) 845-8437 FAX A/C Noceeelee3-e6eo EMAIL .BarbaraB@lassiter-ware.com INSURERS AFFORDING COVERAGE NAIC # INSURER AAmerisure Insurance Company 9488 INSURED Air Mechanical & Service Corp. 2700 Ave of The Americas Englewood FL 34244 INSURER B Amerlsure Partners Insurance 11050 INSURERC: INSURERD: INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:15-16 Master 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. ILTR TYPE OF INSURANCE POLICY NUMBER POLICY MI II DYinm POLICY M/LDI D/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY I CLAIMS -MADE a OCCUR CPP2095042 /1/2015 /1/2016 PREMISES Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 X Contractural Liability X XCU Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 095041 /1/2015 /1/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS H AUTOS UNisured Motorists $ 20,000 X $10,000 PIP X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE u2095043 /1/2015 /1/2016 DIED I X I RETENTION$ 10,00 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) NIA C2095044 /1/2015 /1/2016 X WC STATU- OTH- E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) RE: Central A/C Maintenance & Repairs for Middle Keys Facilities, Monroe County, Florida. Monroe County Board of County Commissioners is named as Additional Insured with respect to General Liability, Automobile Liability and Umbrella Liability when required by written contract. 8 P ANAGEME DA11 0 Y �' lei3illl�lsfG1��:Nl�a�a:�yi7;t�l►1 • Ff_10IyaAAt\1[olo - W1174roczW/.iA Monroe Count Sq �1�Sdammissione 1100 Simonto�= q ee" Gato Bldg, Room 2-213 r� Key West , FIGMiim' 80J 031N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CAN ELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE c Rebecca Snow/BARBAB AGORD 25 (2010/05) INS025 nnlnns m ©1988-2010 ACORD CORPORATION. All rights reserved. Tho Or npn name anrf Inn^ are ranieferarl merlre of Orr1Rr1 ACOO 0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYW) �� 12/16/2015 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 PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 16,PRTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to ITM 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 Bets Crawford NAME: y Lassiter -Ware Insurance of Jacksonville PHONE (800) 845-8437 FOX (888)883-8680 8375 Dix Ellis Trail -MAIL DDRESS,Betsyc@lassiter-ware.com Suite 105 INSURERS AFFORDING COVERAGE NAIC # Jacksonville FL 32256 INSURER AAmerisure Insurance Company 19488 INSURED INSURER BAmerisure Partners Insurance 11050 Air Mechanical & Service Corp. INSURERC: 2700 Ave of The Americas INSURERD: J Englewood FL 34244 I INSURERF: I I rnvooer_Cc 9%F0TIFIf`ATFIJIIMRR0•16-17 Master RFVISIANNt1MRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER MM/DDY/YYYY EFF MM/DDY� LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO REN D PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 A I CLAIMS -JADE F_x1 OCCUR CPP2095042 1/1/2016 1/1/2017 PERSONAL BADVINJURY $ 1,000,000 X Contractural Liability X XCU Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ PRO LOC POLICY X JFQT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ ANY AUTO BODILYINJURY(Peraccident) $ ALL OWNED SCHEDULED AUTOSAUTOSPROPERTYDAMAGE NUTOS ED HIRED AUTOS X AUTOS 7xx A2095041 1/1/2016 1/1/2017 Peraccdent $ UNisured Motorists $ 20,000 $10,000Pip X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 51000,000 A EXCESS LIAB CLAIMS -MADE CU2095043 1/1/2016 1/1/2017 DED I X I RETENTION $ 10,00 $ WORKERS COMPENSATION TH- X I WC STATU- OER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L. EACH ACCIDENT $ 500,000 A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A C2095044 1/1/2015 1/1/2016 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below / E E lW tPYPR c WAI N A DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Central A/C Maintenance & Repairs for Middle Keys Facilities, Monroe County, Florida. Monroe County Board of County Commissioners is named as Additional Insured with respect to General Liability, Automobile Liability and Umbrella Liability when required by written contract. T101^AT0 U^1 MCO - '• 14II1JJ-117:I1I1ti YCF1 1 ATIr7N steryou-alice@monroecounty SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board Of } COI1nL� lYtlJ",UMIL' � ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Gato Bldg, Room 2 - 213 ;-; i.� J ai 8()J 03111.4 Key West , FL 33040 _ Kirk Bramlett/BETSYC ACORD 25 (2010/05) v iyaa-�u Iu hwr�u �.vr<rvRr+l Iv1•. r+u nynw rcaclvay. INS025nn+nnsini Tho Annon noma onrl Innn ora ronieforarl mnrlre of Ar`r1Rr1 COMMENTS/REMARKS Air Mechanical & Service Corp.. ertificate Notes for Policy Term 12/31/15-12/31/16(WC) and 1/1/16 to 1/1/17 General Liability: 1. Blanket Additional Insureds when required by written contract including Ongoing Operations and Products & Completed Operations per Form CG7048 (09/13). 2. Blanket Additional Insured Form #CG7048 (09/13) will convert to Form #CG2010 (11/85) when specifically required by written contract. 3. Blanket Waiver of Subrogation when required by written contract per Form CG7049 (11//09). 4. Primary & Non -Contributory when required by written contract per Form CG7048 (09/13). 5. General Aggregate Limit Applies Per Project per Form # CG7049 (11/09). Automobile Liability: 1. Blanket Additional Insureds when required by written contract Per Form #CA7171 (05/08). 2. Blanket Waiver of Subrogation when required by written contract Per Form #CA7171 (05/08). 3. Automobile is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Workers' Compensation: 1. Blanket Waiver of Subrogation when required by written contract, Form #WC000313. 2. Workers' Compensation provides coverage for the Workers' Compensation benefits of the State where the project is located. 3. Worker's Compensation is a statutory coverage mandated by State Law. As such, coverage is primary and non-contributory. Umbrella: 1. General Liability, Automobile and Employers Liability are listed in the underlying schedule on the Umbrella policy. 2. The Umbrella policy contains its own terms and conditions, however, the following endorsements have been added: a. Umbrella Policy per Project Aggregate per form CU7212 (08/07). b. Primary & Non Contributory when required by written contract per form CU7467 (08/10). Transfer of Rights of Recovery if prior to loss. 19eneral Information: 1. The General Liability, Automobile and Umbrella policies all contain a Severability of Interest Provision. 2. The General Liability policy contains no specific residential exclusions and is subject to ISO Form CG0001 (04/13) 3. The certificate notes shown above reference the following policies: CPP2095042, CA2095041, WC2095044 and CU2095043 ALL COVERAGE IS SUBJECT TO THE POLICY TERMS, CONDITIONS AND EXCLUSIONS. I OFREMARK COPYRIGHT 2000, AMS SERVICES INC. '