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COI Expires 10/01/2017COASGU N-02 11 . • rzvreyk ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) a/6/2o17 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 Towne Insurance Agency LLC 301 Bendix Road Suite 300 Virginia Beach, VA 23452 CONTACT Mary A. Norton NAME: PHONE FAX (A/C, No, Ext): 8619 (A/C, No):(757) 468-9917 A DRESS: mnorton@towneinsurance.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: XL Specialty Insurance Company 37885 INSURED INSURER B : Harleysville Insurance Company 23582 Coastal Gunite Const. Co. ATTN: Shelly Blake P.O. Box 977 INSURER C: Arch Insurance Company 11150 INSURER D: Signal Mutual Indemnity Assn. Ltd. INSURER E : Cambridge, MD 21613-0788 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 TYPE OF INSURANCE ADDL SUBR WVD POLICY NUMBER (POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR UM00028978MA17A 04/16/2017 04/16/2018 EACH OCCURRENCE $ 1,000,000 FREMGE TO RIES (E.ENTED n $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [X] jre7 LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 $ OTHER: B AUTOMOBILE LIABILITY EO MBIc aED SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ X ANY AUTO BA00000098123S 04/16/2017 04/16/2018 BODILY BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS Peoaaiden DAMAGE $ ED AUTOS ONLY AUOTOS ONLY $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS -MADE UM00025117MA17A 04/16/2017 04/16/2018 AGGREGATE $ 5,000,000 DED X RETENTION $ 25,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YE WFIER/MEMggER EXCLUDE (MandD? atory in NH) N / A ZAWC19922800 10/01/2016 10/01/2017 X STATUTE ERH E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 D Work Comp 21500 10/01/2016 10/01/2017 USL&H 1,000,000 D MEL J16-60215 10/01/2016 10/01/2017 Jones Act 10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Card Sound Bridge Repair Project, Key Largo, Monroe County, FL Monroe County Board of County Commissioners, its employees and officials and Florida Department of Transportation a include a additional insured if required by written contract in accordance with endorsement MMGL621 attached. 30 day NOC attached. PP V IS M ACE;nnFN_r .— WAIVE N/A ES CERTIFICATE HOLDER CANCELLATION t 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 Monroe County Board of County Commissioners 1100 Simonton Street Key West. FIL 33040 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ENDORSEMENT This endorsement, effective 12:01 a.m., April 16, 2015 forms a part of Policy No. UM00025117MA15A issued to Coastal Gunite Construction Company by XL Specialty Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION This endorsement modifies insurance provided under the following: Bumbershoot Coverage Form It is understood and agreed that Condition (F) Cancellation of the policy form is deleted and replaced by the following: F. Cancellation Either the Company or the Named Insured may cancel this insurance by giving the other Thirty (30) days written notice, (Ten 10 days for non-payment of premium), after which this Policy shall be of no force or effect. Written or telegraphic notice sent to the Named Insured at its last known address shall constitute complete notice of cancellation. Such notice sent to the Named Insured in care of the broker or agent who negotiated this Policy shall have the same effect as if sent directly to the Named Insured. If cancellation is at the Named Insured's option, the Company will retain earned premium hereunder as per customary short rate table; if cancellation is at the Company's option, pro-rata. Unearned premium will be returned as soon as practicable, in either case. Subject always to minimum premiums agreed upon, if any. In the event of an underlying war risks or terrorism insurance being canceled such cancellation shall simultaneously cancel any applicable excess coverage insured herein. All other terms, conditions, limitations and exclusions remain unchanged. XL-30-30b 0602 © 2012 X.L. America, Inc. All Rights Reserved. Page 1 of 1 May not be copied without permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY EARLIER NOTICE OF CANCELLATION PROVIDED BY US ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attached clause" is to be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/01/16 (Date) at 12:01 A.M. standard time, forms a part of Policy No. ZAWCI9922800 of the Issued to COASTAL GUNITE CONSTRUCTION (Named Insured) Insurance Company Authorized Representative For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule below. All the terms and conditions of the Policy which are not inconsistent with this endorsement continue to apply. Number of Days' Notice: 60 00 WC004 00 1103 SCHEDULE Page I of 1 INSURm COPY ENDORSEMENT This endorsement, effective 12:01 a.m., April 16, 2017 forms a part of Policy No. UM00028978MA17A issued to Coastal Gunite Construction Co. by XL Specialty Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED, LOSS PAYEE and WAIVER OF SUBROGATION CLAUSES (BLANKET) This endorsement modifies insurance provided under the following: Marine General Liability: General Conditions, 1. Persons Insured It is hereby understood and agreed that this Policy shall include as Additional Insured or Loss Payee, any person or organization to whom the Named Insured has agreed by written contract to provide coverage, but only with respect to operations performed by or on behalf of the Named Insured or to your premises or the premises that you use, and only with respect to occurrences subsequent to the making of such written contract. When required by such written contract, this policy is primary insurance with respect to the interests of the Additional Insured, and the other insurance maintained by the Additional Insured is excess and not contributory with this policy. Notwithstanding the above, it is further understood and agreed that wherever Additional Insured or Loss Payee are added to this policy it is specifically agreed: Such Additional Insured or Loss Payee are included only with respect to such activities insured by this policy as would exist in the absence of the naming of Additional Insured or Loss Payee and coverage hereunder shall in no way be considered extended by the inclusion of Additional Insured or Loss Payee. The inclusion of Additional Insured or Loss Payee in no way increases the Limit of Liability hereunder. C. In the event of cancellation or change in policy coverage unless specifically endorsed in writing to the contrary hereon, no obligation is imposed on this company to send notice of cancellation or change of coverage to an Additional Insured or Loss Payee and notice to the original named assured shall discharge all obligations of this company hereunder. This company shall not be required to notify Additional Insured or Loss Payee of any cancellation received from the original assured hereon. Underwriters waive their rights of subrogation against any person or organizations to whom the Named Insured is obligated by written contract to provide such waiver, but only to the extent of such obligation and only with respect to operations performed by or on behalf of the Named Insured or to your premises or the premises that you use. All other terms and conditions remain the same. MMGL 621 0213 © 2013, XL America, Inc. All Rights Reserved. Page 1 of 1 May not be copied without permission. ENDORSEMENT This endorsement, effective 12:01 a.m., April 16, 2017 forms a part of Policy No. UM00028978MAl7A issued to Coastal Gunite Construction Co. by XL Specialty Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CERTIFICATE HOLDER ENDORSEMENT This endorsement modifies insurance provided under the following: All Coverage Forms Provided By This Policy We will adjust "loss" to Covered Property with you, if caused by or resulting from a Covered Cause of Loss. We will pay any claims for "loss" jointly to you and any Certificate Holder as their interests may appear. This applies to all Covered Property for which a Certificate Holder is on file with us or your insurance broker or agent. If we cancel this policy, we will notify the Certificate Holder at least ten days before the effective date of cancellation if we cancel for nonpayment of premium, or 30 days before the effective date of cancellation if we cancel for any other reason. All other terms and conditions remain the same. IXI 403 01 10 © 2010 X.L. America, Inc. All Rights Reserved. May not be copied without permission.