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Item C10BOARD OF COUNTY COMIVIISSIONERS AGENDA ITEM SUMMARY Meeting Date: January 19 2011 Division: Emer e�ncy Services Bulk Item: Yes X No Department: Fire Rescue Staff Contact Person/Phone #: Darice 16004 AGENDA ITEM WORDING: Approval of a Renewal Agreement by and between the Board of County Commissioners of Monroe County, Florida and Emergency Medical Sciences Academy, Inc. (EMS Academy) to provide an emergency medical services (EMS) training environment. ITEM BACKGROUND: In September of 2006 the Board of County Commissioners approved an Affiliation Agreement with EMS Academy which would provide a resource for a comprehensive learning experience for the EMS Academy students, within a clinical field setting, for completion of the students' program criteria (EMT -Basic and Paramedic). The Affiliation Agreement included an option to extend the Agreement for an additional one (1) year period on a yearly basis. Fire Rescue is requesting approval to exercise this option. PREVIOUS RELEVANT BOCC ACTION: On September 20, 2006 the Board approved the Affiliation Agreement with EMS Academy for the provision of an EMS training environment for the period September 20, 2006 through December 31, 2007. On December 19, 2007, January 28, 2009, and December 16, 2009 the Board approved Renewal Agreements for the years 2008, 2009, and 2010. CONTRACT/AGREEMENT CHANGES: The Renewal Agreement will be for the period January 15 2011 through December 31, 2011. All other terms of the original Affiliation Agreement of September 20, 2006 remain in full force and effect. STAFF RECOMMENDATIONS: Staff recommends approval of the Renewal Agreement between EMS Academy and the Monroe County Board of County Commissioners so that Academy students can have the training environment they require to complete EMS courses. These EMS courses are also available for locals who are interested in pursuing further courses in the Emergency Medical Services field. 40 TOTAL COST:N/A INDIRECT COST: BUDGETED: Yes No DIFFERENTIAL OF LOCAL PREFERENCE: NIA COST TO COUNTY:N/A SOURCE OF FUNDS: REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year APPROVED BY: County AttY�� OMB/Purchasing Management -� g Risk DOCUMENTATION: Included X Not Required DISPOSITION: Revised 7/09 AGENDA ITEM # MONROE COUNTY BOARD CP COUNTY COMMISSIONERS CONTRACT SLUANLkRY Contract wiffi,Emergency Medical Sciences Contract Academy, Inc. MS Academy) Date: January 1, 2011 Expiration Date; December 31, 2011 Contract Purpose/Description: '>;''o provide an EMS training environment for students of EMS Academy withina clinical field suing with Monroe.County Fire Rescue. Contract Manager: Dance Mayes _ Fire Rescue Stop 14 (Name) .,.,..._...... (Ext. Department/Stop for BOCC meeting on Jan. 1 , 011 Agenda Deadline: Jan. 4, 2011 CONTRACT COSTS Total Dollar 'value of Contract; ILIA Current Year Portion: Budgeted? Yes❑ No F1 Account Codes: Grant: County Match: ADDITIONAL COSTS Estimated Ongoing Costs: �/Vr For: (Not included in dollar value above) (e . maintenance, utilities, janitorial, salaries, etc. CONTRACT ACT REVIEW Changes Date Out Bate In Needed ex Division Director ��'� Yes❑ No Fisk Mansg ens t Yes Noe""' O.M.B./Purc Ing Qt( Yes❑ No i County Attorney k�wr'e El No Comment OMB Evan Revised 1 MCP # RENEWAL AGREEMENT This RENEWAL AGREEMENT dated the day of , 2011, by and between the Board of County Commissioners of Monroe County, Florida, hereinafter referred to as "AMBULANCE SERVICE" and EMERGENCY MEDICAL SCIENCES ACADEMY, INC., hereinafter referred to as the "AGENCY". WITNESSETH WHEREAS, the parties hereto did enter into an agreement dated September 20, 2006 to provide a comprehensive learning experience for participants form the AGENCY, within a clinical setting; and WHEREAS, said agreement provided an option for an additional (1) year period extension if elected by both parties; and WHEREAS, both the AGENCY and the AMBULANCE SERVICE have elected to exercise said option; now therefore IN CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as follows: p � 1. The parties elect to renew the contract for an additional year pursuant to III. C of the paragraph agreement entered September 20, 2006. 2. The effective date of this amendment is January 1, 2011 and shall extend through December 312 2011, under the same terms and conditions of the contract dated September 20, 2006. 3. All other terms and conditions of the contract dated September 20, 2006 shall remain in full force and effect. (SEAL) Attest: DANNY L . KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By: By: Deputy Clerk (CORPORATESEAL) Attest: By: Mayor/Chairman EMERGENCY MEDICAL SCIENCES ACADEMY, INC, ton Title: Title: MON R@E COUNTY ATTORNEY APAOVr-- ASPR T N IA L. tA ASSISTA T C UNTY TTORNEY Date . - -� : 3 .� �0 l DATE (MWDDIYYY' ACCP1?V CERTIFICATE OF LIABILITY 10/6/2010 THIS CERTIFICATE IS ISSUED AS A MATTER F INFORMATION MA`r'IOL ONLY AND CONFERS NO RIGHTS F T UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE ATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, lD, EXTEND OIL ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT l T(TUTB A CONTRACT BETWEEN THE ISSUING Ire ER( , AUTHORIZED REPRESENTATIVE OR PRODUCER, , AND THE CERTIFICATE HOLDEN. 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 coffer rights to the certificate holder in lieu of such endor ement(s). PRODUCER CONTACT Seitlin Insurance 'J00 Andrews Ave., Suite 300 fto, . PHOEx# • (9 4 938- 788 FAX o : 954) 938-85 6 Fort Lauderdale FL 33309 ESS : PROD RECEWED CU D = INSURER ,5 AFFORDING COVERAGE NAIL INSURED IN UR A .Philadel hia Trade i!�Ins. Co, 18058 Emergency feda.cal. Sciences Ac d, Inc. � - INSURE B :eeral Star lndemni�y Co. 3732 2000 West. Commercial Blvd. 20 URE Cmeri an Casuai� Co. o Reading20427 :AINSLIRER LaLlde dale 33 09 o Cl .ions insurance CoTpany 10834 By 54jU�R-EA INSURER F COVERAGES iP ATF N11MRFR- 3c -r-r Pr-v1-Cz1nM M1 iftfiRr-p- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED ED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING 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, EXC LUSIONS AND CONDITIONS OF SUCH POLICIES. LI MITS BLOWN MAY HAVE BEEN f EDUCED BY PAID CL IM . INSR LTR TYPE OF INSURANCE ADDL INSR SUM VVVQ POLICY NUMBER POLICY EFF MMJDDlYYYY POLICY EXIT M DD}YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 1, 0 0 0'; 5t0 1 COMMERCIAL GENERAL LIABILITY PHP 33753 10 7 10 10 7 2011 DAMAA. PREMIE TO E TW curr I ES Ea occurrence) 100,000 MED EXP (Any one person) 5 51000 CLAIMS -LADE [il OCCUR PERSONAL & ADV INJURY S 1,coo,Qo0 GENERAL AGGREGATE , 000 r 000 GEN'L AGGREGATE Ll MIT APPLIES PER. PRODUCTS - COMP/OP AGG 2,000,000 POI,tD PRO--� LOB A AUTOMOBILE LIABILITY X ANY AUTO PHPK633753 10 7 2010 10 7 2011 COMBINEacrid DSINGLE LIMIT l, 000 , o o BODILY I NJ U RY (Pe rpersort) ALL OWNED AUTOSBODILYINJURY (Pe raccident) SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) NON -OWNED AUTOS S UMBRELLA LIAR EXCESS LIAR OCCUR CLAWS -MADE IT,�C3�572F' 10'7010 10'7�11 EACH OCCURRENCE 10,000,000 AGGREGATE 10, 000,000 DEDUCTIBLE RETENTION 10,000 WORKERS COMPENSATION AND E PLOYERV LIABILITY YIN ANY PROPRIr TOR/PARTNER/E E UTI E OFFICEI IMr BER EXCLUDED? N I A 01B13-208D547-00 10 7 010 10 7 01UL O TATU- JOTH- E.L. EACH OIDENT500.0000 E.L. DISEASE - A EMPLOYEE S 500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. [DISEASE - POLICY LIMIT 500,000 C Student Medical �} 01ry 7294541 10 7 2010 10 7 011 Each Oeeura e : 1, 000 , 000 Professional Liab . Aggregate: , OBI, 000 DESCRrPTI0 N OF 0PERAT] 0NS I LOCATIONS I VEHI C LE (Attach ACORD 101, Additional Remarks Schedule, If more space is requ[red) CERTIFICATE HOLDER AS DESIGNATED ORGANIZATION IS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY WHEN REQUIRED BY WRITTEN CONTRACT, SUBJECT TO THE TERMS, CONDITIONS AND EXCLUSIONS OF THE POLICY. LE TIFIGATE HOLDER r--AMr•-r-1 I ❑'li [ nM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN iRE COUNTY BOCC ACCORDANCE WITH THE POLIO`{ PROVISIONS. 490 63 STREET AUTHORIZED REPRESENTATIVE SUITE #140 9 Marathon FL 33050 I 1 BBB-20 AGURL) CORPORATION. All rights reserved. ACORD 25 (200 l0 ) The ACORD name and Ingo are registered marks of ACORD RENEWAL AGREEMENT This RENEWAL AGREEMENT dated the 1.6 tin day ()f December , 20, by and between the Board of County Commissioners of Monroe County, Florida, hereinafter referred to as "AMBULANCE SERVICE" and EMERGENCY MEDICAL SCIENCES CA-DMY, INC., hereinafter refeiTed to as the "AGENCY". WITNESSETH WHEREAS, the parties hereto did enter into an ageement dated September 20, 2 0 06 to provide a comprehensive teaming e penonce for participants form the AGENCY, within a oli c l sett ; and WHEREAS., said agreement provided an option for an additional 1 year period extension if elected by bath parties; and WHEREAS, both the AGENCY anal. the AMBULANCE SERVICE have elected to exercise said option; now therefore IN CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as follows: The parties elect to renew the contract for an additional year pursuant to paragraph 111.0 of the agreement entered September 20, 2 006 ! . The effective date of this ar endrment is January 1, 2010 and shall extend through December 1;.2.0 10, under the same tones and conditions of the contract dated September 20, 2 006, . + All'offier te=s and conditions of the contract dated September 20, 2006 shall remain in fall -force 'and. .effect! , to t " Ate"''' L. KOLHAGE, CLERK x By (Y±-221 • Deputy C1 rk (CORPORATB SEAL) Attest: : "title; BOARD of Co'UNTY COMMISSIONERS OF MONROE CU LORD • ✓✓✓ Mayor/Chairman EMERGENCY MEDICAL SCIENCES ACADEMY, INC, 'Witte: MO ROE COUNTY -ATTORNEY PRO�FQ AS T is CYNTH I AO L. ALL SSI ANT COUNTY ATTORNEY Date I OPO4... X �yra^i• +51 I.9lwr Cert ID 22776 ACORD f CERTIFICA11 iF ii r � INSURANCEPRODUCER DATE (flMfDDYYf ) 1 fLfeL&ITY to" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION r , . SET_TL1 i ! 6 00 N. AMRE TE AVEIME, S000 NOV � FORT >JRDL�, �� o � 1 ty ONLY AND CONFERS NO RIGHTSUPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOE NO AMEND, EXTEND R ALTER THE COVERAGE E AFFORDED THE POLICIES LOW. I EF AFFORDVE A E CAI �# (95) 938-8788 (954) 934-66 0 INSURED � .. INS UR ER A: PRILNDE L PHIA II I INS . CO 18058 Emergency Medical Sciences Academy, Inc. rNSU RB: GENERAL STAR IVDEMITY CO. 37362 INSURERC: TECHNOLOGY INSUR14 CZ COMPANY 43276 Oar C:O�R D J. , 5 E # INSURER D. AMERICAN CAStMLTY CO/ EADX1;G 20427 FORT LAUDE DALE FL 33309 INSURER E: COVERAGES E THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE E FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 1 ANY REQUIREMENT, T M CAR CONDITIOM OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED CAR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXGLUSIONS AND CONDfTIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCER BY PAID CLAIMS. Itq ft 0v POL[C1f F,IUMBER POLICY EFTECTIV POLICY EXPIRATION LIMITS GENERAL L€A131LITY EACH OCCURRENCE S 00 4 000 A X C0MtMEROI L GE NE RALLtA81LIIT CLAIMS MARE 10 OCCUR PliP 480 8D 10/7/2 09 3,7 010 p E E (Ea oc ar cL 100,000 MED EXP �Anv one person) 5,000 PERSONAL & ADINJURY S 10000,000 GENERALAGGREGATE , OOD,000 PRODUCTS -COMP/OP AG S 2,000,000 EN'L A GRE ATE LIMIT APPLIES PER: PQL, C"Y PRO- � LOG A AUTOMOBILE X vsILE L A II.IrY ANY AUTO PHPX480580 10 "7/2009 10 7/ 0 0 COMBINED (NGLE LIMIT (Ea41cctdersf) $ 11000# 000 INJURY (Per person) ALL OWNED AUTOSBOINLY SCHEDULED AUTOS BDDILY INJUR �i��C #��x'It) S t X #y-jIRy�E� D `A�,rUy�TOS T �+ 4'Fill"i YMIwLE4i A�.1�Q� 4 k"+F' ~• e 1 ft� 4 i v. � 7r 5 F 1 J • , I''f •t{x . ,. .4F PROPERTY DAMAGE (Per aceldent) GARAGE U ABILITY !E y AUTO ONLY - EAACCIDENT OT3. ER T HA N EA ACC S ANY AUTO B EXCESSAJM5RELLA LIABILire X1 OCCUR CLAIMS S MADE ICfG39572SE 1017 009 10/7/2 10 EACH OCCURRENCE S 1010001 000 AGGREGATE S 10, 000, 000 S S DEDUCTIBLE RETENTION 1#IOU 0 C %VOR ER COI'd PENSATION AND EMPLOYERS` LIABILITY ANY PRO PRIETOPJPARTt4ERFEXECUTI E OFFIOEMMEMBER EXCLUDED? Des, describe under ECIAL PROVISIONS below T C3209'719 9 1 009 I0 7/ OID C BTATLI� OT"" 8Y_LIWI1E; _ER E.L, SACH ACC]DrE T S 500,000 E.L. RISE SE - EA SIMPLOYEF. S 5001000 E.L. 01 S EASE • POLICY LIMIT S 500,000 ID OTHER STUDENT M DICAL PROF 0127294541 10 7/ 009 ID 7/ 010 $1,000,DOO EACH OCCURANCE OCCURRENCE FORM # 000 0 000 AGGREGATE DeSCRIPTI0N OF OPERATI0N S I LOCATIONS I VEHICLES t E} CLUSI0NS A00ED BY ENDORSECr ENT # SPECIAL PRO tS10NS *10 DAYS NOTICE OF CANCELLATION IN THE EVENT OF NOIT-PAYNENT OF PREMU i. CERTIFICATE HOLDER A DESIGNATED ORGANIZATION IS AN ADDITIONAL INSURED AS RESPECTS GENERAIL LXABILITY StMaECi,' TO THE TERMS, C O=T-TIO S AND EXCL10rSTONS OF TIJE P{ LIL*Y. I-Pr-M 11i'14.P/AI r- rlVLUt ki MO ROE COUNTY $CCC 90 63 STREET SUITE #14 0 Marathon FL 33050 SHOULD ANY 0 F THE ABOVE DI SVRIB ED P0LlCIE S eE DANCEsI.I.,E;D BEFORE THE EXPIRATION DATA THEREOF, THE I S SUI NO IHSURER W1L.L ENDF-AVOR TO MAIL 3 0 DAYS WRME14 NOTICrz T€7 THE OERTIMCAT E HOLDER 11AMED TO THE LEFT, 8UT FAILURE TO 00 $O SHALL IMPOSES NO OBLIGATION OR LIABILITY OF AN ■ KIND UPON THE L11SURFER, ITS AGENTS OR REPRESENTATIVES. SENTATIVES. AOHORIZED REPRESENTATIVE A QURD 25 { 001[ ) 0 ACORD CORPORATION 1988 Page 1 of I IMPORTANT If the certificate holder is an ADDITIONAL INSURED, , the polio r ies must he endorsed. A statement on this certificate does net confer rights to the certificate Folder in lieu of such endorsement . 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 . DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constIt to a contract between the issuing Insurers , authorized representative or producer, and the certificate holden nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. AUUMU ZO t UUIIU8) 10 27 009 Page 2 of I RENEEA ACTREMEN This RENEWAL AGREE A�:day'Df ...... .. .... 2009, by � and between the Board of County COMMSSIOners of Monroe Counfy, Floridaereinafter referred to as 4LAM13ULANCE S VCE" And EARGENCY NMDICAL SCIENCES ACADEMY, INC., hereinafter referred to as the `".A.xi\TY'. . WTNSETH WHEREAS, the padies hereto did enter into an agreenaent dated September 20, 2006 to provide a comprehensive lean-dexperience for participants form the AGENCY, within a deal setting; and WI-MREA , said agreement provided an option for an additional 1 year p rigid extension, if elected by both pages; and WBERE.AS, both the AGENCY and the AUBuLANCE SERVICE haelected to exercise said option; now therefore IN CONSIDERATION of the7mutual convenants aad obligations contained herein, the parties agree as follows: .. �.. 2. The parses elect to renew the contract for a 'additi n.al year p=uant to paragxaph M.0 of the agreement entered September 2, 2006. .e effective date of this amendment is January 1, 2009 and extend through December 1, o , under the same terns and conditions o the contact dated September o, 2006. . &,er14z_ 4 ,w 1e� and conditions o the contract dated September 20, 200 shall remain full Deputy C .Ko HA:x , Lr. (CORPORATESEAL) Attest: / By. BOARD OF COUNTY COMMISSIONERS OF MO ROE COUNTY, k'LflRIDA Mayor/Chairman NMRGNCY MEDICAL SCIENCES ACADEMY, INC, y: .tie: �Qe� MONROE COUNTY ATTORNEY APB zzi�:�" CYNTHIA L, HALL ASS I STANT C 0 U NTYATTO FqN EY Date - - o ACORD CERTIFICAVIEWC PftOE]IJER t - SBITLIN 6700 N. ANDREV75 AVENUE, STE #300 FART LAUDE"ALB FL 33309 ' (s ) 938-8709 (954) INSURED 000 WSST COMMACZAL $LVID. , ST2 02011 rOILT LAUDEDDAM 17EL 33309 COVERAGES ITY INSURANCE 1 DAB 13/2008 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE D04S NOT AMEND9 EXTEND OR AL79R THE COVERAGE AFFORDIED 13Y THE POLICIES BELOW, INSURERS AFFORDING OVE A E IC I I NSURER A: RIZILADELPHIA XIMMMITY 111 . CO.18050 INa!lRER C$NE Ir STIR INDEHUXTY CO. 37362 INSURE C: =CHHOLOGY ZNSVPJWCR C01SP2LNY 43276 IN URERO.' COXCAaO TNStFPJLNCE COMPANY 66 INSURER F; 0 THE POL(CIES OF INSURANCE LISTED BELOW HAVE 13E N ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHTANDIN ANY REQUIREMENT, TERM OR CONDiTICN OF ANY CONTACT OR OTHER DOCUMENT WTH RESPECT TO WENCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND COND111ONS OF,5UCH PCLlCIE S. AriVjRl~c-A'TF 1 IVIT I- nMW h A & V W A % = 93=r_1.t t51=mi Inr-ri nv MAort rx! A#ajr ]h' rftADD* f POLICY �, UMar:R POLICY1~FFECTWE PULIGYEXP.1 110N ]rp' rrS GENERAL LIABILITY EACH OCCURRENCE S _j CLAWS hxAC7E OCCUR MEV EXP(AneCkmon) S 1000 _........ ... PERSONAL&AD INJURY S 11000,000 GENERAL AGORE TE S 21000,000 GENL AGGREGATE LIMIT APPLIES PEft PFIODUCTS-GGMRR)PAG0 S 2,000,000 POLICY DiprRiEELoc AUTOMOBILE LIA01#.I' Y COMBINED SINGLE LIMIT � A ANY AUTO PHE9353270 101712008 10/7/ 00 (aa dint) ALL OWNED AUTOS t 86mmIIFIy s SG HEOULF_D AtjT0 W4r potson) HIRED AUTOS r r��yy��}i�+�i� I�1J}�e L INUURY i* N ib Eke AUTOS (P4r it dont) J i'4iJP R1 1 DAMAGE P(PoCadij GARAGES IABILIT1 AUTO ONLY- EA : I fT ANYAV*O * AC I�Tf�Ef� �`f�A#+f AUTO ONLY: : AliC 5 EXCBS #lJMSR LLA UABILITY EACH WCURRENCE s 10 01000, 000 S :xjOCCUR CLAIMS MADE ItIC395725D 10 200 10/7/2009 AGGREGATE S 10, 000, 0vo DEDU IIBLU �C ft�fl�ION 1�.4r:� 0 WORfCE tS 00UPE ATICF1 AND SWC3 80 07 1/ 000 1 00 X 7�lZ#J• DTI - i EMPLOYERS' LIAR#LM x ANY PROPMETO 1PARTNER*_X ;CL TIVE E.L. EACH ACCIDENT s 500,031) 0FRCEM WnEn VC LUDED? "All.disc ba undor E.L. DISEASE - EA EMPLOYEE S soof000 SAC1AL PRO�VI IONS below eL, EmmsE - P4LtCY umm 500,000 �y D OTHER S UDa MEDICAL ]tVlp 10 7 2DOO 10 '7 200P 41,000000 F.1;�Lc�r4�Ywmy�+�y,yccup�Rm $3 / OO O o O V O V Yi'i�ti ATE - - - - — ,.._.,.._ ..,. _q.* ,aV , li,F4"Wb6:.sj G�uL.Uaj f%k ^UWL: p Uy CNUUMt;L-mr'N1 f J'WAi, PFtoV1510NS *10 DAYS NOTICy- Off' MRCELLATXOR IN THE ZVENT OV N N�P YMZNT OF $REn4XU . CXRTXPXC=1Z HOWOR AS DR-9XMMTJM0 OAGT Z?LTX0N IS AN ADDITIONhL XNEIMD AS RESPECTS GgNEPLAL LIABILITY SUBJECT TO TFM TZRXS, D2 1GI S AM EXCIjUSIONS OF THE POLICY-. CERTIFICATE HOLDS r%AK1e% 1 II A+rWAII SHOULD ANY DFTHE ABOVE DI RJEIE0FOLICIFESsECANCELLEDBEFORET[EXPIRATION ON O C4F1 OC DATE THExEoF, TH IssulNa jNsunF_R wILL ENoEAvoR TO MAIL � DAys 'RwmN NOTICS 10 THE CRRTIFI ATE HOLOER HATAEO TO THE LEFT, SIFT FAILURE TO 00 SO SMALL 49 €1 63 STRMT IFdPOSE N0 0BLIGATION 0R LIABILITY OF ANY KIN0 U PON 'TIM 114SIIRER, ITS AGENTS OR tFITE If1400 A a+ on FL 33050 REPRIE3Eii4TVES. A THO RIZED REP R E TIr '4�r'�' x1 � • op Page 1 of I 10 3 009 If the certificate holder is an ADDITIONAL INSURED, the poll y(l ) Bust be endorsed. A staternenI n this certificate does not confer rights to the certificate holder In Cleo or such endorsement s . If SUBROGATION IS fAIV , subject to the terms and conditions of the policy, certain policies may require are endorsement. A statement, on this certificate does not confer rights to the certificate holder In lieu of such ndor ement(s). DISCLAIMER This Certificate of Insurance on the reverse side of this form does nut constitute a contract between the Issuino Insurers , authorized representa,tl a or producer, and the certificate Felder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. Page 2 of I RENEWAL AGREEMENT � � `his �EYV GREW d/��C day o ,.2007, mid betweenIffie Board of County olun)iioller ` Monroe C nt-y, rA, hereinafter referred to as "AWM` AICE SE`RN71C-F7-M1d ffiRGENCY MEDICAL SCIENCES ACADEMY, INC., hereinafterre e Ted to as the "AGENCY". WITNSH WHEREA S, the Parties hereto did enter into an agreement dated September 2 , to provide a comprehensive ems• aaioip�t from A..,�rNCYr�itlea ; and WHEREA.., said agirftnient provided an option for an additional year period extension if elected by both pe; and WHEREAS 2, both the AGENCY aild the AMBULANCE S13RVICE have elected to exercise said fro • now therefore IN CONSIDERATION of the mutual coveliants and obligations contained heir hx, the parties agree as oos: i The parries elect to renew the contract for an bdditionalyear pursuant to paragraph III.C. of the agreement entered September 2 . The effective dato offs m e dinent is Janus I v 20 08 and shad. extend through December 31, , raider the same tee and conditions of the contract dated September 20, 2006. + , �Ik ' tmms and Wnditions of the contract dated September 20,2006 feet. RAG, CLERIC A� COMMISSIONERS •YOF MONROE C FLORA A +y.r By� r.r. • By: Deputy Crer1c Mayor/Chairinak (CORPORATE SEAL) Attest: &Ant Title: {mot l/ i(t�-5 ~ - Notary PublIc - Slato of Florida � `** Bonded by Wonal Notary Assn, EMERGENCY MEDICAL SCIENCES ACADEMY, MY, INC, Bar. Title: - -� ��1+/+r�tirYYF MONROE COUNTY ATTORNEY ri x�0- M: L. HALL 4+*r •'_ ter. a .. inn—r-.-y+1 +' : �R-11� +�ir ��Mn F J ..s /jJjf/.� f Cl }!j�vk 'rr(µ/1'y j[i�� .1yaIr (.f ai F � L P i/ #! Y w! ��a�iaa+r,rir�.�L. �` •'V +wF��IM�* + #; �y Pis }DUC .....-1.- .a„Y,r-r�-w-r-r.+�.+w -} f i007 0kvLY"fijjqrJF CONFERS NO RIGUS Upk0mTNE cl-WrIFICATE ROLUM THM coR ru A T boas e AMEND L--JtTEPJD OR .A€.T z 'SOY. cow i--mrmt " THE P0L(c!c-:,q0W. INSUMRS AFFORDINGCOVERAGE SIG eA BL'C- 4 r FJ 1111200 INS P,, : LZ13EE DUAL =M . rgP: Co-, 23035 0 is=)� 3:09 JrEJIir1: THE IREQU 4 INS TPRURAI. C0f4 � I � #�N €C ISSUED T THE INSURED W EVE FOR THEPO l PEWID INDICATED. NOTWITHSTANDING MMAY AY E PERTAIN E I ilt{RA 11 D ! ORA L" a H R Do0UMEW 1�'#`0 I�PE T TO I 1IC THI TINC��TE J AI" 8E I l� D D �'AI �'i J l E l AFFORD [ } S T [ OVOI; ] I � lrz]E�! I BU34C -T ALL THE IERMS, II L. ION AND NDI�`�ON aF U �`i POW)lE • AGGREGATE T LIMITS r`�011 NfoAy� V SEMI DUor ByF�AID CLAIMS. if MR � # • ,.,,,, �. c r r r rr rr~f v I * •f p - � r r 0" t Itr �rar-�, [arrsrr Cry OCCU RENCE CLAWON�A13E OCCUR 00 p00 IUD A�1 ar�� won .5 � OUO KRSONALAADVINMRY EWLAC�f RELATE So � 000, coo PoLf '�R�I��LE�►#k�`A��J.it��: A TO {rccea tiOMWNWAE OS Rai%LVINJURY � r 1 AOPI Ummi i �� . ■Y�J�ay � 7�R/ 1y�i ■a yy' r-� la�IrY`L �y i� /l++il�YwY*tia� W!a Y AlJT0 +M =EAACC(0E AUYAU O s� yyq • .' a A '' rti a�tA�}Kr vp OCOUR 0MAIMSMAW 41�wvh-A - DENJOPaLE SILL %0.000 Old WORIMRscompgNSAMNANO WPRO PMF-T(WA=ER=Wtrr9F- J ,19CaF MWA3 ECGLUD �� r scr ba under EL1 DISEASE -F-A IJdP S ADO 000 I,A-PR0VJ9lQ r bofo�, Orr II-L DIS PAS F--POI.Icy [I &UT 5 Soo, DOO rr H LM,U�£y��ys ly D378X ihTn}D OWMrSILTIOR :" i h 1i 'Jt` 1+ #J u xusmm Zs Xm0plMrsiMTMIAL ZTA5xrjz,.0y -CERTIFICATE NOLDI-ER IMIM.Grbr comrZip 80 490 43 STST SUZTB lil0 1i=D-o-A I?L 330 0 RD 2.5 06lij4) ,i m UftLf-ATlQ N RD ULD AlffOF THEAllO EOV,2bra GVOU0WSZrx Wl GELLED Giz-FopE TOI=C-RPMTlag NOTICE T THI C5Pt 7F[GA DIL 0 HAM I0 YHE LWr D Ur FAtWatiTo LD s o quAL . [ I # S 110 0SMATION Oft UhMny OF AW WN0 WWI T"l! 1110101, MS AC;Wq OR 0ACORD CORPORAWOt41088 #{�� R \ V w+ �}. # i .r t R / - ts' #�. N t �:� +� h �+w � f � } yrt w,. I. ... t/!++ � 1�' rr �..#M. .. �V y +� �+t�t+Arr. �+R�y4't• �.+. •#i#S } t �� .. - .M +] # iF Ott sWA./+'M/+YM��4Li4 L./�+y �- -.4T li+• 1Mw�� fM�i. #�iiirrtXlY.r. ft.� �+'li AM.t� 4 145Lwi+��i'4rii r� �fywM alrtwF� OMPORTANT I r tiro efUTI in e 1101der is ill ADDITIONAL INSURED, the policy(jag) must be endorsed. A statement oji thIs c 1 iulo fe does not 01' n,9iits to the caMicate holder in Ilesuch endor'ss exlf . ff SUBROGATION IS W IVZD# subleot to the terms and conditions of file policy, co) ire pallejes may MqUIre an endorsement. A stalement oil this ce ifiooto does not confer rjhts to the CerMwe.. holder In lieu of- suej, andor a e i(. DISCLAMER The Cerffic-tite of Insurance err file reverse side of this fo does not consfftuta a contract between the Issulng insurer s f authorized representative or producer, and the certificate holder, tor does It ;3fRn-nat1vG1Y or negEttlVelY amerid., extend or after the coverage afforded by 1110 policies listed thereon. YF -Fr -, .0 r-1 - u, LL T J1 C y' 1�"j t?l C111 P-11i -1�\ t7 E, 1.0 PRIUCMA OTG AGENCR This AGREEIVMNT between , WE GENCy M j AL Se. NCES i 'C#, h0reinafter refeiTed to as the AGENCi, and the]BOARD OF COUNTY COMMISSIONERS OF M NRE COUNTY, FLQRIQA, hereffiafter referred to as 'a MV"CE is Oil the AI�M LP�NCE SERVICE is enterecl into tilis..2d fr--jay of -H0 ]PURPOSE W/SJi:f Yy1L' +4.I1`Wi11iWERNT ' a'ly glr e'cl that the, Pl as 0 of tW s AG EEIvEN' is to provide, c1filical setting,nin X e enfor m o a ts - the , �`pNCy, W1� a AGREEMENT. in a - cwrdmice with provisions of the guidelines set for& M tWs n If 17 a GENERAL ]PROVISIONS ILSL.ONI:D OF .Ci1GREi1lilT.n.L:/N.il -r . Both pardes agree that therewill b nodistinction in � to ciaor Plao• creed, , sex, color, age, nations o � religion, a xe status , disability or .r and adhere o th revisions o FAA and State laws 13, The ANMULANCE SERVICE will provide, to the Paiticipant, Lit the PalticiPant's O-Xpense, no care for suds or acute ilkess wee o utY at the AMBULANCE SERVICE ia accordance with the provisions . this ag�re=ent, o The term Oftbis AGREEMENT shall be from the date of the G EEMEN , and hall remain . U1 force and effict Untfl December , 2007. Either party may elect annuaUy to extend this AGRE)RAIHNT for an adMonal one 1 year P01io d upon viat least flArty (3 0) days prior Wittea notice of intento extend. Either eo rna ' tmlinate this AGREEMENT by givingleast ffiirfry (30) day Amtten n0fice to the other paty. NOTICE: Were n0fice is required wider this AGREEMENT to . c given to either • the notice shafl be, mailed o; roe• AGENCY: For AMBULANCE • Frank Galgana, Program Director Cl"k 0. Mal.Jr.,Fire Chi cmf/Div. Director EMS Acaderny, Inc. Monroe Colmty Fire Rescue 600 N, Phic Island Rd,t Suite 3 Street Suite 140 Plwitatiojr4 FL 33324Marathon33050 I IT 19 11 B 9- - 11. rh HPI 11 0---e (0) r F E M re, A G r!- EUNCY A c 3E-s1iCY 1shaH dsip c a person or persons to coordinate and act ai8on VW th the approp ri ateHULA` E SERVICE p ars1 1. 1 AGENCY sMI provide the AYLBULANCE SERVICE vdth a list, Palficipants the lemuing ortilt'pelimice at least tee. 1 o days before each program is to stet. Q, AGENCY shaU illstlrc that PaltioiPants have fhc necesswy di acfic leavnhig cx,,4k�.nce at the AAMULANCE SER.SCE. . 4 A(3NCr slaal nisc that the participants tom l �provisions . S[ �' of . E. AGENCY does uadertalce and agree mess the AMBULANCE SERVICE and its officers, 4irectols,f eMPIOYees, and agents, and reasonable tt 's fees o account thereof, that way be sustained wed reason of any and all claims, judgments, demands, salts, actions, and executions for dam every� d age and y whomever and whenever made o bta ed, allegedly causedby .ng out 04 or relaflmg in .1 y manner to the aivitr of any Participant or participants supplied. by the AGENCY pursuant to this ,+RHI�MNT. '. AGENCY slAW procure and aiu� d the � o ' G� d any renewa a�iHty msurc to corer my and all ab'tyOncludiug Professional liability) claims, damages, r �� t� for o Persons Or ProPertY of whatsoever Und of ntc an out of the activities off p"cipauts coed out under this AGREEMENT. ce shall be on an occamce as's M a=Unts no less than $L0002000/ $3.7000,000 for persond +, es $50,000 forproperty .. mae; and the AMBULANCE SERVICE shall be an additional named F # -insured under sc general and rofess* lonal liabilitypolicy orpolicies. shall submit certificatos Of iusmce to 1hc AI�MLANC AGREE encmg msurance at the time of the execution o �s and s requested the CE S '' IC . AGENCY agrees that the A�ULANCE SERVICE wiU rye no des thm `ty days vaitten nofice prior.* to cancellation, modification, or 0n-renewal o o s 'auc i * come des crc.�. a camas whdo o have patient contact non -wed health ar . . a t WHI not be required o be covered by professional liability insurance. 2 -If C Ek? FP:1 PW CF1 F 11 OPOh-TEmI4, P,)lffLffTg EnO OT, 1TM( Ah®r FRIA441 15 - 1171 J Ru V-h C TI, it sho.11the i vo it �r f the- AD,0 . A `. S ' .V A. Provide m aPPYO Ii ate o H (Pmtation of P ar i au s C onne oti on with its facilities and its polices and procedures. . PyOvide OPPOrftwities for a leatlimg exPmience with appropiiate supra son, 'C; P,4-e tc"in U tim ate resp o ns lb il ity for patient care even if th at care 's giv en a patticipafing stadent. Do Desigtiate a piveeptor (or coordinator) fits staff to act as the haiso with the AGENCY in this AGREEMENT'`, as appropiiate to the leamiqg objectives. Vlio SP'EC`1T+lf(C QDNSEDEIC.IMS OF 7I`M ]PARTICIPANT it s aR be. respollsibility of thearapa assignOd throUgh this AGREEMENT o: * Comply with the policies and procedurea of the AIVIDULANcF, SERVICE. B. Provide the necessmy a .d approPtate Moira WhRe on duty in the AMBULANCE Obtain prior Mitten appxoval of both pares to this AeREYMNT before publi�ug any material related to the learning experienceprovided uader .e terms of the AGREENMNT. " `. D. Sigu a ""Hold Harmless gree a&' with the AMMULANCE SERVICE ' or to commencing his/hOr OxPelience ' 1fi& the AAIBULANC . .. SERVICE ofWhich is attached to this , .GREMBN' as ExWbitA. At aU t�mt weak.' to ap r ruts bad c on c ep. c�� ro . moo, and comply ail respects with the study a {emts sot fob in the requirement sheets. VE, REQUEST FOR I THDRA AL OF PARTICIPANT ThO AMBULANCESERVICE shaR resme the right to deny any Participant from mess to its facilities whose conduct or work with patients or personnelis not in accOrd=() with the Policies and procedures of the AMBULANCE SERVICE or is eel tO patients or others. r 3 Mod, may madebynautiW consent x"' both wgifmg, all d afta che d t o IN G jvffiNrj-n ap d shall i aclucle the MICI. Sigaaftires eLpairdes c1greemgflee modification. - *. Mg COPIES 01F AGRE-T-MtRdENT COPics Of WS Signed AGEEMENT shall be placed on Me and be, availablethe WrPorato office of the AG Ncy and ill the offices of the AMrBU A`Cp Sr.�' IN WITNESS WIRBREOF the parties himreto have caused this GREIVM�T to be L 'Llttheir reSP eCtiVQ C0113or moles m1d Aleir WrPoreate seals to b e affted by dul' ffl,Fs, aU on the day and year fuss set foA above. .. ! }'. '. pnAr L, Kplhage, clerk ]EmcrgencY Medical Sciences academy, Inc. xF Frank GaaJlgamn Bow of Coity Como+ OfMOnr0e County, Florida 4 mayor MONROE COUNTY ATTORNEY PPROVED AS TO FORM. 02 Sum �. I PA O A 4 , MP r2INCY REDO CAL SUENCES ACAMEawvay HOLD HARMLIESS AGRECEMC=My Ar[41D RELEASE Medical In consideration for the CouWey providing rrie this opportunity to acquire* ' 'n z nd , the undersigned, agree to i eninlf�j Protect, and hold harmlanyess Coif and its officers, directors, employees,e ty Judgments, c pan , vests, damages or injury risi r out of or i n connecrion With any and negligent conduct on my pay%, however caused, ri instructional training activity. I agree that I Will defend at My own expense, any and all action lawsuits or proceedings which may be bro4ught against the County the above and hail satisfy, pay and discharge any and all judgments that may Oe entered agall'st the Couhty in any such claims, lawsuits, or proceedings. f understand that, generally, while I am engaged in the activities of and related to this course Of instruction and training, I am not considered an employee � not eligible the County end therefore, � le for any benefits available c rat ' employees, nor to pursuantWorkers Cornpensation coverage to R rl a Statute chapter - o or its successor amendments/statutes). i understand that there are 'Inherent risks 'in training with limited t � , in Judi but not * w i jurYt sure to dw cr 111 e s , and exposure ctagis rss and cntracti� - c dies. rtrrihis training can result III severe Injury and even death. I release coon r .. n consequences - . � � d f� 1��1��:�,r r c sin oUt of my training with County. x Date of Instructional Activities. �. Date Date L y i a � Date: Witness:. Date: # 1'l i � t + I f/ S � �I � �f � �. i ... �* . . a}�..... rr' �..��rt.i i„�•.�p . y., , , ,+�• �L # i . . r #f i i' :•,4 �fi'j""'-Fr� i,�•{J ^f I"'� k,.... f1- �1J�11fI J'f:♦�� }j� ,�f� y +'+ �• ..n r . .. '+:� .L'•.i r •.3i�+ > ,,.a i..� 7a�_r � ry•�.r�r�+t-r+[[. �+w+.. Y,.F r��rt-�� *• � �,#.��i��]jl�ll �i� ;�f�i�`�� r��r"'�F ;�4 •4{ �� '��F� r„�� +Y��fS� rt� �' � � f. •+ � � �#� �}" � L.�4 i �+�� 4F Lr �� '+ c�p r . i . i f{ x .t{� i � R ,47{ ry • � . /`+��i i, � �j s"�, ��[.rvr+} et E u ��pyn ea up x� _ q � - .. � ky� ; {/�; ! j MdE)j ,•a-+.„ 1"+��'kU L. � a � At D am PRE � � er W 0 NOS: f (l FINE ISLAW rrt 320 WSUR RIM F THE POLICIES OF INSURANCE LISTEO BELOW WAVE BEEN ISSUED TO nJE INSUREDNAMED ABOVE FOR 7N POL GY ANY RrzQU13�E ENT L TEES[ OR CONDIT10J OF ANY ONMCT O 0-ti.1 R C3 T IR P� � �' 1�l�IC�1 P [�D IC�DI ATED. n�aTmTHS Da�v MAY PERTAIN, THE INSUM AFFORDED BY THE POLICIES QE PJJ3�D � �1 I ��.�� ' "� A�� ' #� `� � TIrx A fiAy arz ISSUED op POLICIES. AGGREGATE L'M' T;S HO MAY t-iAll 8EE EDU m B PAi LA�[1�5, 2 (CLUSIO AND CONDM o El l, '!3 R w a ENC-RAL Lum IL _....... _ A ]� � MAIMERGALGENE I4L1AZVTy CLS12-10389 0411112006 CL41AIS MAOE OCCUR AWAUTO ALL OWNED AUrOS HuRED Atoms • OI-L3WNER UTO : I i P, *i 43ARAGEWBILITV IANYAUTO ; . J, PW#CN _ - gyp' i + `* i y�V *F ah+�►�iN r rrt r Lift 4PL0jEEt 'I jU ANYPROMETiORIPART ERr-XECl;TIVE OFRCEWMEM ER EXCLUDED47 IF dribs r�rar O~MER (WIM2007 r, 1 r yy ``l�ayTi k� axee �-y /�++��3}��yy �y��±±�� }}��'yk �y yiy* ��+� . i+ i+kF�x�y�kf� l��y{��Y*i . ' il;�►�r�3F'�Q+J ��{Ii4Y�3�J � �ki+�FTi�LV�a�i7 ��fii`{i�a�Y=T��s�V�i[JFY€� WI��1.1 f:IS Gk1��i�+��Ni�4#f ��!'E{if+'4L 13J10V 'IEfi�TII T HOLDERI Lf 3T 13 A ADDITIONAL INSURED � i0i�fs :ERTIFICATE 140LDER MONROE CIOUNTY 409 63 STREET" SUITE 140 ARAMN, FL 0 0 UR.RENCE Y �01 ago ffx n W.1anow) - A ADVIUJULIV 21001609 — 'COMBINED SINGLE Wir Acddont) (Farporn) {Peraccidan PIMPARTY DAMAGE (P-9rz=CdDn ALTM ONLY- r=A AOCfpm3r s THEItTI A M 0NLf; w�. w 11V �'A7L� 4- FACH Accimm 3 13E PL CANCELLATION S OLILOAt4 EA WI.Oi-BC PI]F.liC[E8I3 AlICE OBEFOR THEpilpi T1 tI t)A E P# y l$$ir tNa I IURER LL El1DF-AVOit TG t4AIL IDAya Wp i'I=t t'OT[cr=TOTHF-cEtmFWAT9 1113LD EmtmwTo Tm Lgpt,,cuir FAILURE7OODS013BALL IW08E 110 CIBUCATION OR IJABIL jY lujqD UPON THE INSURER, Ag WITS OR FtC�l�ii'�B. AMOMME RPREWMM� ]... f #r • F E f r 1 f holder Is art ADDITIONAL ' U R the OU I must bo on ��i 1•1htt nre fiisor, ee € cer l HMO 1101der In Him Of SUCK on dorsernent , 1f SUBROGAT ION !! WAIVED, ijJeCt tO file terms and con iltion of le olio certain cie 1-n #eqlir G �li1clor#�ti./11Jk�t• statial#ioilt Viy C��f+7 1ft4 L7�J �Lot L � i policies L4L� holder In Reel O such enr�er nt(s). a��r rights �� r��f� �e DECLAIMER ThO Cerl(fic8tOf Insurance on tha r var (3 81cle of this form dws not constitute the Issuing Insul er s , autjj0j.jz,3rj papresentsfive or produm, and the certif# at affirmatIvely or negativa[ r-amend, extend or after the cOvOmoe afforded by the � � 1icies listed thereon. i * r•.� f f '. * kI RI firr i +a .`• F ++ 4 f i —Tf 4. t; t;, !, B"t �4� 1 1UU# ��3.R�"jjr11 7i�+�. 4 +i��t rTit j•1 �j�'••R++��ne . - -''�* +-�r w,�•s!' .+it <� r. .F R.,, a +_.. `�• ,J'� R.w 3r! 1] +•• .l. f. .• + Y t * W if Y■ maw R�—!.__.J .+•w•,w }7t Jt �i3��—��r�� Y/Y+IIY "ice • +i M, I . -- MS....- OEM �: M: r IE&,' e11117"clio pi11es r-L PAC" R EN I AL S C12PjCC-ci AC. kmmfAy I# S RC 8 01 COVERAGE WAIL f, 00 u } : i • 1 I i D ��'� � rr� u . : 4 T A� Iris LIM SUITE 0 NSVI RE B. 01 URER 'LIRE � TANY HIS PCL[CfES OF INSURANCE LISTED OELOW 14AVE BEEN ISSUED T+1IUD NAMED ABDIf a�x € a=ANY �r e��ro �r�Jovr--Arv�rr f 1 Ai -� INSURANCE F ` ] p BY Tn-1 POLICIES Ljrz# 8 FZ.EIN f t ii PECr T WHCH VIS E Fl 1' B tS k1 ] jq .�atrarETr~�� tar�v r-nr �tr cr,It. t�, :�.sIrs vt or. srtr OLE: 5M. UABILUV � � M QhWCRCfAL CEN E RAI- LEU LW FQ4ENC 1112005 ,66� L M MADE OCCUR 11 s 10 MAL LIAO ,A=lt - fP�R Or=rxS"1�A R E3�4 LIMMAFPL�E P� R ffg s SUN 090 POUMV Lee ` Y A fiR COMBINED WNSUE WAIT HWULEn AM MAM LITo ON-O NrmAUTOs PROPERTMAMAM o G L(M[Lr N A O + `y ' # ++ r y.. + ii w x •,-! ► * �i� it w a t r CLAVAS MADE +5'Si # F ii y 11 V PY t R �^�an COUPENCATrG an Er PL.�}YERS$ It OILS LY �fi�- • ANY 0F1QP a WPAi� Rl arUTjV D'Ff E IEMBE REXCLUDw? Ea SAL A I! S ER .Lw 9 3 -- E FtO i R,. yR�`�■ r` i'.+r y�(�4■}*t'! +■ aa�� +F}�,! +1 J+ r}y�J}+�y; yA�3 LRWy}�i `J4� ]�•y�■r �i■.��{� ��•if+iiii�M�IA��\•I�TYM��TRY��1,4��iAii !`�y�/}�l �ijJ+1��}y; rT'1 1■��,., }��l �/.y/ �ii��i��.YF•#M1��.##��1■E ��.ay+C■ Ji iL-R IFI TE NOLDgm FA0NRO E -� 1q 1007198) AN BEI13ULUA Var-T iaABOVEf)rZOCRIS POr�Ct BE Art SLLEDaEFORETHE�IRA710N 1]AT� �� , THE laBUING INCUR R MLL ENUEAVOR TO WL DAYS WWMrj NOTICE TOM-: EFET1 M H OLDER J TC)E LMj BUT F URS TO 00 50 ML 'AflF00� P1 UGA'"ON Obi► Its P A?i1f IaNa Upotj -Ff]r- INS Ra , fi$ �'�� or, (3D PAS . • * :... r r� tille�'f��te as 11c�t co life r rig 11ts tO 110 ��l I � �� fL�,#�rQ47dr �� eu of such en dorsenj ell t(s). If B OGATION Is 1lwf I , subject to t119 terms ar1c, conditions c r y x'C l'l i 7 E3 'I 1 t c C policy, cC:l ]it� p t sIe may holcle' Ili Ifei, o U 6, llaorsem �� s . 0� v� confer rfgto tile certificate DISCLAIMER Tile Ciardficate of Insurenr tip �st�� r�� i#��r� ��ss��i�#� - onot constitute contract between � p�ar��sr, and (he certificate holder, nor does it affirmatively or sativ11, amend,:tGnr after the r'ovara,98 -- affOrded b#ate Policies Usbad tcraon. 0%i3R(� 11