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Certificates of Insurance DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 06/08/2022 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 Peter J Moon NAME: The Whitlock Group,Inc. p/cNr o Ext: (678)906-2008 a/c,No): (855)906-2012 3300 Breckinridge Blvd Ste 200 E-MAIL pmoon@twgins.net ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Duluth GA 30096 INSURERA: Travelers Indemnity Co.(IND) 25658 INSURED INSURER B: Travelers Casualty Ins Co ofAmerica 19046 THC Inc INSURER C: Travelers Property Casualty Co of America 25674 3300 Breckinridge Blvd.Suite 200 INSURER D: Travelers Casualty&Surety Co. 19038 INSURER E: Hiscox Insurance Company 10200 Duluth GA 30096 INSURER F COVERAGES CERTIFICATE NUMBER: CL226804130 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDreme $ 300,000 MED EXP(Any one person) $ 5,000 A Y Y 660-2C334829 06/15/2022 06/15/2023 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 4'000'000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y Y BA-1 N10529A 06/15/2022 06/15/2023 BODILY INJURY(Pe r accide nt) $ AUTOS ONLY AUTOS X HIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /� AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C EXCESS LAB CLAIMS-MADE CUP-2C19758A 06/15/2022 06/15/2023 AGGREGATE $ 4,000,000 DED I X1 RETENTION $ 51000 $ WORKERS COMPENSATION ER/� STATUTE EORH AND EMPLOYERS'LIABI LI TY Y/N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ D OFFICER/MEMBER EXCLUDED? ❑ N/A Y UB-1J362029 06/15/2022 06/15/2023 (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 $ ERRORS&OMISSION LIABILITY EACH CLAIM $5,000,000 E $50,000 Retention MPL1097786.22 06/15/2022 06/15/2023 AGGREGATE $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) (See attached Comments/Remarks page for coverage details) Risk Approve Monroe County Board of County Commissioners are named as additional insured with regard to general liability and automobile liability. Auto coverage is for non-owned/hired or borrowed vehicles.The Named Insured has NO OWNED vehicles. Workers Compensation includes the coverage for Florida. By- w . CERTIFICATE HOLDER CANCELLATION WANN KtkX""W._ SHOULD ANY OF THE AL_._ THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St. AUTHORIZED REPRESENTATIVE Key West FL 33040 �i roc�� `✓ ,���r��;, @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00000002 LOC#: ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED The Whitlock Group,Inc. THC Inc POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance:Notes ADDITIONAL COVERAGE DETAILS: "Blanket Additional Insured status is provided for General Liability for on-going and completed operations on primary and non-contributory basis when it is required by written contract with the named insured. "Blanket Additional Insured status is provided forAutomobile Liability when it is required by written contract with the named insured. "Blanket Waiver of Subrogation for General Liability,Automobile Liability and Workers Compensation is provided when it is required by written contract with the named insured. "Professional Liability is on a Claims Made basis with retroactive date of 01/24/1994.Retention is$50,000 each claim. "Umbrella or Excess Liability follows the form of and is excess over the underlying liability limits as shown in this certificate for general liability and for automobile liability. ""Auto coverage is for non-owned/hired or borrowed vehicles.The Named Insured has NO OWNED vehicles. CANCELLATION NOTICE:Insurer(s)will deliver a thirty(30)day written notice of cancellation or non-renewal to the Certificate Holder. "This certificate of insurance is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage,terms exclusions and conditions afforded by the policies referenced herein." ACORD 101 (2008/01) © 2008ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 06/15/2021 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 Peter J Moon NAME: The Whitlock Group Inc HCONN. Ext: (678)906-2008 a/c,No): (855)906-2012 3300 Breckinridge Blvd Ste 200 E-MAIL pmoon@twgins.net ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Duluth GA 30096 INSURERA: Travelers Indemnity Co.(IND) 25658 INSURED INSURER B: Travelers Casualty Ins Co ofAmerica 19046 THC Inc INSURERC: Travelers Property Casualty Co ofAmerica 25674 3300 Breckinridge Blvd.Suite 200 INSURER D: Travelers Casualty&Surety Co. 19038 INSURER E: Hiscox Insurance Company 10200 Duluth GA 30096 INSURER F COVERAGES CERTIFICATE NUMBER: CL2151703502 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 INSURANCEAUULbUbK POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDrence $ 300,000 MED EXP(Any one person) $ 5,000 A Y Y �6y60-2C334829 06/15/2021 06/15/2022 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: Npr(mv d Ge.sk aMa Irn� t WIt� �ltt hmentS GENERAL AGGREGATE $ 4,000,000 X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 4'000'000 JECT POTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y Y BA-1N10529A 06/15/2021 06/15/2022 BODI LY I NJ U RY(Pe r accide nt) $ AUTOS ONLY AUTOS X HIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /� AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C EXCESS LAB CLAIMS-MADE CUP-2C19758A 06/15/2021 06/15/2022 AGGREGATE $ 4,000,000 DED I X1 RETENTION $ 51000 $ WORKERS COMPENSATION X1 SPER TATUTE EORH AND EMPLOYERS'LIABI LITY Y/N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ D OFFICER/MEMBER EXCLUDED? ❑ N/A Y UB-1J362029 06/15/2021 06/15/2022 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1000000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , , ERRORS&OMISSION LIABILITY EACH CLAIM $5,000,000 E $50,000 Retention MPL1097786.21 06/15/2021 06/15/2022 AGGREGATE $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) (See attached Comments/Remarks page for coverage details) Monroe County Board of County Commissioners are named as additional insured with regard to general liability and automobile liability. Auto coverage is for non-owned/hired or borrowed vehicles.The Named Insured has NO OWNED vehicles. Workers Compensation includes the coverage for Florida. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St. AUTHORIZED REPRESENTATIVE Key West FL 33040 ,��/ . @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00000002 LOC#: ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED The Whitlock Group Inc THC Inc POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance:Notes ADDITIONAL COVERAGE DETAILS: "Blanket Additional Insured status is provided for General Liability for on-going and completed operations on primary and non-contributory basis when it is required by written contract with the named insured. "Blanket Additional Insured status is provided forAutomobile Liability when it is required by written contract with the named insured. "Blanket Waiver of Subrogation for General Liability,Automobile Liability and Workers Compensation is provided when it is required by written contract with the named insured. "Professional Liability is on a Claims Made basis with retroactive date of 01/24/1994.Retention is$50,000 each claim. "Umbrella or Excess Liability follows the form of and is excess over the underlying liability limits as shown in this certificate for general liability and for automobile liability. ""Auto coverage is for non-owned/hired or borrowed vehicles.The Named Insured has NO OWNED vehicles. CANCELLATION NOTICE:Insurer(s)will deliver a thirty(30)day written notice of cancellation or non-renewal to the Certificate Holder. "This certificate of insurance is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage,terms exclusions and conditions afforded by the policies referenced herein." ACORD 101 (2008/01) © 2008ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 06/05/2020 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 Peter J Moon NAME: The Whitlock Group Inc aCNNo Ext: (678)906-2008 IX No): (855)906-2012 3300 Breckinridge Blvd Ste 200 E-MAIL pmoon@twgins.net ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Duluth GA 30096 INSURERA: Travelers Property Casualty Cc of America 25674 INSURED INSURER B: Travelers Casualty Ins Cc of America 19046 THC Inc;THC Realty,Inc. INSURER C: Travelers Casualty&Surety Co. 19038 3300 Breckinridge Blvd.Suite 200 INSURER D: Hiscox Insurance Company 10200 INSURER E: Duluth GA 30096 INSURER F: COVERAGES CERTIFICATE NUMBER: CL206502978 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 INSURANCEADDLSUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE � OCCUR -PREMISES (Ea oNTE cur DAMAGE TO ance $ 300,000 MED EXP(Any one person) $ 10,000 A Y Y 660-2C334829 06/15/2020 06/15/2021 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X JECT LOC PRODUCTS-COMP/OP AGO $POLICY ❑ PRO 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y Y BA-1 N10529A 06/15/2020 06/15/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY X AUTOS ONLY Per accident X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 A EXCESS LIAB CLAIMS-MADE CUP-2C19758A 06/15/2020 06/15/21021 AGGREGATE $ 4,000,000 DED I X1 RETENTION $ 5,000 $ WORKERS COMPENSATION X1 SPER TATUTE EORH AND EMPLOYERS'LIABILITY Y/N 1,000,0 00 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ C OFFICER/MEMBER EXCLUDED? ❑ N/A UB-1J362029 06/15/2020 06/15/2021 (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 $ ERRORS&OMISSION LIABILITY EACH CLAIM $5,000,000 D $50,000 Retention MPL1097786.20 06/15/2020 06/15/2021 AGGREGATE $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) (See attached Comments/Remarks page for coverage details) Monroe County Board of County Commissioners are named as additional insured with regard to general liability and automobile liability. Auto coverage is for non-owned/hired or borrowed vehicles.The Named Insured has NO OWNED vehicles. Workers Compensation includes the coverage for Florida. CERTIFICATE HOLDER CANCELLATION DA 2 S 2 2 „ SHOULD ANY OF THI NW nV THE EXPIRATION DA Monroe County BOCC Insurance Compliance ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 100085-FX AUTHORIZED REPRESENTATIVE Duluth GA 30096t " ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00000002 f LOC#: AC401?L> ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED The Whitlock Group Inc THC Inc POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance:Notes ADDITIONAL COVERAGE DETAILS: *Blanket Additional Insured status is provided for General Liability for on-going and completed operations on primary and non-contributory basis when it is required by written contract with the named insured. *Blanket Additional Insured status is provided for Automobile Liability when it is required by written contract with the named insured. *Blanket Waiver of Subrogation for General Liability,Automobile Liability and Workers Compensation is provided when it is required by written contract with the named insured. "Professional Liability is on a Claims Made basis with retroactive date of 01/24/1994.Retention is$50,000 each claim. *Umbrella or Excess Liability follows the form of and is excess over the underlying liability limits as shown in this certificate for general liability and for automobile liability. **Auto coverage is for non-owned/hired or borrowed vehicles.The Named Insured has NO OWNED vehicles. CANCELLATION NOTICE:Insurer(s)will deliver a thirty(30)day written notice of cancellation or non-renewal to the Certificate Holder when it is required by written contract with the named insured. "This certificate of insurance is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage,terms exclusions and conditions afforded by the policies referenced herein." ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD From: pmoon@twgins.net To: monroecountyfl monroecountyfl@Ebix.com CC: Subject: 2020 Renewal COI(Liability) for THC, Inc. Date: 6/8/2020 1:43:52 PM Attachment(s): Good afternoon, Attached please find 2020 renewal Certificate of Liability Insurance for THC, Inc. Thank you, Pete.- /ffoolr, CIS R Insurance Services Sr.Account Executive/Operations Manager The Whitlock Group 3300 Breckinridge Blvd.,Suite 200 Duluth,GA 30096 Office:678-906-2008 ext.201 Toll-Free Fax:855-906-2012 pmoon@twgins.net OFFICE HOURS: 8:30 AM to 5:30 PM Monday through Friday To report a claim any time day or night, please go to our website,www.twgins.net/claims-billing,find your insurance carrier in the list and click on "report a claim". We are happy to provide CERTIFICATES of insurance or EVIDENCE OF PROPERTY insurance at your request,but we ask that you provide us 24 HOURS'notice. *COI without Certificate Holder's email address or fax number will be sent to the policyholder*If you have a RUSH request,please make sure you advise us and we will try to comply with your needs. Thank you IMPORTANT NOTICE: For your protection, coverage cannot be bound or changed via voicemail, email,fax or online via the agency's website, and it is not effective until confirmed directly with a licensed agent. CONFIDENT14LITY NOTICE: The content of this message and any file transmitted with it is a confidential and proprietary business commnnication,which is solely for the rise of the intended recipient/sj.any Ilse,distribution,chlplication or disclosure by any other person or entity zs strictly prohibited.If you are not an intended recipient or/hi.s has been received in error,please notify the sender and immediately delete all copies of this communication. AC CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 05/31/2019 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 Peter J Moon NAME: The Whitlock Group Inc PHONE HOON o,Ext): (678)906-2008 FAX No): (855)906-2012 3300 Breckinridge Blvd Ste 200 E-MAIL pmoon@twgins.net ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Duluth GA 30096 INSURER A: Travelers Property Casualty Co of America 25674 INSURED INSURER B: Travelers Casualty Ins Co of America 19046 THC Inc;THC Realty,Inc. INSURER C: Travelers Casualty&Surety Co. 19038 3300 Breckinridge Blvd.Suite 200 INSURER D: Hiscox Insurance Company 10200 INSURER E: Duluth GA 30096 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1953102513 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 ADDLSUBFF POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MM/DDIYYYY) (MMIDD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTE CLAIMS-MADE X OCCUR PREMISES(Ea occur ence) $ 300,000 MED EXP(Any one person) $ 5,000 A Y Y 660-2C334829 06/15/2019 06/15/2020 PERSONAL BADV INJURY $ 2'000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRO X POLICY 4,000,000 JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ • AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED BA-1N10529A 06/15/2019 06/15/2020 BODILY INJURY(Per accident) $ AUTOS ONLY -AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000'000 A EXCESS LIAB CLAIMS-MADE Y Y CUP-2C19758A 06/15/2019 06/15/2020 AGGREGATE $ 4,000,000 DED X RETENTION$ 5,000 $ WORKERS COMPENSATION X STATUTE OTH- ER AND EMPLOYERS'LIABILITY YIN 1 C ANY PROPRIETOR/PARTNER/EXECUTIVE NIA Y UB-1J362029 06/15/2019 06/15/2020 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 $ ERRORS&OMISSION LIABILITY EACH CLAIM $5,000,000 D $50,000 Retention MPL1097786.19 06/15/2019 06/15/2020 AGGREGATE $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) (See attached Comments/Remarks page for coverage details) Monroe County Board of County Commissioners are named as additional insured with regard to general lia i' re, (yipl ells ' i i BY EGLL NN ! )4 DATE CERTIFICATE HOLDER CANCELLATION WAIVER NiA. 22YES-- 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. • 1100 Simmonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 '• 6 Aka- ] ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD . • AGENCY CUSTOMER ID: 00000002 LOC#: AC®RD ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED The Whitlock Group Inc THC Inc POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 . FORM TITLE: Certificate of Liability Insurance:Notes ADDITIONAL COVERAGE DETAILS: 'Blanket Additional Insured status is provided for General Liability for on-going and completed operations on primary and non-contributory basis when required by written contract with the named insured. *Blanket Additional Insured status is provided for Automobile Liability when required by written contract with the named insured. `Blanket Waiver of Subrogation for General Liability,Automobile Liability and Workers Compensation is provided when required by written contract with the named,insured. 'Professional Liability is on a Claims Made basis with retroactive date of 01/24/1994.Retention is$50,000 each claim. 'Umbrella or Excess Liability follows the form of and is excess over the underlying liability limits as shown in this certificate for general liability and for automobile liability. "Auto coverage is for non-owned/hired or borrowed vehicles.The Named Insured has NO OWNED vehicles. CANCELLATION NOTICE:All policies contain the cancellation terms of 10 days notice prior to cancel date for non-payment of premium and 45 days notice prior to cancel date for any other reason.This is per the State of Georgia regulations. "This certificate of insurance is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage,terms exclusions and conditions afforded by the policies referenced herein." ACORD 101(2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC o ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DDIYYYY) kt....../- 06/06/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 Peter J Moon NAME: The Whitlock Group Inc PHONE (678) 906 - 2008 I FAX (855) 855 906 - 2012 (A /C, No, Ext): (A /C, No): 3300 Breckinridge Blvd Ste 200 E-MAIL DRE SS: pmoon @twgins.net AD INSURER(S) AFFORDING COVERAGE NAIC # Duluth GA 30096 INSURER A : Travelers Property Casualty Co of America 25674 INSURED INSURER B : Travelers Casualty Ins Co of America 19046 THC, Inc INSURER c : Travelers Indemnity Co. (IND) 25658 THC Realty, Inc INSURER D : Charter Oak Fire Ins Co 25615 3300 Breckinridge Blvd. Suite 200 INSURER E : Hiscox Insurance Company 10200 Duluth GA 30096 INSURER F : Admiral Insurance Company 24856 COVERAGES CERTIFICATE NUMBER: CL186602062 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 S W POLICY NUMBER UHH POLICY EFF POLICY EXP LIMITS LTR INSR VD (MM /DOIYYYY) (MM /DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO CLAIMS -MADE I X OCCUR PREMISES (Ea occurrence) $ 300,000 — MED EXP (Any one person) _ $ 5 _ A Y 660 - 20334829 06/15/2018 06/15/2019 pERSONALBADVINJURY $ 2, 00 0,0 00 GEN'L AGGREGATE LIMIT APPLIES PER _GENERAL AGGREGATE $ 4 PRO X POLICY LOC PRODUCTS $ 4 JECT _ _ OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY (Per person) $ B OWNED SCHEDULED BA 06/15/2018 06/15/2019 BODILY INJURY (Per accident) $ AUTOS ONLY _ AUTOS — X HIRED N ON -OWNED PROPERTY DAMAGE $ AUTOS ONLY X A UTOS ONLY (Per accident) - $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C EXCESSLIAB CLAIMS - MADE Y CUP 2C19758A 06/15/2018 06/15/2019 AGGREGATE $ 4,000,000 DED X RETENTION $ 5 �/ TA $ WORKERS COMPENSATION X STUTE I OTH AND EMPLOYERS' LIABILITY YIN 1,000 D ANY PROPRIETOR /PARTNER /EXECUTIVE I., NI UB - 1J362029 06/15/2018 06/15/2019 E.L EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1 , 0 0 0 , 0 0 0 If yes, describe under 1000000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ , , EACH CLAIM 5,000,000 ERRORS & OMISSION LIABILITY E $50,000 RETENTION MPL1097786.18 06/15/2018 06/15/2019 AGGREGATE 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) (See attached Comments /Remarks page for coverage details) Monroe County Board of County Commissioners are named as additional insured with regard to general liability and excess /umbrella liability. APPR VE RI 1 /NT BY t u.- -d3 !.. DATE - I ( -t - • CERTIFICATE HOLDER CANCELLATION WA,VR W YU_ 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. 1100 Simmonton Street AUTHORIZED REPRESENTATIVE Key West c c • t, r) (ince )-1 FL 33040 ✓ © 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ADDITIONAL COVERAGES Ref # Description Coverage Code Form No. Edition Date F CONTRACTORS POLLUTION LIABILITY - EACH CLAIM Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 10,000 SIR Ref # Description Coverage Code Form No. Edition Date F CONTRACTORS POLLUTION LIABILITY - GENERAL AGGREGATE Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 2,000,000 Ref # Description Coverage Code Form No. Edition Date DIRECTORS & OFFICERS LIABILITY - ALL CLAIMS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 2,000,000 10,000 Ref # Description Coverage Code Form No. Edition Date EMPLOYMENT PRACTICE LIABILITY - ALL CLAIMS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 2,000,000 10,000 Ref # Description Coverage Code Form No. Edition Date FIDUCIARY LIABILITY - ALL CLAIMS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 2,000,000 0 Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium OFADTLCV Copyright 2001, AMS Services, Inc. COMMENTS /REMARKS ADDITIONAL COVERAGE DETAILS: *Blanket Additional Insured status is provided for General Liability including completed operations when required by written contract with the named insured. This insurance is primary & non - contributory over other insurance available to the additional insured only when required by written contract with the named insured. *Blanket Waiver of Subrogation for general liability, automobile liability and workers compensation is provided when required by written contract with the named insured. *Professional Liability is on a Claims Made basis with retroactive date of 01/24/1994. Retention is $50,000 each claim. *Umbrella or Excess Liability follows the form of and is excess over the underlying liability limits as shown in this certificate for general liability and for automobile liability. *Employee Dishonesty coverage of $350,000 with Third -Party coverage is included on policy #106533282. Carrier: Travelers Casualty and Surety Company of America, NAIC # 31194 * *Pollution Liability is applicable to San Antonio project only and on a Claims Made basis with retroactive date of 12/1/2010. Limits of Liability are $1,000,000 per pollution incident /$2,000,000 aggregate, $15,000 deductible. * *Auto coverage is for non - owned /hired or borrowed vehicles. The Named Insured has NO OWNED vehicles. CANCELLATION NOTICE: All policies contain the cancellation terms of 10 days notice prior to cancel date for non - payment of premium and 45 days notice prior to cancel date for any other reason. This is per the State of Georgia regulations. "This certificate of insurance is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage, terms exclusions and conditions afforded by the policies referenced herein." OFREMARK COPYRIGHT 2000, AMS SERVICES INC. A� ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 06/06/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 PeterJ Moon NAME: The Whitlock Group Inc HO Ext): (678) 906 -2008 FAX X, No): (855) 906 -2012 3300 Breckinridge Blvd Ste 200 ADDEMAIL SS: pmoon @twgins.net RE INSURER(S) AFFORDING COVERAGE NAIC # Duluth GA 30096 INSURER Travelers Property Casualty Co of America 25674 INSURED INSURER B : Travelers Casualty Ins Co of America 19046 THC, Inc INSURER C : Travelers Indemnity Co. (IND) 25658 THC Realty, Inc INSURER D : Charter Oak Fire Ins Co 25615 3300 Breckinridge Blvd. Suite 200 INSURER E: Hiscox Insurance Company 10200 Duluth GA 30096 INSURER F : Admiral Insurance Company 24856 COVERAGES CERTIFICATE NUMBER: CL186602062 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 SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM /DD/YYYY) (MM /DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE 1 X OCCUR PREMISES SES (Ea occurrence) $ 300,000 MED EXP (Any one person) $ 5,000 A Y 660 - 26334829 06/15/2018 06/15/2019 PERSONAL &ADV INJURY $ 2.00 0,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY 1 JECT PRO- LOC PRODUCTS - COMP/OP AGG $ 4,0 00 '0 00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) - ANY AUTO BODILY INJURY (Per person) $ ' B OWNED SCHEDULED BA- 26154462 06/15/2018 06/15/2019 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS X HIR NON -D $ AUTOS ED ONLY X AUTOS OWNE PROPERTY DAMAGE ONLY (Per accident) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C EXCESS LIAB CLAIMS -MADE Y CUP- 2C19758A 06/15/2018 06/15/2019 AGGREGATE $ 4,000,000 DED 1 XI RETENTION $ 5,000 $ WORKERS COMPENSATION XI STATUTE I 1 ER H AND EMPLOYERS' LIABILITY Y / N 1,000, D ANY PROPRIETOR/PARTNER/EXECUTIVE I N N / A UB-1J362029 06/15/2018 06/15/2019 E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1, 0 00 ,000 If yes, describe under 1, DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ ERRORS & OMISSION LIABILITY EACH CLAIM 5,000,000 E $50,000 RETENTION MPL1097786.18 06/15/2018 06/15/2019 AGGREGATE 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) (See attached Comments /Remarks page for coverage details) APPROVED BY SK MANA , ■ / Monroe County Board of County Commissioners are named as additional insured with regard to general liability and excess/umbrella liability. � )/) / ,I/ J- DATE _ ` 4 • _J WAVER N/A4 YES 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. 1100 Simmonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 P. 6 4i �d 1 jJ © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/0 The ACORD name and logo are registered marks of ACORD ADDITIONAL COVERAGES Ref # Description Coverage Code Form No. Edition Date F CONTRACTORS POLLUTION LIABILITY - EACH CLAIM Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 10,000 SIR Ref # Description Coverage Code Form No. Edition Date F CONTRACTORS POLLUTION LIABILITY - GENERAL AGGREGATE Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 2,000,000 Ref # Description Coverage Code Form No. Edition Date DIRECTORS & OFFICERS LIABILITY - ALL CLAIMS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 2,000,000 10,000 Ref # Description Coverage Code Form No. Edition Date EMPLOYMENT PRACTICE LIABILITY - ALL CLAIMS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 2,000,000 10,000 Ref # Description Coverage Code Form No. Edition Date FIDUCIARY LIABILITY - ALL CLAIMS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 2,000,000 0 Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium OFADTLCV Copyright 2001, AMS Services, Inc. COMMENTS /REMARKS ADDITIONAL COVERAGE DETAILS: *Blanket Additional Insured status is provided for General Liability including completed operations when required by written contract with the named insured. This insurance is primary & non - contributory over other insurance available to the additional insured only when required by written contract with the named insured. *Blanket Waiver of Subrogation for general liability, automobile liability and workers compensation is provided when required by written contract with the named insured. *Professional Liability is on a Claims Made basis with retroactive date of 01/24/1994. Retention is $50,000 each claim. *Umbrella or Excess Liability follows the form of and is excess over the underlying liability limits as shown in this certificate for general liability and for automobile liability. *Employee Dishonesty coverage of $350,000 with Third -Party coverage is included on policy #106533282. Carrier: Travelers Casualty and Surety Company of America, NAIC # 31194 * *Pollution Liability is applicable to San Antonio project only and on a Claims Made basis with retroactive date of 12/1/2010. Limits of Liability are $1,000,000 per pollution incident /$2,000,000 aggregate, $15,000 deductible. * *Auto coverage is for non - owned /hired or borrowed vehicles. The Named Insured has NO OWNED vehicles. CANCELLATION NOTICE: All policies contain the cancellation terms of 10 days notice prior to cancel date for non - payment of premium and 45 days notice prior to cancel date for any other reason. This is per the State of Georgia regulations. "This certificate of insurance is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage, terms exclusions and conditions afforded by the policies referenced herein." OFREMARK COPYRIGHT 2000, AMS SERVICES INC. ACORD® �� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 6/5/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER The Whitlock Group Inc 3300 Breckinridge Blvd Ste 200 Duluth GA 30096 CONTACT Peter J Moon NAME: FAX, PHONE Ex, (678) 906-2008 1 FAX (e55)906-2012 No AIL ADORESS:pmoon@twgins.net INSURE S AFFORDING COVERAGE NAIC 0 INSURERA:Travelers Property Casualty Co of 25674 INSURED THC Inc THC Realty Inc 3300 Breckinridge Blvd. Suite 200 Duluth GA 30096 INSURERB:Travelers Casualty Ins CO of 19046 INSURERC:Travelers Indemnity Co. (IND) 25658 INSURER D :Charter Oak Fire Ins Cc 25615 INSURERE:HiSCOX Insurance Company 10200 1 INSURER FAdmiral Insruance Company 24856 COVERAGES CERTIFICATE NUMBER:CL176501663 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I�TR TYPE OF INSURANCE AD L UBR POLICY NUMBER MNOVLDIDYlYYYY MNVDD� LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7X1 OCCUR EACH OCCURRENCE $ 2,000,000 DAMAGE To RENTED PREMISES Ea occurrence $ 300,000 X MED EXP (Any one person) $ 5,000 Contractual X 660-2C334829 6/15/2017 6/15/2018 X Subcontracts, Indep cont PERSONAL BADVINJURY $ 2,000,000 GENI AGGREGATE LIMIT APPLIES PER X POLICY ❑ PROJECT F7 LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMPIOPAGG $ 4,000,000 Damage to Premises Renter to $ 300,000 OTHER. AUTOMOBILE LIABILITY COM IN IN L UMIT Ea accident S 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BA-2C154462 6/15/2017 6/15/2018 BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ E UMBRELLA UAB N OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE E 4,000,000 C X EXCESS LIAB CLAIMS -MADE DIED I X I RETENTIONS 5,000 y X CUP-2C19758A 6/15/2017 6/15/2016 WORKERS COMPENSATION ER OTH- D AND EMPLOYERS' LIABILITY Y 1 N ANY PROPRIETORIPARTNER/EXECUTIVE --I OFFICEWMEMBER EXCLUDED? N ; (Mandatory In NH) N / A UB-1J362029 6/15/2017 6/15/2018 STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 3 1,000,000 R yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT f 1,000,000 E Errors. Omissions Liability MPL3097786.17 6/15/2017 6/15/2018 EACH CLAIM 5,000,000 F Pollution Liability** FEI-ECC-17258-04 06/15/2017 06/5/2018 EACH INCIDENT 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) (See attached Comments/Remarks page for coverage details) Monroe County Board of County Commissioners are named as additional insured with regard to oral liability and excess/umbrella liability. APPRO M G NT D W 6i I.CK 111-II.A 1 C 11UL.UGK l;ANUtLL.A I tUN - - -- - -- DeGraw-Donald@monroecounty Monroe County Board of County Commissioners 1100 Simmonton Street 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 Whitlock, CIC, CRMf ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (204101) The ACORD name and logo are registered marks of ACORD INS025 mm,lnn / C-L. , 14.t COMMENTS/REMARKS ADDITIONAL COVERAGE DETAILS: *Blanket Additional Insured status is provided for General Liability including completed operations when required by written contract with the named insured. This insurance is primary & non-contributory over other insurance available to the additional insured only when required by written contract with the named insured. *Blanket Waiver of Subrogation for general liability and for workers compensation is provided when required by written contract with the named insured. *Professional Liability is on a Claims Made basis with retroactive date of 01/24/1994. Retention is $50,000 each claim. *Umbrella or Excess Liability follows the form of and is excess over the underlying liability limits as shown in this certificate for general liability and for automobile liability. *Employee Dishonesty coverage of $250,000 with Third -Party coverage is included on policy#105042619. Carrier: Travelers Property Casualty Insurance Company **Pollution Liability is applicable to San Antonio project only and on a Claims Made basis with retroactive date of 12/l/2010. Limits of Liability are $1,000,000 per pollution incident/$2,000,000 aggregate, $15,000 deductible. **Auto coverage is for non-owned/hired or borrowed vehicles. The Named Insured has NO OWNED vehicles. CANCELLATION NOTICE: All policies contain the cancellation terms of 10 days notice prior to cancel date for non-payment of premium and 45 days notice prior to cancel date for any other reason. This is per the State of Georgia regulations. "This certificate of insurance is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage, terms exclusions and conditions afforded by the policies referenced herein.'' OFREMARK COPYRIGHT 2000, AMS SERVICES INC. I CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDfYYY) 6/5/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED "RESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. -.?ORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Peter J Moon NAME: The Whitlock Group Inc PHONE (678) 906-2008 FAC No: (855)906-2012 3300 Breckinridge Blvd Ste 200 E-MAIL ADDRESS:p wgmoon@tins.net Duluth GA 30096 INSURERA:Travelers Property Casualty Cc of 25674 INSURED INSURERB:Travelers Casualty Ins Co of 19046 THC Inc INSURERC:Travelers Indemnit Co. (IND) 25658 THC Realty Inc INSURERD:Charter Oak Fire Ins Co 25615 3300 Breckinridge Blvd. Suite 200 INSURERE:Hiscox Insurance Company 10200 Duluth GA 30096 INSURERF:Admiral Insruance Company 24856 COVERAGES rFRTIFIr ATF NIIMRFR•CL176501663 0F11ICInAI IVIIl1ADCD- 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/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 X MED EXP (Any one person) $ 5,000 Contractual X 660-2C334829 6/15/2017 6/15/2018 X Subcontracts, Indep cont PERSONAL BADVINJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO ❑ LOC JECT GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 Damage to Premises Renter to $ 300,000 OTHER: NUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BA-2C154462 6/15/2017 6/15/2018 BODILY INJURY Per accident ( ) $ X NON -OWNED HIRED AUTOS N AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB N OCCUR EACH OCCURRENCE $ 4,000,000 X AGGREGATE $ 4,000,000 C EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ 5,000 $ X CUP-2C19758A 6/15/2017 6/15/2018 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) H yes, describe under SCRIPTION OF OPERATIONS below DE N / A UB-1J362029 6/15/2017 6/15/2018 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE9 $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1 000,000 E Errors& Omissions Liability MPL1097786.17 6/15/2017 6/15/2018 EACH CLAIM 5,000,000 F Pollution Liability** FEI-ECC-17258-04 06/15/2017 06/5/2018 EACH INCIDENT 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) (See attached Comments/Remarks page for coverage ails Monroe County Board of County Commissioners areed ad i al insured w'r _ EAP liability and excess/umbrella liability. ED SKM E W N .SUN 19 2017 _ i t'FRTIFIf_aTF Hrll IIFR f`AAIf`CI I ATIn AI Ci\ DeGraw-Donald@monroecounty SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simmonton Street AUTHORIZED REPRESENTATIVE Key West, FL 33040 tC, " G Whitlock, CIC, CRM/��- U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 rgmann COMMENTS/REMARKS '`DDITIONAL COVERAGE DETAILS: Blanket Additional Insured status is provided for General Liability including completed operations when required by written contract with the named insured. This insurance is primary & non-contributory over other insurance available to the additional insured only when required by written contract with the named insured. *Blanket Waiver of Subrogation for general liability and for workers compensation is provided when required by written contract with the named insured. *Professional Liability is on a Claims Made basis with retroactive date of 01/24/1994. Retention is $50,000 each claim. *Umbrella or Excess Liability follows the form of and is excess over the underlying liability limits as shown in this certificate for general liability and for automobile liability. *Employee Dishonesty coverage of $250,000 with Third -Party coverage is included on policy#105042619. Carrier: Travelers Property Casualty Insurance Company **Pollution Liability is applicable to San Antonio project only and on a Claims Made basis with retroactive date of 12/1/2010. Limits of Liability are $1,000,000 per pollution incident/$2,000,000 aggregate, $15,000 deductible. **Auto coverage is for non-owned/hired or borrowed vehicles. The Named Insured has NO OWNED vehicles. CANCELLATION NOTICE: All policies contain the cancellation terms of 10 days notice prior to cancel date for non-payment of premium and 45 days notice prior to cancel date for any other reason. This is per the State of Georgia regulations. "This certificate of insurance is issued as a matter of information only and confers no ights upon the certificate holder. This certificate does not amend, extend or alter the .overage, terms exclusions and conditions afforded by the policies referenced herein.'' OFREMARK COPYRIGHT 2000, AMS SERVICES INC. '