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Certificates of Insurancells. O CERTIFICATE OF LIABILITY INSURANCE[9,DATE 13120M/DD/YYYY) 13/2012 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 endorsements . U014011114. I, PRODUCER eOCINtI9g OeveloCT STA, a Division of Oswald Companies Fxnent 3401 Enterprise Parkway, Suite 101 Beachwood OH 44122 SEA1� '. NTA NAME: Patricia Cholewa PHONE FAX No EMAIL ADDREss: INSURERS AFFORDING COVERAGE NAIC # INSURER A flartford Casualty Ins, Co. 29494 TIME: _ INSURED M _ B�` F. INSURER B:Hudson Specialty Insurance Co. 25054 INSURER C : mbi-k2m Architecture, Inc. Spectrum Design Services Inc. 1001 Whitehead St., Suite 101 INSURER D : Key West FL 33040-7522 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 15600000 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR UBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYW LIMITS A GENERAL LIABILITY Y Y 45SBA107008 /14/2012 /14/2013 EACH OCCURRENCE $1,000,000 X MMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 CLAIMS -MADE El OCCUR tAll Ap E I •C M A MENT MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 Xrimary & BY WAIVER- A YES X Non -Contributory GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 $ POLICY X PRO- X LOC A AUTOMOBILE LIABILITY Y Y 45SBA107008 /14/2012 /14/2013 COMBINED SINGLE LIMI T Ea accident) $1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIREDAUTOS X AUTOS X $ Al Primary A X UMBRELLA LIAB X OCCUR Y 45SBA107008 /14/2012 /14/2013 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 EXCESS LIAB CLAIMS -MADE DIED X I RETENTION$10,000 Excludes Professional $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N Y 45SBA107008 /14/2012 /14/2013 VJC gySTATU- X OTH- 1 ER OH -STOP GAP ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ N / A E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) E L DI5EA C - EA EMPLOYEE $1,000.000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 B Professional Liability N Y EE7204505 /13/2012 /13/2013 Each Claim $3,000,000 Claims Made Aggregate $3,000,000 Retro Date: 9/1/2001 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured by written contract or agreement. Project: Marathon Customs Terminal Mk-11118 CERTIFICATE HOLDER CANCELLATION Monroe County Attn: Ann M. Riger 1100 Simonton Street, Room 2-216 Key West FL f33040 C' 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 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/13/2012 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 endorsements . PRODUCER ractrmet ��county n� STA, aDivision of Oswald CompaniesFA 3401 Enterprise Parkway, Suite 101 Beachwood OH 44122 SEP � � CNAMEN AC' Patricia Cholewa PHONE 6. - - A/C No : - E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:HarffOrd Casualty Ins, Co. 29424 frME: INSURED Y. INSURER B INSURER C : mbi-k2m Architecture, Inc. INSURER D : Spectrum Design Services Inc. 1001 Whitehead St., Suite 101 Key West FL 33040-7522 ~ INSURER E : ,--- INSURER F COVERAGES CERTIFICATE NUMBER: 7441138720 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 I LTR TYPE OF INSURANCE ADDL INSR UBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY Y Y 45SBA107008 /14/2012 /14/2013 EACH OCCURRENCE $1,000,000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $10,000 CLAIMS -MADE IT] OCCUR NX:A:l PERSONAL & ADV INJURY $1,000,000 Primary & AP V BY DA X Non -Contributory GENERAL AGGREGATE $2,000,000 W GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 $ POLICY X PRO- X LOC JECT A AUTOMOBILE LIABILITY Y Y 45SBA107008 /14/2012 /14/2013 Ea accident$1,000,000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ $ X Al Primary A X UMBRELLA LIAB X OCCUR Y Y 45SBA107008 /14/2012 /14/2013 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 EXCESS LIAB CLAIMS -MADE —I.E. X I RETENTION$10,000 Excludes Professional $ A WORKERS COMPENSATION Y 5SBA107008 /14/2012 /14/2013 WC STATU- X OTH- FR OH -STOP GAP AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? a (Mandatory in NH) N / A E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below I B Professional Liability Claims Made N Y AEE7204505 /13/2012 /13/2013 Each Claim $3,000,000 Aggregate $3,000,000 Retro Date: 9/1/2001 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured by written contract or agreement. Project: Marathon Customs Terminal Mk-11118 rFRTIPIrATF I-Inl nFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ann M. Riger 1100 Simonton Street, Room 2-216 Key West �FQ L 33040 AUTHORIZED REPRESENTATIVE 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD , 6MlDD1YYYY} CERTIFICATE OF LIABILITY INSURANCE[4/012/2013 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 13Y THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS►, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditlons 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 end_orsement(s). PRODUCER I LUAYRLT Suite 101 OH 44122 INSURED MBIK2-1 mbi-k2m Architecture, Inc_ Spectrum Design Services Inc. 1001 Whitehead St., Suite 101 Key West FL 33040-7522 INSURER 8: INSURER C : INSURERO: -- INSURER E: COVERAGES CERTIFICATE NUMBER: 161297152 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 NTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE: BEEN REDUCED BY PAID CLAIMS, INSR TYPE OF INSURANCE ADpL POLICY NUMBER POLICY EPF re"EYJww LIMITS GENWALLIABILITY Y Y 45SBA107OD8 911412012 /14/2013 EACH OCCURRENCE $1 ( COMMERCI OWERALLIABILIIY CLAIMS4A O4 El OCCUR Al Primary 8 V D ISK jA_ S1 MEDEXP arts ;1 ( PERSONAL a ADV INJURY it ( Non -Contributory GENERAL AGGREGATE $1 AGGREGATE LIMITAPPLIES PER: PRODUCTS - COMP/OP AGG Si GEN'L - POLICY X PRO. LOC ; AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS Y Y 45SBA)07008 311412012 /14/2013 1 GODLY INJURY (Par person) S BODILY IWURY(Per aaddern) S K HIRED AUTOS X NON-OMEDTOS PROPERTY DAMAGE s K Al Primary ; K UM8RELLALIAa X OCCUR Y r 45SBAIOTOOB 1412012 114/2013 EACH OCCURRENCE AlEXCESS W AGGREGATE 11 LIAR CLAIMS -MADE WORKERS COMPENSATION Y 5SBA107008 /1412012 ill412013 WC STATII X OTH- ANO EMPLOYERS' LIASILrtY Y / N OH -STOP ANY PROPRIETORIPARTNERIEXECUTIVE OFFICE"EMSER EXCLUDED? rN7 NIA E.L EACH ACCIDENT $1 000 000 (Mend.twy In NH) n yes E.L DISEASE • EA EMPLOYE ;1 000 000 DESCdeecbe under E.L OF OPERATIONS below E,L, DISEASE -POLICY LIMIT S7 LRD 000 ProfesSional Liability N Y �EE7204506 411312013 113/2014 EaCh Clakn $3.000.000 Claims MWe Aggregate $3,000.000 Ratro Date: 9/1/2001 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addklonel Rfm■rk■ Schedule, R mon apse* w requwad) ldditional Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured by written contract or agreement. ?roiect: Marathon Customs Terminal Mk-11118 Monroe County Attn: Ann M. Riger 1100 Simonton Street, Room 2-216 Key West FL 330Q SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 9E CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ROFR90ENTATIVE �w• /l �%E.Clrr't� 01888-2010 ACORD CORPORATION. All rights reserved, ACORD 25 (20,W05) The ACORD name and logo are registered marks of ACORD GC.-:JL� ACCORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/12/2013 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 endorsements . PRODUCER y� Oswald Companies 0t'� 60 CONTACT NAME: PHONE - - A/C No : - - 3401 Enterprise Parkway, Suite 101 toeCex0e E-MAIL ADDRESS: Beachwood OH 44122d(° Oe� �C\ 0S T®N INSURERS AFFORDING COVERAGE NAIC # URER A :Hartford Casualty Ins. Co. 29424 �,i) INSURED MBIK2-1 L�,S B:HUdSOn Specialty Insurance Co. 25054 INSURER C : mbi-k2m Architecture, Inc. INSURER D : Spectrum Design Services Inc. INSURER E : 11 Whitehead St., Suite 101 � Key West FL 33040 522 ;err INSURER F : COVERAGES CERTIFICATE NUMBER: 236037888 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR UBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE KIOCCUR X AI Primary & Y Y 45SBA107008 ^ V W ] / /14/2012 /14/2013 EACH OCCURRENCE $1,000,000 DAMAGE TO PREMISES Ea occu RENTED nce $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 X No, GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY X PRO- X LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON OWNED X HIRED AUTOS X AUTOS X Al Primary Y 45SBA107008 /14/2012 /14/2013 Ea accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y 45SBA107008 /14/2012 /14/2013 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 DED X I RETENTION$10,000 Excludes Professional $ A WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) ti yes, describe under DESCRIPTION OF OPERATIONS below N / A y 5SBA107008 /14/2012 /14/2013 11 WC STATU- X OTH- OH -STOP GAP E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT J $1,000,000 B Professional Liability Claims Made Retro Date: 9/1/2001 N Y EE7204506 /13/2013 /13/2014 Each Claim $3,000,000 Aggregate $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured by written contract or agreement. Project: Marathon Customs Terminal Mk-11118 Monroe County Attn: Ann M. Riger 1100 Simonton Street, Room 2-216 Key West FL 33040 Cc �� UANkor-LLA 1 IUN 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 rd.olz' 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD tHUMA 40 Payroll Nang Reaarcas trMit Mlanagnront 9501 UNION CEMETERY ROAD LOVELAND, OH 45140 PHONE (513) 605-3522 a r e FAX (513) 605-3523 Bata111ts MBI/K2M ARCHITECTURAL and HUMACare, Inc.- Consolidated Employee Management have entered into a co -employer / PEO relationship in which HUMACare Inc. assumes workers' compensation liability under the certificate attached. Questions regarding the certificate and/or the liability relationship should be directed to the Risk Management Department, 513-605-3522. Bureau of Workers' Ohio Compensation Columtw3o s, SpringOH 43215 Certificate of Premium Payment This certifies the employer listed below has paid into the Ohio State Insurance Fund as required by law. Therefore, the employer is entitled to the rights and benefits of the fund for the period specified. For more Information, call 1400-OHIOBWC. This certificate must be conspicuously posted. Policy No. and Employer Period Specified Below 1349248 ohiotw✓acom HUMACARE 9501 UNION LOVELAND, ' 1' "n4qThru 8r31l2013 MGT INC You can reproduce this certificate as needed. Ohio Bureau of Workers' Compensation Required Posting Effective Oct. 13, 2004, Section 4123.54 of the Ohio Revised Code requires notice of rebuttable presumption. Rebuttable presumption means an employee may dispute or prove untrue the presumption (or belief) that alcohol or a controlled substance not prescribed by the employee's physician is the proximate cause (main reason) of the work -related injury. The burden of proof is on the employee to prove the presence of alcohol or a controlled substance was not the proximate cause of the work -related injury. An employee who tests positive or refuses to submit to chemical testing may be disqualified for compensation and benefits under the Workers' Compensation Act. �j �q Bureau of Workers' V d io Compensation You Mr mu this IWV"p WIM m. «Kann of premwn pwfmenL c✓c I CERTIFICATE OF LIABILITY INSURANCE I �,°af , .. °""Y" THIS CERTIFICATE M ISSUED AS A MATTER OF INFORMATION ONLY AND CONIFERS NO 1111611 111 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 NSURER(S). AUTHOROW REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT., if the ar-11 P - holder is an ADDITIONAL INSURED, the poaey(les) must be slRdorssA If SUBROGATION IS WAIVED, subject to on lanrRs end Gw"lllons of tlls POIDy, certain Poftw Dry require w endowed- - - A sesarrrsnt on tlds c rtlseabs doss not cc in rWft to the PRODUCIR The James B. Oswaldcamerw 1100 SUperlor venue.StM1600 1 Cleveland OH 44114 Mesa) 1001WFRltehead St, l Ite 101 Key West FL 33040.7522 COVERAGES MBIK2-1 CERTIFICATE UHURFR--Yn-2,2a",2A eMnavw U Immos. THIS B TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED -NAMED -ABOVE-FOR- IM POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOIAREIENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THINS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES. LIMITS SHONM MAY HAVE BEEN REDUCED BY PAID CLAIMS. rx rnEOF RANcx Lash GNUMALLUUmuTY Y Y 468BAIO7= 4R013 W14AM4 EMNOCCUR&NCE $1 X COMMERCIAL GENERAL UASKnY QmwAw To KEW=1 CWMFMIOE FX7 OCCUR M D EXPJArV AirSIOAM X Al PrImyd PMV0 AL&ADVUWRY fi x r OENEIALAOORrG11TE OENL ADOREGATE UKT APPLIES PER: PRODUCTS-COMMOP AGO FR7 M §F1 Loc i A A romonu LIASKTTr Y Y 4LI M0700i WIV2013 W14=14 simuw ANY AUTO fODLY SN AIRY ww Pa ) f ALL AUTO � SDOLy winY (Pw omm" i FIREDAUTOS' qAUTOS f AlPdmary i X UNLtall.ALIAN N OCCUR Y Y 4E811AIOl00i 4/2M3 AIrM4 EACH OCCURRENCE i1,000,000 Vrim LIAS C<ASN{ ANAOE F AGSREGATE i1.000,000 X I W71IRMNS10.000EmkduMokWm f wO�ISrb1IPEa11 AND EIPLOYLwa' LIABILITY YIN Y 0700f 4=3 4=14 X ClWOPGAP NIA ANY PROM N E.L. EACH ACCIDENT SIAWJMO =dnalb, undw El- DISEASE -EA it EL DNIEASE- PDUCY LUT 1 RIPTION OF TIONG bd, B I'- " a * LN�w N Y 3=3 3=4 E=h CWm 51,000,OOD RNm Daw W1r1001 AgWvgmb i1.000.000 - SEWRPY ON OF OPEIATIMN I LOCATIONS I VElWM CANNA ACOIID 10I, Ad*@=d Rwmft SdmduN, N ■en 4w b q- Addand Waiver of Subrogation as designated Strove is provided When reW Natrrle� Irmured by written amtrad or ��rereftioommneeerrllIttInsured • Marattwn Airport Custorne and Border. MIF13008 By Gam DA W Monroe Attn Ann M. 1100 SkrlonlOn Street, Room 2-216 Key West FL =M sHIouLD ANY of THE AaovE OEscAIB�N�n BE MI THE ExPIRATIDN DATE TFIMlBDF. BE ACCORDANCE WITH THE POLICY PROYIBIOHM, cn r-1 AUTHORQSD MENNU 9NTATIVE O 1YS/-MO ACORD CORPORAIM. AN dqrS ano "Pao in MVMWFW UNWlii OR M WKU C� .. CD -- -- C.l1 ACC)RV CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYI) 4/15/2014 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 endorsements . PRODUCER The James B. Oswald Company CONTACT NAME.Paldcia Cholewa FAX PHONE E2a);216-839-2807 A/C No):216-839-2815 ADDRIESS: 1100 Superior Avenue, Suite 1500 Cleveland OH 44114 INSURERS AFFORDING COVERAGE NAIC # INSURER AflartfOrd Casualty Ins- Co. 2Q494 INSURED MBIK2-1 INSURER B INSURER C : K2M Design 1001 Whitehead St., Suite 101 Key West FL 33040-7522 INSURER D : INSURER E : INSURER F : r.r•vc�r�u w u�oon. L;UVt_KAbt0 %,GM • .--. V rvvvJ.- 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. OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD /14/2013 POLICY EXP MM/DDIYYYY LIMITS /14/2014 EACH OCCURRENCE $1,000,000 ITY AL GENERAL LIABILITY Y Y 5SBA107008 r DAMA ET RENTED PREMISES Eaoccurrence $1,000,000 MED EXP (Any one person) $10,000 S-MADE � OCCUR W PERSONALBADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 ibutory PRODUCTS - COMP/OP AGG $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X PRO- X POLICY LOC $ A LIABILITY Y 45SBA107008 /14/2013 /14/2014 Ea accident$1,000,000 BODILY INJURY (Per person) $ OOMOBILE ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS X AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident)$ $ Al Primary A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS MADE Y Y 45SBA107008 /14/2013 /14/2014 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 Excludes Professional X OTH- wC STATU- ly OH -STOP GAP A NIA Y 45SBA107008 /14/2013 /14/2014 DED I X RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUD D? (Mandatory in NH) If yes, descrbe under DESCRIPTION OF OPERATIONS below _Ry$ E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 B Professional Liability Claims Made N Y AEE7204506 /13/2013 /12/2014 Each000 Aggregate $3,000,000 Retro Date: 9/1/2001 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the Named -Insured by written contract or agreement. Marathon Airport Customs and Border. Mk-13008 W _ IQ Monroe County Attn Ann M. Riger 1100 Simonton Street, Room 2-216 Key West FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE .• ft ^^A^ A^^r M r%nonn0A71AAI All rinhfa racarvarl ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1�+q, CERTIFICATEF LIABILITY INSURANCE DATE'(MMIDDYYYYI L.6/19/2014 THIS CERTIFICATE IS ISSUED.AS' A MATTER OF INFORMATION ONLY AND CONFERS: NO RIGHTS UPON THE CERTIFICATE HOLDER: THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND` OR ALTER THE COVERAGE AFFORDED ;BY THE POLICIES BELOWW THIS: CERTIFICATE: OF INSURANCE DOES NOT CONSTITUTE':. A CONTRACT BE ,TtiE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCERS AND.THE CERTIFICATE HOLDER.. IMPORTANT: If theicertificate holder is an ADDITIONAL, INSURED, the policy(ies) must;be endorsed. If SUBROGATION IS WAIVED, subJect.to. thca terms and condltions Of the policy;. certain policies may require an :endorsement. A statemont on thiscertificate does not confer rights. to the certificate holder in lieu of such endorsements . PRODUCER The; lames B`..Oswaltl Company: 1100 Superior Avenue,, Suite 1500 Cleveland OH 44114 NAME: Patdcia_Cholewa__. PHONE e�t)215�.392$ a�.N�2lla 8.3129,8 EMAIL ADQREss•OCho(dwaooBwaldcpmpanies com INSURERS APFORDINGCOVERAGE - NAIC tF INSURER'A:HertfO.LC�CrsiSltiLt}L(DS._0:�iZ... _...,__.. INSURED �j1K K2M Design 1001 Whitehead St:, Suite 101 Key West FL 33040-7522 INSURERe: � XL. �R�s*ialt}�In;�-t�t�L)�e�.�Q�-_......._....._.... . INSURER'C: .._ _ _....... _.__ INsuRERD: _ INSURERS: INSURER F : COVERAGES`' CERTIFICATE NUMBER: 1 d')')7A7.r,RS; 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. NO ANITHSTANDING,ANY REQUIREMENT, TERM OR CONDITION OF:ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO: WHICH.THIS CERTIFICATE MAY':BE ISSUED OR MAY PERTAIN, THE INSURANCE. AFFORDED BY THE POLICIES OESCRIBEO: HEREIN. IS SUBJECT TO ALL THE TERMS, EXCLUSIONS'AND CONDITIONS &SUCH POLICIES; LIMITS. SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF'INSURANCE AUUU INSR WV POLICYNUMBER POLICY EFP.. `MUM Y _ - LIMITS A r ix GENERALLIABILITYI w ' i_. GENERAL LIABILITY CLAIMS MADEX OCCUR Y Y 45SBAIO700k 4/14/2013 114)2014 - EACH OCCURRENCE 51,000;000 .DA;M GT70TE -'N3 ti1SECOMMERCIAL S(Eacccurrercal S 1 000 000 MEB EXP (FXP (Anna perscn) { $10 000 PERSONAL & AOV INJURY' 51 000,000 (^ Al Primary.&. —1 NonContributnry. _ 52,000,000 i_GFNERALAGGREGATE i j GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO00 S2 0;000 1 POLICY x i PRO �? LOG. I ....... $ ..__...... A AUTOMOBILE _. LIABILITY j Y�45,111A*711011-, /14l2013 9t1412014 LE-11,cgm -1 6 1 000 000 BODILY INJURY (Per perspn) S x ANY.AUTO ALLOWNEO SCHEDULED RUTOS i_AUTOS-.. AUTOS IX NON -OWNED NIREDAUT05 AUTOS- t I i I I ...... BODILY INJURY (Per accident) ....:._ _ - S PROPERTY DAMAGE Paracc�dent);,�� 5 s x Al Primary ( A X UMBRELLALIAe X ; OCCUR Y F (45SBA10700$ 114t2013 }(14h20.14 EACH OCCURRENCE ' $1,000,000 AGGREGATE $1,000,000 EXCESS UAS CLA!"A5-MADE ; i DED ! X RETENTION S10.000 Excludes Professional S. A WORKERS COMPENSATION , AND EMPLOYERS' UAStulyA5SBA107005 ANY PROPRiETORIPART'NEfLEXECUTIVE YIN OFFICERIMEMBER EXCLUDED?. a (Mandatory In NH) NIA Y i I (14l2013 01141..2014 ThC STATU- X 'IO H- L OH -STOP GAP L. E L. EACH ACCIDENT 000 51 000,000 _..._._._. El. OiSFA'SE EA EMPLOYE ..si $1,000,006 If y es, dasvibe under DESCRIPTION OF OPERATIONS below i I E:L. DISEASE - POLICY LIMIT $1,000,000 B Professional Uablity Claims Made I N1 Y PPR9716562 112{2014 5E1212015 I 'Each Claim $3,000.000 ;Aggregate $3,000;000. 'Retro Date: 9(112001 I I i Pollufion & Envir.. Liab, Included DESCRIPTION OF OPERATIONS/ LOCATIONS!.VEHICLES (Attach ACORD 101;:Addillanal Remarks $chedula JI'more space I Additional Insured and Waiver of S,u..brogation as designated above is provided when r Uir d e Named Insured by written contract or agreement: APPR G E Marathon Airport Customs and Border; Mk-13008 Y 1 Y WAIVE N/ �YEP _ 1 • a�3 ' �,� SHOULD ANY OF THE ABOVE .DESCRIBED POLICIES BE CANCELLEgBEFORE THE .EXPIRATION DATE THEREOF, NOTICE WILL: BE DELIVERED IN Monroe: County ACCORDANCE WITH THE: POLICY. PROVISIONS. Attn Ann M. Riger. 1,100 Simonton Street,A &PH-Ul L" ifir h10Z AUTHORIZED REPRESENTATIVE Key West FL 33040 038 80.E 0311.E 1 ©1988-2010 ACORD CORPORATION. All rights reserved_ ACORD 25 (201010.5) The ACORD name and logo are registered marks of ACORD ACORV CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYI'YY) 4/15/2014 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 endorsements . PRODUCER The James B. Oswald Company TACT NAME: FAX PHONE -839-2807 A/C No):216-839-2815 E-MAIL 1100 Superior Avenue, Suite 1500 Cleveland OH 44114 INSURERS AFFORDING COVERAGE NAIC # URER A INSURED MBIK2-1 B INSURER C : K2M Design 1001 Whitehead St., Suite 101 Key West FL 33040-7522 INSURER D : INSURER E : INSURER F : RTIFICATE NUMBER• 1287084671 REVISION NUMBER. COVERAGES CE 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 A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY ADDL INSR Y SUBR WVD Y POLICY NUMBER 45SBA107008 POLICY EFF MM/DDIYYYY /14/2013 POLICY EXP MMIDD/YYYY /14/2014 LIMITS EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $10,000 CLAIMS -MADE � OCCUR PERSONAL & ADV INJURY $1,000,000 X AI Primary & GENERAL AGGREGATE $2,000,000 X Non -Contributory PRODUCTS - COMP/OP AGG $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PROJEC- X LOCLIMI $ A AUTOMOBILE LIABILITY Y 45SBA107008 /14/2013 /14/2014 Ea accidenCOMBINEDt) $1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON-OWNED(Per X HIRED AUTOS X AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE accidenl $ $ X Al Primary A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE Y 45SBA107008 /14/2013 /14/2014 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 A NIA Y 5SBA107008 /14/2013 /14/2014 Excludes Professional wO e STATuLIM - X oTH- $ OH -STOP GAP DED X RET NTION$10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If es, dcsa t a or:;c; DESCRIPTION OF OPERATIONS below E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 B Professional Liability Claims Made N Y EE7204506 /13/2013 /12/2014 Each Claim $3,000,000 Aggregate $3,000,000 Retro Date: 9/1/2001 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured by written contract or agreement. Project: Space Planning Facilities Assessment Report AN E T MK-12243 0WA1VN/A0ES_ IIa Monroe County Ann M. Riger 1100 Simonton Street, Room 2-216 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 �.,s , ,f' &4� ACORD 25 (2010/05) o ATIA61 All r0M%+. w arvarl V I­,v —vv.�r rr... �... The ACORD name and logo are registered marks of ACORD ACORV CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 4/15/2014 OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS THIS CERTIFICATE IS ISSUED AS A MATTER 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 endorsements . PRODUCER 10"TICT NAME: PHONE FAX 2815 The James B. Oswald Company r;zt);216-839-2807 A/C No _ _ ADDRIESS: 1100 Superior Avenue, Suite 1500 Cleveland OH 44114 INSURERS AFFORDING COVERAGE NAIC # INSURER AflartfOrd Casualty Ins- CO. 29424 INSURED MBIK2-1 INSURER B:Hudson Specialty. Insurance Co. 25054 INSURER C : K2M Design 1001 Whitehead St., Suite 101 INSURER D : INSURER E : Key West FL 33040-7522 INSURER F : CERTIFICATE NUMBER 251239552 REVISION NUMBER. COVERAGES 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 A TYPE OF INSURANCE GENERALLIABILITY COMMERCIAL GENERAL LIABILITY ADDL INSR Y SUBR WVD Y POLICY NUMBER 45SBA107008 F POLICY EFF MMIDD /V13 o '00X �r!/1es CW1,41PREMISES POLICY EXP MM/DD/YYYY /14/2014 LIMITS EACH OCCURRENCE $1,000,000 Ea olccu ence $1,000,000 MED EXP (Any one person) $10,000 CLAIMS -MADE K OCCUR 4 ' @/ ehi PERSONAL & ADV INJURY $1,000,000 X Al Primary & r/M�, f CENT �.� �j V �, 4 GENERAL AGGREGATE $2,000,000 X Non -Contributory $y PRODUCTS - COMP/OP AGG $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO-JECT X LOCCOMBINED SINULL LIMIT $ A LIABILITY Y 45SBA107008 13 4/20 Ea accident 1,000,000 BODILY INJURY (Per person) $ OAUTOMOBILE ANY AUTO ALL OWNED " SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS X AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident)$ $ Al Primary A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y 45SBA107008 /14/2013 /14/2014 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 Excludes Professional WC STATU- X orH- $ OH STOP GAP A NIA y 45SBA107008 /14/2013 /14/2014 DIED X RETENTION $10,000 WORKERS COMPENSATION AND EMPLOYERS* LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If rs, describe under DESCRIPTION OF OPERATIONS below E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000.000 B Professional Liability Claims Made N Y EE7204506 /13/2013 /12/2014 Each Claim $3,000,000 Aggregate $3,000,000 Retro Date: 9/1/2001 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured bywrittea,contract or agreement. Project: Mk-13082 Marathon Sewer Connections PR E MA MENT Monroe County Board of County Commissioners is an additional insured as noted above. DA ' WAIVER N_ _�e Y . MULUtK 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. Attn:Ann M. Riger 1100 Simonton Street Room 2-216 AUTHORIZED REPRESENTATIVE Key West FL 33040 ._ Anon nAAA cannon #%f%00 %0ATIf%fd All rinhfc rasarvad ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACOORV CERTIFICATE OF LIABILITY INSURANCE DATE (MMMD/YYYY) F4/15/2014 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 endorsements . PRODUCER The James B. Oswald Company NTA T NAME: PHONE - - FOX __ A/C No ADDRESS: 1100 Superior Avenue, Suite 1500 Cleveland OH 44114 INSURERS AFFORDING COVERAGE NAIC # INSURER A INSURED MBIK2-1 INSURER BSur K2M Design 1001 Whitehead St., Suite 101 Key West FL 33040-7522 INSURER C : INSURER D : INSURER E : INSURER F : w0rn1L1 10"RAQC12• COVERAGES CERTIFICATE NUMBEta: 702342528 .«-•.-•�•- •--•-•__._. 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 INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIY POLICY EXP MM/DD/YYYY /14/2014 LIMITSYYY EACH OCCURRENCE $1,000,000 A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR a X AI Primary & Y Y 45SBA107008 4 �/0�lr, F/NJ� 4Ap �� J � ,Z', F-_*/2: /14/2013 C' Ov !s DAMASES Roccu ante $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 X Non -Contributory PRODUCTS - COMP/OP AGG $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- JECTX LOC7UVffnqEU7M= LIMIT AUTOMOBILE LIABILITY Y 45SBA10700814 �� /14/2014 Ea accident$1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NED X HIRED AUTOS X AUTOS NON-OPer BODILY INJURY (Per accident) $ PROPERTY DAMAGE accident $ X Al Primary _ A X UMBRELLA LIAB EXCESSLIAB X OCCUR CLAIMS -MADE Y Y 45SBA107008 /14/2013 /14/2014 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 A NIA N Y Y 45SBA107008 EE7204506 /14/2013 /13/2013 /14/2014 /12/2014 Excludes Professional wC STATU-X oTH- $ OH -STOP GAP DED X RETENTION $10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AYIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? FN ] (Mandatory in NH) If yes, descr be under DESCRIPTION OF OPERATIONS below Professional Liability Claims Made E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 Each Claim $3,000,000 Aggregate $3,000,000 B Retro Date: 9/1/2001 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured by written contract or Additional agreement. Project: Mk-13142 Monroe ADA Segment 1 8r 2 OPPRO Monroe County Board of County Commissioners is an additional insured as noted above. Y WAIVER /A ym_ 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. Attn: Ann Riger 1100 Simonton Street, Room 2-216 AUTHORIZED REPRESENTATIVE Key West FL 33040 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD OBWC Certificate of Coverage 3/5/2014 10:24:20 AM PAGE 2/002 Fax Server Page 1 of 1 Bureau of Workers' Ohio Columbuss,, Compensation 30 Spring OH 43215 Cerditate of Premium Payment This certifies the employer listed below has paid into the Ohio State Insurance Fund as required by law. Therefore, the employer is entitled to the rights and benefits of the fund for the period specified. For more information, call 1-800-OHIOBWC. This certificate must be conspicuously posted. Policy No. and Employer Period Specified Below 1493325 ohiobwc.com 01/0112014 Thru 08/31/2014 K2M DESIGIS 9501 UNION LOVELAND, You can reproduce this cert'rficate as needed. Ohio Bureau of Workers' Compensation Required Posting Effective Oct. 13, 2004, Section 4123.54 of the Ohio Revised Code requires notice of rebuttable presumption. Rebuttable presumption means an employee may dispute or prove untrue the presumption (or belied that alcohol or a controlled substance not prescribed by the employee's physician is the proximate cause (main reason) of the work -related injury. The burden of proof is on the employee to prove the presence of alcohol or a controlled substance was not the proximate cause of the work -related injury. An employee who tests positive or refuses to submit to chemical testing may be disqualified for compensation and benefits under the Workers' Compensation Act. Bureau of Workers' Ohio Compensation You must post this bnguage with the certificate of premium payment. https://www.bwc.ohio.gov/employerlservicesICertCovReprints/secure/Certificate.asp?uctCI... 3/5/2014 ^ Q® A lv(J/R CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 9/15/2017 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 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)CONTACT PRODUCER The James B. Oswald Company 1100 Superior Avenue, Suite 1500 Cleveland OH 44114 NAME: Serena Turchik PHONE 216-777-6134 A/C No E-MAIL . STurchik@oswaldcompanies.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:XL Specialty Insurance Co. 37885 INSURED MBIK2-1 INSURER B: Hartford Accident & Indemnity I'22357 INSURER C: Hartford Casualty Ins. Co. 29424 K2M Design INSURER D : 1150 Virginia St Key West FL 33040 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 847486592 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD I POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MWDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE CI OCCUR DAMAGE TE PREM SES� a occur ence $ MED EXP (Any one person) - $ i PERSONAL & ADV INJURY $ l GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE$ PRO- �� POLICY EJ JECT L__] LOC PRODUCTS - COMP/OP AGG $ OTHER: B AUTOMOBILE LIABILITY Y ! Y 45UECBHO542 9/14/2017 9/14/2018 COMBI$ Ea accident IN L LI IT $1,000'000 BODILY INJURY (Per person) $ j X ANY AUTO BODILY INJURY (Per accident) 'I $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE Per accident $ Is X 'Al Primary C X UMBRELLA LIAB X OCCUR Y Y 45SBA107008 9/14/2017 9/14/2018 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $10,000 Excludes Professional $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE PER OTH- STATUTE OR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below A Professional Liability Claims Made Retro Date: 9/1/2001 INY DPR9914922 6/12/2017 6/12/2018 Each Claim $3,000,000 Aggregate $3,000,000 Pollution & Envir. Liab. Included DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the N ed Insure b 'tten contract or agreement. Project:Key West Customs Terminal Phase II — 15103 BYPR vtD MENT Monroe County Board of County Commissioners is an additional insured as noted above. WA R A CERTIFICATE HOLDER Monroe County Board of County Commissioners Attn: Ann Riger 1100 Simonton Street, Room 2-216 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 © 1953-2015 ACORD CORPORA I IUN. All rlgncs reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Bureau of Workers' Ohio Compensation 30 W. Spring St. Columbus, OH 43215 Certificate of Ohio Workers' Compensation This certifies that the employer listed below participates in the Ohio State Insurance Fund as required by law. Therefore, the employer is entitled to the rights and benefits of the fund for the period specified. This certificate is only valid if premiums and assessments, including installments, are paid by the applicable due date. To verify coverage, visit www.bwc.ohio.gov, or call 1-800-644-6292. This certificate must be conspicuously posted. Policy number and employer 01493325 K2M DESIGN INC 9435 WATERSTONE BLVD. SUITE 250 CINCINNATI, OH 45249 www.bwc.ohio.gov Issued by: WC �� Period Specified Below 07/01/2017 to 07/01/2018 dclv_ Administrator/CEO You can reproduce this certificate as needed. Ohio Bureau of Workers' Compensation Required Posting Effective Oct. 13, 2004, Section 4123.54 of the Ohio Revised Code requires notice of rebuttable presumption. Rebuttable presumption means an employee may dispute or prove untrue the presumption (or belief) that alcohol or a controlled substance not prescribed by the employee's physician is the proximate cause (main reason) of the work -related injury. The burden of proof is on the employee to prove the presence of alcohol or a controlled substance was not the proximate cause of the work -related injury. An employee who tests positive or refuses to submit to chemical testing may be disqualified for compensation and benefits under the Workers' Compensation Act. Bureau'of Workers' Ohio Compensation You must post this language with the Certificate of Ohio Workers' Compensation. DP-29 BWC-1629 (Rev. July 1, 2015)