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COI Expires 11/02/2017ACORN►® `� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 6/29/2017 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 endorsements . PRODUCER Bowen, Miclette & Britt of Florida, LLC 1020 N. Orlando Avenue Suite #200 CONTACT NAME: Angie Desormeaux PHONE 407-647-1616 aX No): 407-628-1635 E-MAIL Certificates@bmbinc.com INSURER 5 AFFORDING COVERAGE NAIC # Maitland FL 32751 INSURERA:Amerisure Insurance Company 19488 INSURED PEDROFALCO INSURERB:Amerisure Mutual Insurance Company 23396 Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C INSURER C : Big Pine Key FL 33043-4516 INSURER D : INSURER E INSURER F COVERAGES CERTIFICATE NLIMRFR- 1400505855 RFVI.glnN NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIST14D 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. INSRR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDIDYNYYY MM DDIIYYYY LIMITS A X COMMERCIALGENERAL LIABILITY Y Y GL2092941 11/2/2016 11/2/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 GEN'L POLICY a JE � n LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y CA2092939 11/2/2016 11/2/2017 Ea accdent $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO AUTOWNED SCHEDULED BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ B X UMBRELLA LIAB OCCUR Y CU2092942 11/2/2016 11/2/2017 EACH OCCURRENCE $4,000,000 HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ A WORKERS COMPENSATION EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N I A y WC2094526 11/2/2016 11/2/2017 X STATUTE ER STATUTE E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYE $500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below HNp V y ENT E.L. DISEASE -POLICY LIMIT $500,000 A WAIVER N• S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) The following policy provisions and/or endorsements form part of the policies of insurance represented by this certificate of insurance. The terms contained in the policies and/or endorsements supersede the representations made herein. Electronic copies of the policy provisions and/or endorsements listed below are available by emailing: certificates@bmbinc.com When required by written contract, those parties listed in said contract, including the Certificate Holder, are added as an Additional Insureds with respect to the General Liability, Auto Liability and Umbrella Liability as afforded by the policy and/or endorsements. See Attached... GtK I ItIGA I t MULUtK GANGtLLA I ION Monroe County Board of County Commissioners 1100 Simonton Street Suite 2-213 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 r/ " � ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: PEDROFALCO ACORe k-.� LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Bowen, Miclette & Britt of Florida, LLC NAMED INSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key FL 33043-4516 P 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 When required by written contract, a Waiver of Subrogation, with respect to the General Liability, Auto Liability and Worker's Compensation is granted to those parties listed in said contract, including the Certificate Holder. The General Liability and Umbrella Liability, certified herein are primary and non-contributory to other insurance available, but only to the extent required by written contract. Project Reference: Harry Harris Equipment Shed ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD