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COI Expires 06/08/2017® CERTIFICATE OF LIABILITY INSURANCE A�o DATE DDIY/7/ 6/7/2016 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 squire an endorsai rian.t. A statement on this certificate does not confer nights to the certificate holder in lieu of such endorsement(s). PRODUCER The Johnsons Insurance Agency 30975 Ave A Big Pine Key FL 33043 CONTACT Susan Cherrybon PHGNE (305) 872-2888 NC No: (305)872-2324 -MAILADDRESS: �'Scher @ohnsonsinsure.com E-MAIL-ADDRESS:� INSURERS AFFORDING COVERAGE NAIC # INSURER A:Hartf ord Accident & Indemnity 22357 INSURED Diversified Services Of Key 50d lath Ave Key West FL 33040 INSURER B : C: -INSURER INSURERD: INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL166711954 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 UBR POLICY NUMBER MM/LDDY/YYri MMIDD/YWY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE F OCCUR DAMAGE R PREM SESOEa oN uErDence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ GEN'L PRODUCTS - COMP/OP AGG $ POLICY PRO ❑ JECT LOC $ OTHER: AUTOMOBILE LIABILITY COEaMBINED ccidentSINGLE LIMIT a $ 1,000,000 BODILY INJURY (Per person) $ a %� ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS X 21UECZP7136 6/8/2016 6/8/2017 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ PIP -Basic $ 10,000 UMBRELLA LIAB H OCCUR EACH OCCUR ENCE AGGREGATRO EXCESS LIAB CLAIMS -MADE DIED RETENTION$ rn WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N PER STATU OERH E.L. EACH AGMENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEAS MPLOYE �} E.L. DISEAS - LICY LIMI 7713 If as, describe under DESCRIPTION OF OPERATIONS below ..` Cam' 71 J J r © DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) . CERTIFICATE HOLDER IS ADDITIONAL INSURED WITH RESPECT TO WORK PERFORMED BY OR ON BEHALF OF THE NAMED INSURED AS REQUIRED BY WRITTEN CONTRACT. PLEASE REFER TO THE ADDITIONAL INSURED ENDORSEMENT. Description of operations: janitorial services. Y AGEM 4PPE - N/A CERTIFICATE HOLDER CANCELLATION LAIal w (305)295-3179 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County Commssioner THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 AUTHORIZED REPRESENTATIVE S Cherrybon/SUECHE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025onwi) V