Certificate of Insurance
A CORDTM CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
12/17/2009
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
USllnsurance Services, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
200 West Cypress Creek Rd #500 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Lauderdale, FL 33309
954 607-4000 INSURERS AFFORDING COVERAGE NAIC ,
INSURED INSURER A: Hartford Casualty Insurance Company 29424
Bermello, Ajamil & Partners INSURER B: Employers Insurance of Wausau 21458
2601 S. Bayshore Drive, Suite 1000 INSURER C: Continental Casualty Company 20443
Miami, FL 33133 INSURER D:
INSURER E:
Client#. 31137
BERMEAJA
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSRC TYPE OF INSURANCE POLICY NUMBER PJ>1-{i1:'~8'w~ Pgi~l,~.tb~~N LIMITS
A GENERAL LIABILITY 21 UUNIT3215 11/11/09 11/11/10 EACH OCCURRENCE $1 000 000
r-- ~~~~~r9"'~~~~~~n~A\
X. COMMERCIAL GENERAL LIABILITY $300 000
- o CLAIMS MADE [KJ OCCUR MED EXP (Anyone person) S 10 000
PERSONAL & ADV INJURY $1 000000
-
i-- GENERAL AGGREGATE $2.000 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2 000.000
~ POLICY n ~~8i n LOC
A ~TOMOBILE LIABILITY 21 UUNIT3215 11/11/09 11/11/10 COMBINED SINGLE LIMIT
~ ANY AUTO (Ea accident) $1,000,000
- ALL OWNED AUTOS BODILY INJURY
S
SCHEDULED AUTOS (Per person)
-
~ HIRED AUTOS .l)Y ~ Vi BODILY INJURY
$
~ NON-OWNED AUTOS (Per accident)
I--- l)111 PROPERTY DAMAGE $
-fr-~~ (Per accident)
GARAGE LIABILITY ~ JO L/ J AUTO ONLY - EA ACCIDENT S
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
A EXCESS/UMBRELLA LIABILITY 21XHUIT2953 11/11/09 11/11/10 EACH OCCURRENCE $5.000.000
~ OCCUR D CLAIMS MADE AGGREGATE 55.000.000
$
~ DEDUCTIBLE $
X RETENTION $ 10 000 $
B WORKERS COMPENSATION AND WCCZ91443789 11/11/09 11/11/10 X I WC STATU- I IOJ~-
Jtofy IMI S
EMPLOYERS' LIABILITY $1 000000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.l. EACH ACCIDENT
OFFICERlMEMBER EXCLUDED? E.l. DISEASE - EA EMPLOYEE $1,000,000
~~E~I~s~~~V;~1o~s below E.l. DISEASE - POLICY LIMIT $1,000,000
C OTHER Professional AEH288262231 11/11/09 11/11/10 $2,000,000 Each Claim
Liability $4,000,000 Aggregate
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
General Engineering Services for Monroe County
Monroe County Board of County Commissioners are named as additional
insured with respect to Commercial General Liability, and Commercial
Automobile Liability.
CERTIFICATE HOLDER
CANCELLATION
Monroe County Board of County
Commissioners
Attn: Michelle Lee
1100 Simonton Street
Key West, FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -3D- DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
~~
ACORD 25 (2001/08) 1 of 3
#S4161438/M4133135
CGREU
@ ACORD CORPORATION 1988