COI Expires 10/03/2018,4c R a
CERTIFICATE OF LIABILITY INSURANCE DATE(1o/0v2017/Y)
o17
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
NAME: Lilllam ReyeS
Regan Insurance Agency HONE Ext : (305)852-3234 A/C, No : (305)852-3703
90144 Overseas Hwy.
ADDRESS: y Ire e r aninsuranceinc.com
INSURER(S) AFFORDING COVERAGE NAIC #
Tavernier FL 33070 INSURERA: National Fire & Marine Ins Cc 20079
INSURED
INSURER B
Upper Keys Community Pool Inc, DBA: Jacobs Aquatic Center INSURER C
PO BOX 1994 INSURER D
INSURER E
Key Largo FL 33037
INSURER F
-" -"'-' -- Kr-vlblUN 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.
LTR
x
TYPE OF INSURANCE
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
INSD
WVD
POLICY NUMBER
MWDD/YYYY)
MM/DDM'YY
LIMITS
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
$ 1,000
A
Y
72LPS029868
10/03/2017
10/03/2018
PERSONAL & ADV INJURY
$ 1,000,000
GEN'LAGGREGATE
X
LIMIT APPLIES PER:
POLICY ❑ PRO- ❑
JECT LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMP/OP AGG
g Included
OTHER:
$
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMA E
POPERYer accide den
$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
N / A
EACH OCCURRENCE
$
HCLAIMS-MADE
AGGREGATE
LIED RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
PER OTH-
STATUTE OT
ER
E.L. EACH ACCIDENT
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Community Pool
Certificate holder is shown as an additional insured per policy forms, conditions, limitations and exclusions.
P V #A1 EMENT
ABy
WANE /
rcorrc�rwrc unr nrs
Monroe County Board of County Commissioners Tourist Dev Council -
1100 Simonton Street
Key West
FL 33040
. wn
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
W IUtis-ZU'l5 ACORD CORPORATION. All rights reserved.
ACORD 25 (2�15/03) The ACORD name and logo are registered marks of ACORD