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COI Expires 06/08/2018A R®® EEC__...... CERTIFICATE OF LIABILITY INSURANCE DATE (MMDIYYYY) 11ro1/2/2017 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, th.a policy(los) must have ADDITIONAL INSURED provisions or tie 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 endorsoment(s). PRODUCER NAME: CONTACT Susan Cherrybon iuc°NrEo F t : (305)872-2888 (arcFAX, No : (305)872-2324 The Johnsons Insurance Agency ADDRESS: Scherry©johnsonsinsure.com 30975 Ave A INSURER(S) AFFORDING COVERAGE NAIC 0 Big Pine Key FL 33043 INSURER A : Hartford Accident & Indemnity 22357 INSURED INSURER B : INSURER C : Diversified Services Of Key INSURER D : 50d 11th Ave INSURER E : INSURER F : Key West FL 33040 COVERAGES CERTIFICATE NUMBER: CL1782818831 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. LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MMIDDIYYYY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 3 DAMAGE CLAIMS -MADE 7 OCCUR PREMISES Ea occurrence $ MED EXP (Any one person) S PERSONAL 8 ADV INJURY s GEN'LAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ JE 0. LOC PRODUCTS - COMPIOP AGG 5 $ OTHER: AUTOMOBILE LIABILITY OMBiNED SINGLE LIMIT Ea accident) 3 1,000,000 BODILY INJURY (Per person) $ x ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y 21 UECZP7136 06/08/2017 06/08/2018 BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident) $ HIRED NON-OWNED AUTOS ONLY AUTOS ONLY PIP -Basic s 10,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAR DED RETENTION S $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN STATUTE I ER ANY PROPRIETORIPARTNEMEXECUTIVE E.L. EACH ACCIDENT 3 OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory In NH) E.L DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) CERTIFICATE HOLDER IS ADDITIONAL INSUERD 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. I Description of operations: Janitorial Service •APP AGEMENT Y'.(/ WANE A YES- C (`FRTIPMATF MAI DER 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. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 J Grp W1888-2015 ACORD PRPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD