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COI Expires 05/24/2018Policy Number: Date Entered: 7/5/2016 'w CERTIFICATE OF LIABILITY INSURANCE ATE(i/2o MMIDD�") 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 ISSUING INSURER(S), AUTHORIZED _THE 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 Joel R. Shapiro Enterprises, Inc 9313 Old Kings Rd S Jacksonville, FL 32257 CONTACT Les Boblenz NAME: PHONE3-7343 -8542 ANo No.,,,: )AIC,No: ADDRESS: AIL commercial@insuresig.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Nationwide Insurance Co of America 25453 INSURED FIRE -TECH REPAIR SERVICES, INC. INSURER B: INSURER C: Robert Burley INSURERD: 103680 OVERSEAS HIGHWAY KEY LARGO, FL 33037 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: 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 OF INSURANCE ADDLTYPE INSD WVDSUSR POLICY NUMBER EFF MMIDDIYYYY MM/DDPOLICY Y EXP /YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE(RENTED PREMISESS Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT ❑ LOC POTHER: PRODUCTS - COMP/OP AGG $ $ A AUTOMOBILE LIABILITY ANY AUTO X ACP5954930099 05/24/2017 05/24/2018 COEaMBINED accidentSINGLE LIMIT $ 300 r000 BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILYINJURY(Peraccident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N /A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Monroe County BOCC is named as Additional Insured. 4 APP ANAGEMEM 4 UATE It '/A ' WAVER Y S _ cc.-pv�, CERTIFICATE HOLDER CANCELLATION County of Monroe Risk Management SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE ACCORDANCE WITH THE POLICY PROVISIONS. WILL BE DELIVERED IN Key West, FL 33040 GG '�"V�t✓WGv AUTHORIZED REPRESENTATIVE Joel R. Shapiro ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Plus software. www.FormsBoss.com; Impressive Publishing 800-208-1977