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Certificates of InsuranceCPH N-1 QUID ,d►C'oR®h CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIY 03141/201R 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(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 15 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rilahts to the certificate holder in lieu of such endorsement(s). JCJ Insurance Agency 2205 Hillcrest Street Orlando, FL 32803 Mark E. Jackson INSURED'"^ - ""'• 540 West Fulton Street Sanford, FL 32771 rance.com COVERAGES CERTIFICATE REVISION 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 O SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. m .........---....... ........... ...._,.................................. INSR , l�+DDL AE! TYPE OF INSURANCE POLICY NUMBER .............................................. ........... ........._............ POLICY EFF POLICY EXP ''++ 1 LIMITS ..._, ..._ A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE sNX CUR y C5099618199 0410112018 0410112019 D GE TO RENTED 300,000 w. m..mn ....,_ MED EXP An one rsan 5,000 NN _.,_. PERSONAL 8 ADV INJURY 1,000,000 ENLAGGREGATE LIMIT PLIES PER ENERALAGGE TE 2,040,040 POLICY Xrl jrNrN LOC ._. PROOUCT5-COMPtOPAGG 2,040,040 OTHER: Emp Ben. 1,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 ANY AUTO y C5099618204 0410112018 0410112019 DILYINJURY Par S OWNED SCHEDULED AUTOS ONLY ALITNO.pSyy IR DILY INJURY Per accident 3 p TOS ONLY X AUTOS ONY a ERTY DAMAGE C X UMBRELLA LIAB X OCCUR EACHOCCURRENCE 5,000.000 EXCESS LIAO CLAIMS -MADE Y C5099618218 0410112018 0410112019 A REGATE $ 510000000 D X I RETENTION$ 10,000 D WORKERS COMPENSATION X PER OTH. AND EMPLOYERS' LIABILITY Y 1 N ° PSW0002947 r 4110112018 0110112019 1,400,400 ANY POPRIETORIPARTNERIEXECUTIVE ppFt Eq�M RED7 N rHIA NHIMg�REXCLUi EL EACH s 1,000,000 IMandaiary�n E.L. DISEASE - EA EMPLOYFd S K describe under 1,000,000 006RIPTION P RAT_ N I ICY IMIT D Professional Liab RDP0031831 0410112018 04101/2019 Per Claim 5,000,000 Claims -Made Form Aggregate 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is requlredl Certificate Holder is an Additional Insureds with regards to General, Auto and Umbrella Liability when required by written contract. PP VEt `E +TENT 8 CERTIFICATE-HOLDERCANCELLATION MONR102 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED FORE Monroe County Board tY THE EXPIRATION DATE THEREOF, NOTICE ILL BE DELIVERS IN Of fT ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners PO Box 1026 Key West, FL 33041 I AUTHORIZED REPRESENTATIVE CORD 25 (2016103) Q 1 8 -2 15 ACORD CORPORATION. Il rights reserved. CPHEN-1 OP ID: SL .44COR0" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 11/22/2017 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, the policy(ies) must 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 JCJ Insurance Agency 2208 Hillcrest Street Orlando, FL 32803 Mark E. Jackson CONTACT Kristin McIntosh NAME:PHONE FAX AIC No EXt :321-445-1117 A/C, No): 321-445-1076 E-MAIL ts ADDRESS: cer@/ c/'Insurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Continental Casualty Company 20443 INSURED CPH, Inc. INSURER B: Valley Forge Insurance Company 20508 CPH Engineers, Inc. 500 West Fulton Street INSURER C: Transportation Insurance 20494 INSURER D: RLI Insurance Company 13056 Sanford, FL 32771 INSURER E : 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 TYPE OF INSURANCE DDL INSD UBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE FRI OCCUR X 5099618199 04/01/2017 04/01/2018 PREMISES Ea occurrence $ 300,000 X MED EXP (Any one person) $ 5,000 Contractual Liab X XCU PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICYa JECT LOC PRODUCTS -COMP/OPAGG $ 2,000,000 Emp Ben. $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1 000,000 , BODILY INJURY (Per person) $ B ANY AUTO X 5099618204 04/01/2017 04/01/2018 ALL OWNED SCHEDULEDBODILY AUTOSAUTOS INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ rX X NON -OWNED HIRED AUTOS AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 C EXCESS LIAB CLAIMS -MADE X 5099618218 04/01/2017 04/01/2018 DED I X I RETENTION$ 10000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A PSW0002907 01/01/2018 01/01/2019 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Professional Liab RDP0028016 04/01/2017 04/01/2018 Per Claim 2,000,000 Claims -Made Form Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Certificate Holder is an Additional Insureds with regards to General, Auto and Umbrella Liability when required by written contract. �MEN7 JAPP4REAYES_ DATWA� CERTIFICATE HOLDER CANCELLATION MONR102 Monroe County Board of County Commissioners PO Box 1026 Key Wes�, FL 33041 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 i� ` e C�? ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD CPHEN-1 OP ID: SL '4TE ��R" CERTIFICATE OF LIABILITY INSURANCE (MM/DDfYYYY) DA02/28/2017 oz/2si2o17 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 require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER JCJ Insurance Agency 2208 Hillcrest Street Orlando, FL 32803 Mark E. Jackson CONTACT NAME: Kristin McIntosh A//� No Ext : 321-445-1117 FAX No): 321-445-1076 E-MAIL ADDRESS: certs@jcj-insurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Continental Casualty Company 20443 INSURED CPH, Inc. CPH Engineers, Inc. 500 West Fulton Street INSURER B : Valley Forge Insurance Company 20508 INSURER C : Transportation Insurance 20494 INSURER D: RLI Insurance Company 13056 Sanford, FL 32771 INSURER E : 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 TYPE OF INSURANCE D INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Al OCCUR Contractual Liab X C5099618199 04/01/2017 04/01/2018 EACH OCCURRENCE $ 1,000,000 -DAMAGE-To RENTED PREMISES Ea occurrence $ 300,000 X MED EXP (Any one person) $ 5,000 XCU PERSONAL & ADV INJURY $ 1,000,000 x AGGREGATE LIMIT APPLIES PER: POLICY a PRO- JECT LOC GENERAL AGGREGATE $ 2,000,000 GEN'L PRODUCTS - COMP/OP AGG $ 2,000,000 Emp Ben. $ 1,000,000 OTHER: B AUTOMOBILE LIABILITY ANY AUTO X C5099618204 04/01/2017 04/01/2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ JX ALL OWNED SCHEDULEDBO AUTOS AUTOS DILY INJURY (Per accident)HIRED $ AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C EXCESS LIAB CLAIMS -MADE X C5099618218 04/01/2017 04/01/2018 AGGREGATE $ 4,000,000 DIED I X I RETENTION$ 10000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? FN—] N / A PSW0002907 01/01/2017 01/01/2018 PER OTH- X STATUTE I I ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEO $ 1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Professional Liab RDP0023754 04/01/2017 04/01/2018 Per Claim 2,000,000 Claims -Made Form Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is an Additional Insureds with regards to General, Auto and Umbrella Liability when required by written contract. "PAED MENT PYWAI�YES _ MONR102 Monroe County Board of County Commissioners PO Box 1026 Key West, FL 33041 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 i�"� ` f @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD