COI Expires 04/01/2018FRALEMA-01 IMARTINEZ
r
,4coRon CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYY)
01/04/2018
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
Anderson & Jacob Insurance Consultants
3350 South Dixie Highway
Miami, FL 33133
CONTACT Ileana Martinez
NAME:
PHONE FAX
AIc, No, Ext): (305) 596-0500 AIc, No :(305) 270-1657
ADo"alEss: imartinez@anderson-jacoby.com
INSURERS AFFORDING COVERAGE
NAIC #
INSURERA:ALLIED INS CO
36528
INSURED
INSURER B: ADMIRAL INS CO
24856
F R Aleman & Associates Inc.
10305 NW 41st Street
INSURER C :
Ste#200
INSURER D
INSURER E :
Miami, FL 33178
INSURER F :
CnVFRAGFS CERTIFICATE NIIMBFR- REVISION NIIMRFR-
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
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM DD
POLICY EXP
MM DD
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE OCCUR
X
ACP3036461755
12/31/2017
12/31/2018
PAEMI ES( RENToccED rrenc
$ 300,000
MED EXP (Any oneperson)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY D JECT LOC
PRODUCTS-COMP/OPAGG
$ 2,000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea acciden
1,000,000
$
BODILY INJURY Perperson)
$
ANY AUTO
X
ACP3036461755
12/31/2017
12/31/2018
OWNED SCHEDULED
AUTOS ONLY X AUTOS
BODILY INJURY Per accident
$
Perr acaden DAMAGE
$
X
AUTOS ONLY X A�TOS ONLY
A
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$
X
EXCESS LIAB
CLAIMS -MADE
X
ACP3036461755
12/31/2017
12/31/2018
DED RETENTION$
$ 5,000,000
WORKERS COMPENSATIONOTH-
AND EMPLOYERS' LIABILITY Y/ N
STATUTE ER
ANY PROPRIETOR/PARTNERIEXECUTIVE ❑
FFICER/MEMBER EXCLUDED?
Mandatory in NH)
N / A
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
B
Professional Liab
X
E000003309202
04/01/2017
04/0112018
Aggregate
2,000,000
B
Professional Liab
X
E000003309202
04/01/2017
04/01/2018
Occurance
2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
Certificate Holder is listed as an Additional Insured:
Monroe County Project Management
1100 Simonton Street R Y IS AGNENT
Room 2-216 E
�WAIVER
Key West, FL 33040 /A I YES
la
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Monroe Count BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Y ACCORDANCE WITH THE POLICY PROVISIONS.
1100 Simonton Street
Room 2-216
Key West, FL 33040 AUTHORIZED REPRESENTATIVE
[. G ' �t"�
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