COI Expires 04/01/2019CERTIFICATE OF LIABILITY INSURANCE[5A°"°"2°'6
TE" DDIYYYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CEIUIFIC,ATE 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
INSURERS(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
XWACr
vW
Lockton Affinity, LLC
P.O. Box 873401
HONE
A/C No.Ext►: 888-553-9002
Ax
ac, No):
DDRESS:
Kansas City, MO 64187-3401E-MAIL
INSURER(S) AFFORDING COVERAGE
NAIC
NSURER-A: ACE American Insurance Co.
22667
INSURED
Habitat for Humanity of Key West and Lower Florida Keys, Inc.
PO Box 5873,
Key West, FL 33045
NSURER-B:
NSURER-C:
NSURER-D:
NSURER-E:
NSURER-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.
IN
ADDL
SUB
POLICY EFF
POLICY EXP
SR
INSR
R
MM/DD/YYYY)
MM/DD/YYYY)
LT
R
TYPE OF INSURANCE
NVD
POLICY NUMBER
LIMITS
GL1064565-18
04/01/2018
04/01/2019
A
GENERAL LIABILITY
X
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
X OMMERCIAL GENERAL LIABILITY
LAIMS MADE X OCCUR
APP
B K KAA
CEMENT
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any oneperson)
$ 0
PERSONAL 8 ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
EN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS — COMP/OP AGG
$ 2,000,000
XdPOLICY
$
COMBINED SINGLE LIMIT
$
AUTOMOBILE LIABILITY
ANY AUTO
CLOWNED SCHEDULED
rIATE�_
WAN
-'.�- r
S__
Ea accident
N/A Y
BODILY INJURY Per Person
$
AUTOS AUTOS
NON -OWNED
_
BODILY INJURY Per accident
$
PROPERTY DAMAGE
HIRED AUTOS AUTOS
Per accident
$
MBRELLA LIAR
XCESS LIAB
OCCUR
CLAIMS MADE
_
,
EACH OCCURRENCE
$
AGGREGATE
$
ED I I RETENTION $
ORKERS COMPENSATION
C STATU-
140 EMPLOYERS' LIABILITY
ORY LIMITS
�TH-
R
NY PROPRIETOR/PARTNER/EXECUTIVE Y/N
FFICER/MEMBER EXCLUDED? I
E.L. EACH ACCIDENT
$
MANDATORY IN NH)
f yes, describe under
E.L. DISEASE — EA EMPLOYEE
$
DESCRIPTION OF OPERATIONS below
E.L. DISEASE — POLICY LIMIT
$
Certificate Holder is named Additional Insured as respects to Landlord.
CFRTIFICATF Mnl nFR CANCELLATION
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
/
Monroe County Board of Commissioners
Simonton St.,
Key West, FL 33040
Key
o.
ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD
1064565