COI Expires 04/01/2019�.1 ®
ACORO
oAre031012018rrrl
CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERI`F TE 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
PCr
ow
Lockton Affinity, LLC
P.O. Box 873401
HONE
A/C No.Ext►: 888-563-9002
AX
aC, No):
-MAIL
DDRESS:
Kansas City, MO 64187-3401
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
MMIDD/YYYY)
MM/DD/YYYY)
LT
R
TYPE OF INSURANCE
6VVD
POLICY NUMBER
LIMITS
GL1064565-18
04/01/2018
04/01/2019
A
GENERAL LIABILITY
X
EACH OCCURRENCE
$ 1,000,000
GE To RENTED
X OMMERCIAL GENERAL LIABILITY
LAIMS MADE X OCCUR
APP
B K MA^�E►�ENT
,SES E. occurrence)
REM
$1,000,000
MED EXP (Any oneperson)
$ 0
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
EN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
X OLICY
$
-
.'
COMBINED SINGLE LIMIT
$
AUTOMOBILE LIABILITY
ANY AUTO
CLOWNED SCHEDULED
�A•rE
WAIVER
- X
U
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 LIAB
XCESS LIAB
OCCUR
CLAIMS MADE
,
2
EACH OCCURRENCE
$
AGGREGATE
$
ED I I RETENTION $
ORKERS COMPENSATION
WC STATU-
TH-
ND EMPLOYERS' LIABILITY
CRY LIMITS
rR
%NY PROP RIETOR/PARTNER/EXECUTIVE Y/N
FFICER/MEMBER EXCLUDED?
E.L. EACH ACCIDENT
$
MANDATORY IN NH)
f es, 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.
CERTIFICATE HOLDER 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
Monroe County Board of Commissioners j
1100 Simonton St., ,v
Key West, FL 33040 y�//
Arr)Rn ,>h ronin/ns► The ACt7RD name and loan are registered marks of ACORD
1064565
ACORO®
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
03012018
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
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
XWrXT
Lockton Affinity, LLC
P.O. Box 873401
ow
HONE
A/C No.Ext): 888-553-9002
AX
A/C, No):
-MAIL
DDRESS:
Kansas City, MO 64187-3401
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
SR
LT
R
TYPE OF INSURANCE
ADDL
INSR
SUB
R
NVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY)
POLICY EXP
MM/DD/YYYY)
LIMITS
A
GENERAL LIABILITY
X OMMERCIAL GENERAL LIABILITY
LAIMS MADE X OCCUR
X
GL1064565-18
AP
04/01/2018
Y RI
04/01/2019
44A.NAC'E4,117-
-
EACH OCCURRENCE
$ 1,000,000
DGE NTED
PRAEM SESOEaEoccurrence)
$1,000,000
MED EXP (Any oneperson)
$ 0
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
EN'L AGGREGATE LIMIT APPLIES PER:
X OLICY
PRODUCTS — COMP/OP AGG
$ 2,000,000
I
$
AUTOMOBINED ILELIMIT
LIABILITY
ANY AUTO
ALL Or SCHEDULED
UTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
BY
�)
_
.
Y�$�_
COMAUTOMOBILE
Ea accident)
$
BODILY INJURY Per Person
$
�$Q6ILYINJURY Per accident
$
WAND W
PROPERTY DAMAGE
Per accident
$
MBRELLA LIAR
XCESS LIAB
I
OCCUR
I CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
ED I I RETENTION $
ORKERS COMPENSATION
ND EMPLOYERS' LIABILITY
NY PROP RIETORIPARTNERIEXECUTIVE YIN
I >✓ r
C STATU-
ORY LIMITS
TH-
R
FFICERIMEMBER EXCLUDED?
E.L. EACH ACCIDENT
$
MANDATORY IN NH)
f yes, describe under
E.L. DISEASE — EA EMPLOYEE
$
ESCRIPTION OF OPERATIONS below
E L. DISEASE — POLICY LIMIT
$
Certificate Holder is named Additional Insured as respects to Landlord.
CERTIFICATE HOLDER 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
County Administrator Monroe County
1100 Simonton Street,
Key West, FL 33040fiiz(
��
cc F uS
ACORD 25 (2010106) The ACORD name and logo are registered marks of ACORD
1064565