Certificates of InsuranceUSAIG Certificate of Insurance
THIS CERTIFICATE CANCELS & SUPERCEDES OUR CERTIFICATE DATED 04-23-2018.
This is to certify to: Monroe County Board of County Commissioners
whose address is: 9400 Overseas Hwy.
Suite 200
Marathon, FL 33050
that: Robert W. Carew
whose address is: N5657 Lac Verde Circle
Green Lake, WI 54941
is at this date insured with one or more of the several participating companies of the United States Aircraft Insurance
Group, for the Limits of Coverage stated below, at the following locations: the United States of America, its territories and
possessions, Canada, Mexico, the Bahamas and the islands of the West Indies and Central America or while en -route
between these places.
Descriptive Schedule of Coverages 2010 Cirrus SR20, N262BC
Kind of Insurance Policy Number Policy Term Limits of Coverage
AIRPORT LIABILITY 360AC-776447 02-15-2018 - Each Person Each Occurrence
Combined Liability Coverage for 02-15-2019
bodily injury and property damage $ 1,000,000
Medical Coverage $ 5,000
Only with respect to operations by, for or on behalf of the "Policyholder":
The "Who's covered" section of your policy, under "Your Liability Coverage," shall include Monroe County Board of
County Commissioners, but only for claims of bodily injury, mental anguish or property damage and specifically
excluding claims for personal injury that result from your ownership, maintenance or use of airport premises.
If we or the Aviation Managers make a material change or cancel your policy for any reason other than nonpayment of
premium, we agree to give thirty (30) days notice before the cancellation date, or the material change becomes effective,
to the following person(s) or organization(s):
Monroe County Board of County Commissioners
9400 Overseas Hwy.
Suite 200
Marathon, FL 33050
However, the "Cancellation" provisions stated above shall not be less than the required statutory limits.
This certificate or verification of insurance is not an insurance policy and does not amend, extend or alter the coverage
afforded by the policies listed herein regardless of any terms or conditions set forth in any other contract, document or
agreement.
UNITED STATES AVIATION UNDERWRITERS, INC., Aviation Managers
Address: 301 North Main, Suite 1450, Wichita, KS 67202
By
date: 05-04-2018
- � CA
- I:. -(Rev.1:
USAIG All -Clear
Additional Insured(s)/Notice of Cancellation
The "Who's covered" section of your policy, under "Your Liability Coverage," shall include Monroe County
Board of County Commissioners, but only for claims of bodily injury, mental anguish or property damage and
specifically excluding claims for personal injury that result from your ownership, maintenance or use of airport
premises.
If we or the Aviation Managers make a material change or cancel your policy for any reason other than
nonpayment of premium, we agree to give thirty (30) days notice before the cancellation date, or the material
change becomes effective, to the following person(s) or organization(s):
Monroe County Board of County Commissioners
9400 Overseas Hwy.
Suite 200
Marathon, FL 33050
However, the "Cancellation" provisions stated above shall not be less than the required statutory limits.
Additional premium for this endorsement is 0.
This endorsement does not change any of your coverage except as stated above. It is effective on the date and
hour shown below, local Standard Time at the "Policyholder's" address.
Policy Issued to: Robert W. Carew
16 360AC-776447 May 3, 2018 at 12:01 A.M.
Endorsement No. Policy No. Date and hour endorsement takes effect
Approved: United States Aviation Underwriters, Inc., Aviation Managers
By
368-0817 / V (360)
USAIG All -Clear
Deletion of Endorsement
Endorsement Number 13, "Additional Insured/Notice of Cancellation", is deleted in its entirety.
Additional premium for deletion of this endorsement $Included.
This endorsement does not change any of your coverage except as stated above. It is effective on the date and
hour shown below, local Standard Time at the "Policyholder's" address.
Policy Issued to: Robert W. Carew
17 360AC-776447 May 3, 2018 at 12:01 A.M.
Endorsement No. Policy No. Date and hour endorsement takes effect
Approved: United States Aviation Underwriters, Inc., Aviation Managers
By
308-1204
(360/400)