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COI Expires 09/07/2018 i AC o • DATE (MMA/DD /YYYY) CERTIFICATE OF LIABILITY INSURANCE 05/31/2018 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on thls certificate does not confer rights to the certificate holder in lieu of such endorsement(s). NAME: CT PRODUCER Thomas Ledwidge THOMAS LEDWIDGE INSURANCE AGENCY PHONE o,Extl. -822 -2424 , N 3 05822 -2558 StateFarm 6177 MIAMI LAKES DRIVE E i ADDRE Thomas @LedwidgeAgency.com MIAMI LAKES, FL 33014 INSURER(S) AFFORDING COVERAGE NAIC 11 p ®, iNSURERA arm P an : State F Mutual Automobile Insurance Company 25178 y INSURED OAC ACTION CONSTRUCTION CORP (10260) INSURER B: I 11980 SW 144 Ct. Suite 101 INSURER C: • MIAMI FL 33186 -6266 ■ INSURERD: INSURER E : , INSURERF: 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 ADM SUER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE INSD wvD I . POLICY NUMBER (MMIDDIYYYY) (MwDO/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S AP ED iiiiiISK i L ' GEMENT A A $ CLAIMS -MADE 1 1 OCCUR - PREMISES (Ea occurrence) J BY MED EXP (Any one person) 5 PERSONAL 8 ADV INJURY $ D ATE _ . -. V -..— - I _ DATE GEL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 WAIVE N/ Y�S� PRO - (� LOC PRODUCTS - COMP/OP AGG S � PCUCYI 1 JECT (� i OTHER: $ COMBINED SINGLE LIMIT 5 A AUTOMOBILE LIABILITY Y N 017 1523 C07 59 03/07/2018 09/07/2018 (Ea ac _ ANY AUTO E94 2855- D26 -59 04/26/2018 11/26/2018 BODILY INJURY (Per person) 5 1,000,000 ALL OWNED X AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) S 1,000,000 AUT X HIRED AUTOS OS PROPERTY DAMAGE ( $ 1.000,000 -- ON WNED den - ( P_er acciti $ UMBRELLA LIAR _OCCUR } AIV EACH OCCURRENCE 3 CLA1MS-MADE EXCESS UAB �+n -- _... AGGREGATE $ DED 1 1 RETENTION 5 S • WORKERS COMPENSATION I � PER OTH- AND EMPLOYERS' UABIUTY Y I N .i.}113 STATUTE 1 1 ER ANY PROPRIETOR.PARTNERJEXECUTIVE N 1 A W3DdNt/W >ISI - A9 a 0 a �dt/ E 3A .L. EACH ACCIDENT $ _ OFFICE ER EXCLUDED? 1 ' (Mandatory In NH) E.L DISEASE - EA EMPLOYEE 5 In If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below Comp A Call $500 deductible ENOL Y 9481859 E22 59B 05/22/2018 11/22/2018 DESCRIPTION OF OPERATIONS !LOCATIONS l VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) 16 FORD F150 Pickup VIN: 1FTMF1C83GKD92199 CGC License #061561 CERTIFICATE HOLDER CANCELLATION Monroe County Board of Commissioners SHOULD ANY OF THE ABOVE DESCRIBE D POLICIES BE CANCELLED BEFORE 1 100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West, FL 33040 i ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE a ��,: �,+ti fii Ledwl'de, I e tg © 1988 ACORD CORPORATION. All rights reserved ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02- 04-2014 1 �y 1 1 ® 1 DATE (MM!DDIYYYY) A� c R D CERTIFICATE OF LIABILITY INSURANCE 05/31/2018 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 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 i NAME CONTACT Ledwidge THOMAS LEDWIDGE INSURANCE AGENCY PHONE . E# ,. 3D5 -822 -2424 I iAl No):305 -822 -2558 St+ tefSYrt1 6177 MIAMI LAKES DRIVE E E-MAIL ADDRESS: Q MIAMI LAKES, FL 33014 INSURER(S) AFFORDING COVERAGE NAIC # 7(e) . INSURER A : State Farm Mutual Automobile Insurance Company 25178 INSURED OAC ACTION CONSTRUCTION CORP (10260) INSURER B : 11980 SW 144 Ct. Suite 101 INSURERC: I MIAMI FL 33186 -6266 INSURERD: E INSURER E : 1 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 TYPE OF INSURANCE IiADDL iSUBR POLICY EFF POLICY EXP LIMITS LTR IINSDI WVD ' POLICY NUMBER (MMIDDJYYYY1(MMIDDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 DAMAGE TO CLAIMS -MADE 1 1 OCCUR PREMISES E ES a $ MED EXP (Amy ono person) 3 PERSONAL & ADV INJURY 5 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY 1 1 JECOT 1 1 LOC PRODUCTS - COMP /OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY Y N C87 0586 E22 - A 05/22/2018 11/22/2018 ( E a acc I d ED O SINGLE LIMIT S ANY AUTO C87 0587 - E22 - 59A 05/22/2018 11/22/2018 BODILY INJURY (Per person) $ 1,000,000 ALL OWNED X SCHEDULED BODILY INJURY (Per accident) S , 1,000,000 AUTOS _ AUTOS G17 1524 - 007 - 59 03/07/2018 09/07/2018 HIRED AUTOS AUTOS G17 PROPERTY P d Y AMAGE 3 1,000,000 G171522 C07 - 59 03/07/2018 09/07/2018 5 UMBRELLA LIAB _ OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED 1 RETENTIONS 5 WORKERS COMPENSATION e pp� I PER ( OTH- AND EMPLOYERS' RI LIABILITY Y / N RI A D ISK M A GEMENT I STATUTE 1 ER ANY PROPRIETOPARTNEEXECUTIVE E.L EACH ACCIDENT $ OFFICER:�IEMBER EXCLUDED? n NIA BY (Mandatory In NH) s E.L DISEASE - EA EMPLOYEE 5 If qos, smbe under DESCR OF OPERATIONS below DA A E.L. DISEASE - POLICY LIMIT 3 __ . amp : • I 50 (I- . uctIb e WAIVIR W Ili, YIg— DESCRIPTION OF OPERATIONS LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space 15 required} 14 FORD F150 PICKUP VIN: 1FTFW1CF7EFA90329 14 FORD F150 PICKUP VIN: 1FTMF1CM7EFB57405 16 FORD F150 PICKUP VIN: 1FTMF1C88GKD62163 16 Ford F150 PICK UP VIN: 1FTEW1CFXGFB22009 CGC License #061561 CERTIFICATE HOLDER CANCELLATION Monroe County Board of Commissoners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West, Fl 33040 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATNE l � , CG c tm hedw, 4 `g eat a. G �Cc& O 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks ofACORD 1001486 1328499 02-04-2014