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COI Expires 03/17/2019 f ��' DIVESER -02 CAPWELLC ACORE," CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 9/14/2018 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 PRODUCER NRMEACT Susan Cherrybon Johnsons Insurance Agency a Division of LOA PH Ext): I (A/C, Na): 30975 Avenue A Big Pine Key, FL 33043 Amikss: Sue.Cherrybon@loausa.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Sentinel Insurance Company, Ltd 11000 INSURED INSURER B : Hartford Accident & Indemnity Company 22357 Diversified Services Of Key - INSURER C: D -50 11th Avenue Stock Island INSURER D : Stock Island, FL 33040 INSURER E : 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYYI (MMIDD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X 21SBMBU7181 03/17/2018 03/17/2019 pRrM SES (Ea ocaErrence) $ 1,000,000 M ED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ja LOC PRODUCTS - COMP /OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY (Ea a CcdeOUSINGLE LIMIT $ 1,000,000 X ANY AUTO 21 UECZP7136 06/08/2018 06/08/2019 BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY _ AUTOS BODILY BODILY INJURY (Per accident) $ AUTOS ONLY - AUTOG ONLY (Perr acudent)AMAGE $ $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ • DED RETENTIONS $ WORKERS COMPENSATION STATUTE I ER AND EMPLOYERS' LIABILITY Y / N APPROV E.L. E ACH ACCIDENT J ANY P ERIM MB R/PARTNER/EXECUTIVE I I ' R f l • ' ►• . E V1E Wi lgR/MEMBER EXCLUDED? N / A BY (Mandatory In NH) DATE ,4. * i 1.111.11b E.L. DISEASE - EA EMPLOYEE,] If yyes, describe under WAVER 1 DESCRIPTIONOFOPERATIONSbeIow - - - - - - - - - - - - - - /l- y ' ES_ - - - _ _ - E.LDISEASE- POLICY LIMIT_ $ _ - • • DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace le required) Janitorial Services endorsed as Add'I Ins'd on GL policy Al Endt# IH 12 00 11 85 & Waiver Endt# SS 1215 Certificate holder is additional insured with respect to work performed by or on behalf of the named insured as required by written contract. Please refer to the general liability policy additional insured endorsement # IH 12 00 11 85 naming the certificate holder. 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 Monroe County Board of County Commissioners� 1100 Simonton St ;�° 'a` * , '_ Key West, FL 33040 -- - - - ACORD 25 (20/16/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CL.