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COI Expires 10/26/2018 • `,./'- CERTIFICATE OF LIABILITY INSURANCE I DATE (MM1pD/YYYY) 09/12/2018 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 NAnEACT Thomas Ledwidge THOMAS LEDWIDGE INSURANCE AGENCY PHONE 305- 822 -2424 I FAx StafeFanai 6177 MIAMI LAKES DRIVE E E r " Ext1i I (ac, No): 822-2558 MIAMI LAKES, FL 33014 ADDRESS: Thomas @LedwidgeAgency.com ` INSURER(S) AFFORDING COVERAGE NAIC 3S INSURED INSURER A : State Farm Mutual Automobile Insurance Company 25178 OAC ACTION CONSTRUCTION CORP (10260) IN B: 11980 SW 144 Ct. Suite 101 MIAMI FL 33186 -6266 INSURER C: INSURER D INSURER E COVERAGES INSURER F : 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, TERIv1 OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTI 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 ADDLSUBR LTR TYPE OE INSURANCE INSO WYD POLICY NUMBER POLICY EFF POLICY EXP COMMERCIAL GENERAL LIABILITY (MMfOD/YYYY) (MM/DD/YYYY) LIMITS EACH OCCURRENCE 1 5 CLAIMS-MADE OCCUR DAR. 1AGE T N ED PREMISES (Ea occurrence) 5 r . MED EXP (Any one person) 5 GEN'L AGGREGATE LIMIT APPLIES PER: PERSON L 3 ADV INJURY S JECOT 1 LOC GENERAL AGGREGATE _ 5 POLICY Li PRODUCTS - COMP/OP AGG 5 OTHER: A AUTOMOBILE LIABILITY S Y G17 1523 C07 59 09/0712018 03107/2019 COMBINED SINGLE LIMIT ANY AUTO S {Ea accident) ALL OWNED V SCHEDULED E94 2855 - 1326 -59 04/26/2018 70/26)2018 BODILY INJURY (Per person) S 1,000,000 AUTOS ^ AUTOS PROPERTY DAMAGE BODILY INJURY' Per accident 5 NON -OWNED { ) 1,000,000 X HIRED AUTOS AUTOS (Per accident) 5 1,000,000 UMBRELLA LIAR - 5 _ _ OCCUR /�� EACH OCCURRENCE 5 EXCESS LIAB CLAIMS -MADE APP • D • RIS �P(/' NEW - _ �1► AGGREGATE S 050 RETENTIONS DA - f�1 WORKERS COMPENSATION WAIVhN I "' t. .S l y` S AN EMPLOYERS' LIABILITY .I STATUTE 1 I E O R H - Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? j I N / A E.L. EACH ACCIDENT S (Mandatory M NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE 5 DESCRIPTION OF OPERATIONS below. E.L. DISEASE - POLICY LIMIT $ ENOL Y 948 1859 E22 59B 05/22/2018 11/22/2018 comp a coo 5500 deductible " DESCRIPTION OF OPERATIONS! LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is inquired) ' 16 FORD F150 Pickup VIN: 1FTMF1C83GKD92199 18 Ford F150 Pickup VIN: 1 FTMF1CB8JKC01847 CGC License #061561 CERTIFICATE HOLDER - CANCELLATION Additional Insured: Monroe County Board of Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POL!CY.PROVISIONS. Key West, FL 33040 AUTHORIZED REPRESENTATIVE 4-1),-1-0., ( 4,(11/( - c lis,e, • • © 1988-2014 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 Cc.