COI Expires 05/08/2019 AC RD@ CERTIFICATE OF LIABILITY INSURANCE DATE
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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 POUCIES
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(lee)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 rlyhte to the certificate holder In lieu of such endorsement(s).
PRODUCER CONTACT
Five County Insurance Agency Inc -PR"ON� Certificate Department FAX
14120 Metropolis Ave �A(C.NLaE1A):239-939-1400 1 pyc,�);239-939-3813 ____•_ .
Fort Myers FL 33912 •AP' EsLcerts@fivecountyinsurance.cam !_.._ _•.._.____
_— _ INSURER(8)AFFORDING COVERAGE NAIC 0
INSURERA:American Builders Insurance 11240 '
INSURED DEcco-1 ----- -••-r`----•-------
DEC Contracting Group Inc INSURER e:Old Dominion insurance —_._•. -,-_.._ I 40231
1560 Matthew Dr Unit B .asyneac:National Builders Insurance_—____ • 16632
Fort Myers FL 33907 INSURERD:_________
INS-IREN P_:
INSURER F:
COVERAGES CERTIFICATE NUMBER:310836888 REVISION NUMBER: r
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURER 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.
DISK; •'! -• AD SOSR TPOLJCY EFF—PPOLICY EAP i -------
LTR• TYPE OF INSURANCE I,Iiso I wyvn POLICY NUMBER totwooJYYYY)-(MMJPDIYYY'I LIMITS '
C i X I COMMERCIAL GENERAL LIABILITY Y f I PKG016751707 3/8/2019 I 3/8/2020 EACH OCCURRENCE I S 1,000,000
CLAIMS-MADE i X 'OCCUR i - ? i ^OA.AG�I`1'ZIRtNr o-----
_PRQMISES IEo gm I a,vnce) 1 5 100.000
.--- ---- I i MED EXP(My one parson) I S 5,000
•---------._-- i I PERSONAL 6 ADV INJURY 1 S 1,000,000 —_
`GEN1 AGGREGATE LIMIT APPLIES� PER: I GENERAL AGGREGATE I S 2.000,000
_;JECT _
POLICY j
LIi LOC PRODUCTS.COMP/OP AGG 1$2,000,000
1 I OTHER: i i S
B 1AUrOMOBILELIABILITY BIP9520A 5/8/2018 5/8/2019 COMBINED ISINGLE LIMIT I$1,000,000
X I ANY AUTO BODILY INJURY(Par person) I S
! OWNED SCHEDULED BODILY INJURY(Par aaxdent I S
_ AUTOS ONLY AUTOS )I
!X HIRED X NON-OWNED
I ,AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE t S
I
A X_UMBRELLA X OCCUR UM8010902304 3/6/2019 3/8/2020 EACH OCCURRENCE 151,000,000
I EXCESSUAB CLAIMS-MADE AGGREGATE I 5 1.000,000
l —1 DEO I i RETENTION$ S
A .WORKERS COMPENSATION WCV0I6799205 3/8/2019 3/8/2020 X I STRATUTE OTtt-
ER
:AND EMPLOYERS'UABRITY Y/N - -- -•------
'ANYPROPRIETORIPARTNERlEXECUTIVE E.L.EACH ACCIDENT S 1,000.000
OFFICER/MEMBEREXCLUDED? n NIA -- -•.——
(Mandatory In NH) E.L DISEASE-EA EMPLOYEE S 1,1300.000
rn.If yes.desEo under I ---- - --- —
;DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1.000.00D
I
I
DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101,Addldonel Remarks Scheduler,may be attached If moro apace la roqutred)
Re: Key West International Airport Noise Insulation Program,Construction of KWBTS Building B Floors 3-6
• The Monroe County Board of County Commissioners;Key West By the Sea Association Inc their employees and officials are included as additional insureds
with respects to General Liability and Auto Liability. Thirty days Notice of Cancellation applies;10 days for non-payment of premium per Florida Statute.
A P NAGEMENT
DA
WAIVER
CERTIFICATE HOLDER CANCELLATION
. SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
MONROE COUNTY BOARD OF COUNTY ACCORDANCE WITH THE POLICY PROVISIONS.
COMMISSIONERS
99198 OVERSEAS HWY 2 AUTHORIZED REPRESENTATIVE
KEY LARGO FL 33037
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