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Certificates of Insurance
Wright National Flood Insurance Company o d A Stock Company P.O. Box 33003 St. Petersburg, FL 33733-8003 Customer Service: 1-800-820-3242 Claims: 1-800-725-9472 FLOOD DECLARATIONS PAGE RENEWAL FFL99.001 0519 0084705 8/30/21 2000 11523 FLD RGLR PolicV Number I NFIP Policy Number I Product Type: Standard Policy 09 1150454547 11 1 1150454547 lGeneral Property Form Policy Period I Date of Issue Agent Code Prior Policy Number From: 9/01/21 To: 9/01/22 12:01 am Standard Time 1 08/30/2021 0084705 09 1150454547 10 Insured KEY WEST PROFESSIONAL PLAZA INC ETAL/ROBERT SANCHEZ PO BOX 414586 MIAMI BEACH FL 33141-0586 Ira T KEY WEST INSURANCE 4634 GULFSTARR DR ,y DESTIN FL 32541-3715 WAMP yW.. Property Location (if other than above) Address may have been changed in accordance with USPS standards. 1111 12TH ST, KEY WEST FL 33040 FR-ating Information Original New Business Effective Date: 6/21/2003 Flood Risk/Rated Zone: A10 Current Flood Zone: AE Grandfathered: Yes Building Occupancy: Business Non -Residential Primary Residence: N Number of Floors: 3 or more Condo Type: N/A Building Indicator: Elevated Community #: 120168 Map Panel/Suffix: 1709 F Basem ent/E ncl osu re/Crawl space: Community Rating: 05 / 25% Program Status: Regular No Enclosure or Crawlspace Community Name: KEY WEST, CITY OF Elevation Difference: 4 Coverage Deductible Annual Premium BUILDING $500,000 CONTENTS NO CONTENTS COVERAGE THIS IS NOT A BILL DEAR MORTGAGEE The Reform Act of 1994 requires you to notify the WYO company for this policy within 60 days of any changes in the servicer of this loan. The above message applies only when there is a mortgagee on the insured location. Premium Paid by: Insured SDecial Provisions: $1, 250 $645.00 INSURED DECLINED CONTENTS COVERAGE $0.00 ANNUAL SUBTOTAL: $645.00 DEDUCTIBLE DISCOUNT/SURCHARGE: - $7.00 ICC PREMIUM: $6.00 COMMUNITY RATING DISCOUNT: - $161.00 SUB -TOTAL: $483.00 RESERVE FUND ASSESSMENT: $87.00 PROBATION SURCHARGE: $0.00 FEDERAL POLICY SERVICE FEE: $50.00 HFIAA SURCHARGE: $250.00 TOTAL WRITTEN PREMIUM AND FEES: $870.00 This policy covers only one building. If you have more than one building on your property, please make sure they are all covered. See III. Property Covered within your Flood policy for the NFIP definition of "building" or contact your agent, broker, or insurance company. Please refer to the policy for complete terms, conditions, and exclusions. A full, digital copy of your flood policy form is available at www.wrightflood.com/policyforms.htmi. The form which applies to your policy coverage is: General Property Form No Additions and Extensions Forms and Endorsements: WFL 99.415 1117 1117 FFL 99.310 0120 0120 WFL 99.116 0614 0614 This policy is issued by NAIC company 11523 Wright National Flood Insurance Company A stock company Copy Sent To: As indicated on back or additional pages, if any. Patricia Templeton -Jones, President 008470509115045454721242 00000 Agent am FFL99.001 0519 0084705 8/30/21 091150454547 11 Agent (305)294-1096 KEY WEST INSURANCE 4634 GULFSTARR DR DESTIN FL 32541-3715 Refer to www.fema.gov/cost-of-flood for more information about flood risk and policy rating. Claims Information: Please contact your agent or go to www.wrightflood.com to enter your claim as well as receive important information to mitigate the damage to your property. If you need to reach the insurance company the number is 1-800-725-9472. 008470509115045454721242 00000 Agent CITIZENS PROPERTY INSURANCE CORPORATION 1' 301 W BAY ST a* JACKSONVILLE FL 32202 CITIZENS lly PROPERTY INSURANCE CORPORAHON WAMM POLICY CHANGE SUMMARY POLICY NUMBER: 00040026 - 8 POLICY PERIOD FROM 10/17/2021 TO 10/17/2022 at 12:01 a.m. Eastern Time Transaction: AMENDED DECLARATIONS Effective: 10/17/2021 Item Prior Policy Information Amended Policy Information Locations and Buildings 1: 1111 12TH ST Is there a Flood Policy in effect No Yes Flood Insurer Name WRIGHT NATIONAL FLOOD INSURANCE COMPANY Flood Policy Number 09 1150454547 Flood Coverage Requirements Yes This summary is for informational purposes only and does not change any of the terms or provisions on your policy. Please carefully review your policy Declarations and any attached forms for a complete description of coverage. PCS 01 14 Page 1 of 1 r CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPER I Y INSU RANCE CORPORAOON COMMERCIAL PROPERTY POLICY DECLARATIONS POLICY NUMBER: 00040026 - 8 POLICY PERIOD FROM 10/17/2021 TO 10/17/2022 at 12:01 a.m. Eastern Time Transaction: AMENDED DECLARATIONS Effective: 10/17/2021 CNR-W Pay Plan: Citizens Full Pay Bill: Insured Billed Named Insured and Mailing Address Agent FI. Agent Lic. # KEY WEST PROFESSIONAL PLAZA A CONDOMINIUM BRIAN STANTON D053062 C/O ROBERTO SANCHEZ FOUNDATION RISK PARTNERS, CORP. PO BOX 414586 2430 W. OAKLAND PARK BLVD MIAMI BEACH, FL 33141-0586 FORT LAUDERDALE, FL 33311 Telephone: Telephone: 954-735-5500 IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENTS. COMMERCIAL PROPERTY COVERAGE PREMIUM $29,101.00 Required Additional Charges: Catastrophe Financing Surcharge $4,365.00 Tax -Exempt Surcharge $509.00 TOTAL: $33,975.00 Change in Policy Premium: $0.00 See Form CDEC-FE-SCH — Commercial Policy Forms And Endorsements Schedule Countersigned: 09/29/2021 Authorized By: BRIAN STANTON BY: Issued Date: 09/29/2021131 Barry J. Gilway President/CEO and Executive Director Citizens Property Insurance Corporation CDEC1 08 21 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of with its permission. *�r CITIZENS PROPER Y INSO RANCE CORPORAnON CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST JACKSONVILLE FL 32202 COMMERCIAL PROPERTY POLICY DECLARATIONS Policy Number: 00040026 - 8 Effective Date: 10/17/2021 to 10/17/2022 Insured Name: KEY WEST PROFESSIONAL PLAZA A CONDOMINIUM LOCATION NO. 1 BUILDING OR SPECIAL CLASS ITEM NO. 1 CSP Code: 0702 BUSINESS DESCRIPTION: Offices - Non -Governmental DESCRIPTION OF PREMISES 1: 1111 12TH ST FOUR STORY WIND RESISTIVE CONDO OFFICE BUILDING ON STILTS;LOC: Location Address Group I Construction Group II Construction Protection Class BCEGS Grade 1111 12TH ST N/A Wind Resistive N/A Ungraded KEY WEST, FL 33040-4088 Group I Territory Group II Territory Coastal Territory No. of Units N/A N/A Monroe - 86 1 COVERAGES PROVIDED Insurance at the Described Premises Applies Only For Coverages For Which A Limit Of Insurance Is Shown. Covered Limit Of Causes Total Coverage Insurance Of Loss Replacement Cost Rates Premium First Loss Building (Bldg) $1,000,000 Wind $8,072,000 Class $29,101.00 Yes OPTIONAL COVERAGES Applicable Only When Entries Are Made In The Schedule Below Coverage Premium Replacement Cost Building Business Personal Property Yes DEDUCTIBLE Hurricane, Other Windstorm or Hail Percentage Deductible Deductible Percentage (Deductible Amount) Bldg: 3% ($242,160) WINDSTORM MITIGATION FEATURES Terrain Year Built Roof Cover Roof Deck Roof -Wall SWR C 1985 N/A N/A Connection N/A N/A Building Type Roof Shape Windstorm FBC Wind Speed FBC Wind Design N/A N/A Protective Devices N/A N/A Class B Mortgageholder(s) & Other Policyholder Interest(s) — See Policy Interest Schedule. PREMIUM: $29,101.00 CDEC1 08 21 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 3 with its permission. r CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPER I Y INSU RANCE CORPORAOON COMMERCIAL PROPERTY POLICY DECLARATIONS Policy Number: 00040026 - 8 Effective Date: 10/17/2021 to 10/17/2022 Insured Name: KEY WEST PROFESSIONAL PLAZA A CONDOMINIUM FLOOD COVERAGE IS NOT PROVIDED BY THIS POLICY. WINDSTORM OR HAIL DEDUCTIBLES ARE CALCULATED ON TOTAL REPLACEMENT COST OR ACTUAL CASH VALUE, NOT THE LIMIT OF INSURANCE. THIS POLICY CONTAINS A CO -PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. INFORMATION ABOUT YOUR POLICY MAY BE MADE AVAILABLE TO INSURANCE COMPANIES AND/OR AGENTS TO ASSIST THEM IN FINDING OTHER AVAILABLE INSURANCE MARKETS. PLEASE CONTACT YOUR AGENT IF YOU HAVE QUESTIONS ABOUT YOUR POLICY. IF YOU ARE UNABLE TO CONTACT YOUR AGENT, YOU MAY REACH CITIZENS AT (800) 537-7335. CDEC1 08 21 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 3 with its permission. CITIZENS PROPERTY INSURANCE CORPORAHON CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST JACKSONVILLE FL 32202 COMMERCIAL PROPERTY POLICY FORMS AND ENDORSEMENTS SCHEDULE POLICY NUMBER 00040026 - 8 POLICY PERIOD FROM 10/17/2021 TO 10/17/2022 at 12:01 a.m. Eastern Time Named Insured KEY WEST PROFESSIONAL PLAZA A CONDOMINIUM An entry below of "All" indicates the form applies to all items scheduled in the policy Location No. Building No. Form No. Edition Date Description ALL ALL IL 09 35 0702 EXCLUSION OF CERTAIN COMPUTER - RELATED LOSSES ALL ALL IL P 001 01 04 U.S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL ("OFAC") ADVISORY NOTICE TO POLICYHOLDERS ALL ALL CIT 03 21 01 14 WINDSTORM OR HAIL PERCENTAGE DEDUCTIBLE ALL ALL CIT W14 20 0214 CITIZENS CHANGES - PROPERTY NOT COVERED ALL ALL CP 01 40 0706 EXCLUSION OF LOSS DUE TO VIRUS OR BACTERIA ALL ALL CIT W02 55 0219 FLORIDA CHANGES - CANCELLATION AND NONRENEWAL ALL ALL CIT 01 75 0220 FLORIDA CHANGES - LEGAL ACTION AGAINST US ALL ALL CIT W10 10 0219 CAUSES OF LOSS - WINDSTORM OR HAIL FORM ALL ALL IL 00 17 1198 COMMON POLICY CONDITIONS ALL ALL CP 00 90 0788 COMMERCIAL PROPERTY CONDITIONS 1 ALL CIT CNRW 00 03 0821 TABLE OF CONTENTS - BUILDING AND PERSONALPROPERTY 1 ALL CIT CNRW 01 25 0821 FLORIDA CHANGES 1 ALL CP 00 10 0607 BUILDING AND PERSONAL PROPERTY COVERAGE FORM 1 1 CIT 04 14 0821 COVERAGE WRITTEN ON A FIRST LOSS BASIS 1 1 CP 12 09 0995 WINDSTORM PROTECTIVE DEVICES Issued Date: 09/29/2021 First Named Insured Copy CDEC-FE-SCH 01 14 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. CITIZENS PROPERTY INSURANCE CORPORAHON CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST JACKSONVILLE FL 32202 COMMERCIAL PROPERTY POLICY POLICY INTEREST SCHEDULE POLICY NUMBER 00040026 - 8 POLICY PERIOD FROM 10/17/2021 TO 10/17/2022 at 12:01 a.m. Eastern Time Named Insured KEY WEST PROFESSIONAL PLAZA A CONDOMINIUM Location No. Building No. Interest Type Name and Mailing Address No Additional Interests. Issued Date: 09/29/2021 First Named Insured Copy CDEC-PI-SCH 01 14 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. q� ve CERTIFICATE OF LIABILITY INSURANCE snv2020 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: H the certificate tickler Is an ADDITIONAL INSURED, Ste pOIICy(ies) must have ADDITIONAL INSURED provisions or be endorsed. H SUBROGATION IS WANED, subject to due terms and Conditions of Ma policy, Certain pollcke may require an andoneemam. A statement on this certificate does not Confer rt ht$ to the cartNlcate holder In lieu of such endorsement .). PRODUCER Keyy West Insurance 646 United Street, Suite 1 Key West FL 33040 xAXE: =1 On 305294-1096 FAx No:954-T35-2852 ADmaw: certificates atewa ins.com _ INSURE 9AFFORNIGCDVEMOE XYLa SJSURER A: Budinton Insurance Company_. 23620 INSURED ROBESANLCO WSURER B: Roberto Sanchez, Trustee --- PO Box 414586 INSURERC: Miami Beach FL 33141 Ix$URER D: _ INSURER E' _ INSUREN F: COVFRAGFS CERTIFICATE NUMBER: 2107399437 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Lm TWBSPINSURANCE A L$UW POLICYNUMSER MWWYEFF PoIJCYW Uses A X COMMERGIALGENERALLMBILTY Y 721RO02450 3=020 W2=021 EACHOCCURRENCE f1000,NO CLAIMSMAOE O OCCUR PREMISES (Ea rca„enm $100,000 MEDEXPP,y Pen ) $51000 PERSOPALBAWINJURY S1000 ON GEN'L AGGREGATE LIMITAPPUES PER GENERAL AGGREGATE $2,000000 PROOOCTS,COMPIOPAGG $2OW,000 X POLICY�jECT ❑LOP $ OTHER: AVTO.D LMBILRY 1NGLE LIMIT Ee B�12,11 $ BOMLYINJVRY!7 pemm) $ 'MIYAOFO OWNEO SCHEOULED AUTOS ONLY AUTOS AUTOS ONLY AIFEP UTOS ONLY �pV ryry jsK PjT BODILY INJVRY IPx ectiEeMI 3 PRx amkml)OPERTY MAGE $ E BY 726A20 UMBREL4L 'pCCUIR FACT OCCURRENCE $ AGGREGATE_- $ EXCESS LMB ,CLU.E_MAOE FN- Vn DEC RETENTION f WAw k* y\( �y t- ` WOIIXERS COMPENSATION ANDEYPLOVERELMBILNY YIN Am9ROPRIETOP ARNEVEXECUTIVE STATUTE OEFR EL EACH ACCIDENT _ $ El, DISEASE -FA EMPLOYEE --, f GFFpEP➢JEMBE R EXCLUDED? ❑ Menem YIn NX) XIA EL OISHSF-POLICY LIMn E Hyr UnNiM OFO OESCRIPLION OF OPEMTIONB MIgv OESCPoPNIN OFOPERATIONSILOCATIONSIVIONLEB MCg1U 101,AWI11wu1 Rwnen�8cbauh,,vYWMY[NASXmm�pobnM,IM) Certificate holder is listed as additional insured With respect to the general liability as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County BOCC 1100 Simonton Street AUTH=REPRESENTATIVE Key West FL 33G40 4 'n C 1988-2015 ACORD CORPORATION. All Ports reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD acoR" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 3/26/2019 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 Key West Insurance 646 United Street, Suite 1 Key West FL 33040 CONTACT NAME: PHONE FAX Arc No Exc: 305-294-1096 Arc Ne:954-735-2852 ADDRESS: certificates@gatewayins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Burlington Insurance Company 23620 INSURED ROBESAN-CD Roberto Sanchez, Trustee PO Box 414586 INSURER B INSURER C INSURER D Miami Beach FL 33141 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 66030438 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR Y 721 B002116 3/2312019 3/23/2020 EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence S 100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON OWNED HIRED AUTOS AUTOS P B (Slt SY WAIVER N/A EK ENT ES._— COMBINED SINGLE LIMIT Ea accident S BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident) S s UMBRELLA LIAB EXCESS LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE S AGGREGATE S DED I I RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A WC STATU- OTH- T LIMI ER E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT I S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is listed as additional insured with respect to the general liability as required by written contract. L,tK I II -ILA 1 t tIULUtK l,ANUMLLA I IUIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County BOCC 1100 Simonton Street Key West FL 33040 AUTHORIZED ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1 M AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD YYYY) 64 , 2/14/2019 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 CONTACT NAME: Key West Insurance PHONE FAX 646 United Street, Suite 1 AIC No at: 954-735-5500 A/c No:954-735-2852 E'MAKey West FL 33040 ADDRESS: certificates@gatewayins.com INSURED Roberto Sanchez, Trustee PO Box 414586 Miami Beach FL 33141 INSURER D : AFFORDING COVERAGE NAIC N ance Company 23620 COVERAGES CERTIFICATE NUMBER: 1050633613 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 LTR rypE OF INSURANCE ADDL POLICY NUMBER /YSUBR POLICY EFF MMIDDYYY POLICY EXP MMIDD/YYYY LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR Y 721B001902 3/23/2018 3232019 EACH OCCURRENCE $ 1,000,000 DAMAGE ToP RENTE PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X I POLICY I IPRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS APPRO BY RIS QY, DATE AGE COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ a UMBRELLA LIAR EXCESS LIAB HCLAIMS-MADE OCCUR WAMM N EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In Ni If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC STATU- I OTH- TORY E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is listed as additional insured with respect to the general liability as required by written contract. (`FRTIFIr ATF Hni r1FR rAHr F=l I ATIr)N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County BOCC 1100 Simonton Street AUTHORIZED REPRESENT TIVE Key West FL 33040 1 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD