COI Expires 04/01/2020 -� 03/01/20101 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ 9YYY)
9
- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER1FCA1E 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
INSURERS(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 O Nrocr
NAVE
Lockton Affinity,LLC
PHONE =AX
P.O.Box 873401 (A/C No.Ext): 888-553-9002 A/C,No):
Kansas City,MO 64187-3401 E-MAIL
ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC
INSURER-A: ACE American Insurance Co. 22667
INSURED INSURER-B:
Habitat for Humanity of Key West and Lower Florida Keys,Inc. INSURER-C:
PO Box 5873, INSURER-D:
Key West,FL 33045
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.
IN ADDL SUB POLICY EFF POLICY EXP
SR INSR R (MM/DD/YYYY) (MM/DD/YYYY)
LT WVD
R TYPE OF INSURANCE. POLICY NUMBER LIMITS
GL1064565-19 04/01/2019 04/01/2020
A GENERAL LIABILITY X EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED
X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $1,000,000
LAIMS MADE X OCCUR BYP O E� I GcMENT MED EXP(Any one person) $ 0
DATE PERSONAL&ADV INJURY $1,000,000
NAM /A Y — GENERAL AGGREGATE $2,000,000
/GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000
X'OLICY $
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY (Ea accident) $
ANY AUTO — BODILY INJURY(Per Person) $
ALL OWNED SCHEDULED
AUTOS _ AUTOS BODILY INJURY(Per accident) $
NON-OWNED PROPERTY DAMAGE
HIRED AUTOS _ AUTOS (Per accident)•
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB .CLAIMS MADE AGGREGATE $
, ,DED_ I. I_RETENTION$ --- ___ —-
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS'LIABILITY TORY LIMITS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N
OFFICER/MEMBER EXCLUDED? E.L.EACH ACCIDENT $
(MANDATORY IN NH)
If yes,describe under _E.L.DISEASE-EA EMPLOYEE $
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
Certificate Holder is named Additional Insured as respects to Landlord.
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 Commissioners
1100 Simonton St., - +f •• "'0
Key West,FL 33040
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
1064565