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COI Expires 01/01/2020 , 1 ® DATE(MMIDDIYYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 4/1/2019 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 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 endorsement(s). PRODUCER CONTACT NAME: Hylant-Cleveland PHONE FAX 6000 Freedom Sq Dr, Ste 400 E//c.No.Ext):216-447-1050 (A/C,No):216-447-4088 MA Independence OH 44131 • ADDRESS: Cleveland-office@hylant.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Hartford Casualty Insurance Co 29424 INSURED K2MDESI-01 INSURER B:Hartford Underwriters Ins Co 30104 K2M Design, Inc. 3121 Bridge Avenue INSURER C:Hartford Fire Insurance Company 19682 Cleveland, OH 44113 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:692216814 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP W LIMITS LTR INSR VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY 45SBAAM2422SA 4/1/2019 4/1/2020 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) S 1,000,000 Ate.. ''ED Y RISK�MENT MED EXP(Any one person) S 10,000 BY Y d PERSONAL&ADVINJURY 51,000,000 GENLAGGREGATE LIMIT APPLIES PER. 1 �{ — GENERAL AGGREGATE 52,000,000 POLICY JECT LOC DATE L1 ( (.( L. _ PRODUCTS-COMP/OPAGG $2,000,000 OTHER: WAIVtfil PI _- $ Y B AUTOMOBILE LIABILITY 45UECBM4123SA 4/1/2019 4/1/2020 COMBINED SINGLE LIMIT(Ea accident) $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY (Per accident) S A X UMBRELLA LIAB X OCCUR 45SBAAM2422SA 4/1/2019 4/1/2020 EACH OCCURRENCE S 6,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE S 6,000,000 DED X RETENTIONS 1n non $ C WORKERS COMPENSATION 45WBCAC5C80 1/1/2019 1/1/2020 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County Board of County Commissioners("BOCC")is included as an additional insured where required by written contract. This Agreement("Agreement")made and entered into this 21st day of January 2015,by and between Monroe County,a political subdivision of the State of Florida,whose address is 1100 Simonton Street,Key West,Florida,33040,its successors and assigns,hereinafter referred to as"COUNTY,"through the Monroe County Board of County Commissioners("BOCC"),and K2M Design.Inc.whose address is 1001 Whitehead Street.Key West.FL 33040 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. Monroe County 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 Mal ilyt I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD