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COI Expires 12/08/2019 BOYS&-1 OP ID:AS '4c®m® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ��. • 04/15/2019 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 - 954-561-2220 CONTACT Gulfstream Insurance Group Inc PHONE 954-561-2220 I FAX 954-566-0673 P.O.Box 8908 (A/C,No,Ext): (A/C,No): Fort Lauderdale,FL 33310-8908 E-MAIL David Arch ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Berkshire Hathaway Specialty INSURED Boys&Girls Clubs of the Keys INSURER B:Normandy Insurance Company 13012 Area,Inc. Great American Ins Co 1400 United St,Ste 108 INSURER C Key West,FL 33040 INSURER D: 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MMIDD/YYYY) (MM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR Y 47-SPK-259970-01 03/25/2019 03/25/2020 PREMISES(Ea occu D nce) $ 100,000 • MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY jE& LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ . A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ' 1,000,000 accident) $ - X ANY AUTO 47-RWS-259970-01 03/25/2019 03/25/2020 BODILY INJURY(Per person) $ OWNED SCHEDULED .- _AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED X NON- WNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ UMBRELLA LIAB OCCUR • EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY PER ERH Y/N- —NHFL008017201$- — --- 12/08/2013-12/08/2019- 580;000 ANY IE II OR/PARI ECUTIVE ri E.L.EACH ACCIDENT $ OFFICER/MEMBERt EXCLUDED? N/A 500,000 E.L.DISEASE-EA EMPLOYEE $ It yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Crime 47-SPK-259970-01 03/25/2019 03/25/2020 Emp Theft 50,000 A Abuse/Molestation 47-SPK-259970-01 03/25/2019 03/25/2020 Limits $1 MIL/$3MIL DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) D&O/EPL/Fiduciary Coverage: Carrier-Great American, Pol#EPPE191918, Eff. 8/28/17,Exp.8/28/18, Limit$1,000,000, Retention$1,000 Monroe County Board of County Commissioners are additional insured with B pR VE GEtv1ENT respect to general liability. DAT WAIVER NI E. CERTIFICATE HOLDER CANCELLATION MONCBCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of County ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1111 12th Street,Suite 408 AUTHORIZED REPRESENTATIVE Key West, FL 33040 David Arch I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. ---- -- -- — The ACORD name and logo are registered marks of ACORD