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Certificates of Insurance a Ac � DATE (MMfDD7YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/17/2016 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 Geri Navarro NAME: AISI dba Pan American Insurance Agency, Inc. NQ.EXt)• (925) 407-0417 FAX A/c,No): CA License 11 0'89850 E-MAIL ADDRESS: gnavarro@ascensionins.com 1277 Treat Blvd., Suite 400 INSURER(S) AFFORDING COVERAGE NAIC Walnut Creek CA 94597 INSURER A :Travelers Prom. Cas. Co. of America 25674 _ INSURED INSURER B :Travelers Ind. Co . of Connecticut 25682 Ascension Insurance Holdings, LLC INSURER C : Ascension Benefits & Insurance Solutions INSURERD: 700 SE Central Parkway INSURERE: — Stuart FL 34994 INSURERF: COVERAGES CERTIFICATE NUMBER:CL166961192 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 POUCY EFF POLICY EXP LIMITS LTR INSD WVD POUCY NUMBER IMDD/YYYY) (MWDDIYYYYI A X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS -MADE X OCCUR PREMISES (Ea RENTED $ 1,000,000 X 6308F426365TIL16 6/18/2016 6/18/2017 MED EXP(Anyoneperson) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEM_ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY I JEI LOC PRODUCTS - COMP /OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE UABIUTY COMBINED LIMIT $ 1,000,000 (Ea mciden ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BA8F42609ATIL16 6/18/2016 6/18/2017 BODILY INJURY (Per accident) $ AUTOS NONCWMED PROPERTY DAMAGE X HIRED AUTOS R AUTOS (Per accident) $ Non - owned $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB — CLAIMS.MADE AGGREGATE $ DED 1 RETENTION $ $ A WORKERS COMPENSATION X I STATUTE ER AND EMPLOYERS' LIABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N N! A E.L. EACH ACCIDENT $ 1,000,000 (Mandatory H) EXCLUDED? Y. B8F401309TIL16 6/18/2016 6/18/2017 (Mandatory to NH) E.L DISEASE - EA EMPLOYEES i3O00,000 S s, des u nder DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached W more space Is required) Monroe County BOCC is additional insured as required by contract. APPR� ED : EMENT :Y �►_ D• Iilt.Y[ INAI ,. S CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Suite 2 -268 Key West, FL 33040 AUTHORIZED REPRESENTATIVE Steve Martin /GERI ®1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) A ( ` D CERTIFICATE OF LIABILITY INSURANCE DATE(MMOD/YYYY) 11/17/2016 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 pollcy(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: Geri Navarro AISI dba Pan American Insurance Agency, Inc. PHONE (925) 937 -1483 FAX IA1C No. 1: (A/C, No): 1277 Treat Boulevard ADDRE gnavarro @ascensionins.com Suite 400 ADpRESS' INSURERS) AFFORDING COVERAGE NAIC N Walnut Creek CA 94597 INSURERA:Great American E&S Insurance INSURED INSURER B : Ascension Insurance Holdings, LLC INSURER C: Ascension Benefits & Insurance Solutions INSURER D: 700 SE Central Parkway INSURERS: Stuart FL 34994 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1612758012 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER LTR TYPE OF INSURANCE INVD yyvD POUCY NUMBER POLICY POUCY EXP IMM/DO/YYT Y1 IMM(Dp1YYYY1 LIMITS COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ CLAIMS -MADE I OCCUR DAMAGE TO RENTED — PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY _ $ GEML AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT $ (Ea accident) _ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEOULED AUTOS AUTOS BODILY INJURY (Per accident) $ — HIRED AUTOS NON -OWNED PROPERTY DAMAGE AUTOS (Per accident) $ $ — UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED 1 RETENTION S $ WORKERS COMPENSATION STATUTE I ER AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? I J N/ A EL EACH ACCIDENT $ (Mandatory In NH) If yes, de scr i be unde E.L. DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ A ERRORS & OMISSIONS TER3177425 1/31/2016 1/31/2017 Each Claim /Aggregate $15,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 1 more space Is required) DEDUCTIBLE: $50,000 each occurrence /$100,000 aggregate / '/ Appr •' s :4 AGEMENT WA IVER N/A st YES _ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Suite 2 -268 Key West, FL 33040 AUTHORIZED REPRESENTATIVE Steve Martin /DP .a�--,•": 01988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)