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Certificates of Insurance DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCEF10/22/2020 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: Michelle Rushing Bowen, Miclette& Britt of Florida, LLC PHONE FAX 1020 N. Orlando Avenue, Suite 200 WC, /C No Ext: 407 647-1616 A/C No): 407 628-1635 Maitland FL 32751 ADDRESS; mrushing@bmbinc.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:AmerlSure Insurance Company 19488 INSURED PEDROFALCO INSURER B:AmerlSure Mutual Insurance Company 23396 Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C INSURER C: Big Pine Key FL 33043-4516 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1924792931 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 LIMITS LTR INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY Y Y GL209294106 11/2/2020 11/2/2021 EACH OCCURRENCE $1,000,000 Fvl CLAIMS-MADE l DAMAGE TO RENTED OCCUR Approved Risk Management with attachments PREMISES Ea occurrence $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY jE LOG PRODUCTS-COMP/OP AGG $2,000,000 OTHER: 3-11-2021 $ A AUTOMOBILE LIABILITY Y Y CA209293905 11/2/2020 11/2/2021 COMBINED SINGLE LIMIT $ Ea accident 1,000 000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident B X UMBRELLA LIAB X OCCUR Y Y CU209294206 11/2/2020 11/2/2021 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED RETENTION$ $ B WORKERS COMPENSATION Y WC209452606 11/2/2020 11/2/2021 )( PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N 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 $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The following policy provisions and/or endorsements form part of the policies of insurance represented by this certificate of insurance. The terms contained in the policies and/or endorsements supersede the representations made herein. Electronic copies of the policy provisions and/or endorsements listed below are available by emailing: certificates@bmbinc.com When required by written contract,those parties listed in said contract,including the Certificate Holder,are added as additional insureds with respect to the General Liability including ongoing and completed operations,Auto Liability,and Umbrella Liability as afforded by the policy and/or endorsements. When required by written contract,waiver of Subrogation is granted with respect to the General Liability,Auto Liability,Workers Compensation,and Umbrella See Attached... 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 Board of County Commissioners 1100 Simonton Street Suite 2-213 AUTHORIZED REPRESENTATIVE Key West FL 33040 @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: PEDROFALCO LOC#: AC"J?O ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Bowen, Miclette&Britt of Florida,LLC Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C POLICY NUMBER Big Pine Key FL 33043-4516 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Liability to those parties listed in said contract,including the Certificate Holder. The General Liability and Umbrella Liability certified herein are primary and non-contributory to other insurance available, but only to the extent required by written contract. Project:Monroe County Library and Adult Education Center, Marathon Branch Workers Compensation policy covers the state of Florida. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD From: mail-server@csr24.email To: monroecountyfl monroecountyfl@Ebix.com CC: Subject: Renewal Certificate for Pedro Falcon Electrical Contractors Inc. Date: 10/22/2020 7:16:04 AM Attachment(s): THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT FORM A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL. LIABILITY COVERAGE PART Policy Number Agency Number Policy Effective Date GL209294106 o a 4 s 11l212020 Policy Expiration Date Date Account Number 11 t2t2021 112 2 8 2 4 S Named Insured Agency Issuing Company PEDRO FALCON ELECTRICAL BOWEN MTCLETTE BRITT OF AMERISURE INSURANCE CONTRACTORS INC FLORIDA, LLC COMPANY 1. a. SECTION It-WHO IS AN INSURED is amended to add as an additional insured any person or organization: (1) Whom you are required to add as an additional insured on this policy under a written contract or written agreement relating to your business;or (2) Who is named as an additional insured under this policy on a certificate of insurance. b. The written contract,written agreement, or certificate of insurance must: (1) Require additional insured status for a time period during the term of this policy; and (2) Be executed prior to the "bodily injury" 'property damage", or"personal and advertising injury" leading to a claim under this policy. c. If, however: (1) "Your work"began under a letter of intent or work order; and (2) The letter of intent or work order led to a written contract or written agreement within 30 days of beginning such work;and (3) Your customer's customary contracts require persons or organizations to be named as additional insureds; we will provide additional insured status as specified in this endorsement. 2. The insurance provided under this endorsement is limited as follows: a. That person or organization is an additional insured only with respect to liability caused, in whole or in part, by: (1) Premises you: (a)Own; (b) Rent; (c) Lease; or (d)Occupy; (2) Ongoing operations performed by you or on your behalf. Ongoing operations does not apply to "bodily injury"or"property damage"occurring after: Includes copyrighted material of Insurance Services Office, Inc. CIS 70 48 10 15 Pages 1 of 4 Poicy#GL2OQ3Q410G Effective Dates: 11/2/2020-11/2/2021 (a) All work tobe performed by you mron your behalf for the additional insuned(s) at the site ofthe covered operations is complete, including related materials, parts or equipment (other than service, maintenance ornepaio)� nr (6) That portion of"your work"out of which the injury or damage arises is put to its intended use by any person or organization other than another contractor working for a principal as a part of the same project. (3) Completed operations covenaAc but only it (a) The written contract,written agreement, or certificate of insurance requires completed operations coverage or"your work"coverage:and (b) This coverage part provides coverage for"bodily injury"or"property damage"included within the"prod ucbs-comp|eied operations hazard" However,the insurance afforded to such additional insured only applies to the extent permitted by law. b. if the written contract written agreement, or certificate of insurance: (1) Requires"arising out nf'!anguage;or (2) Requires you to provide additional insured coverage to that person or organization by the use of either or both of the following: (a) Additional Insured—Owners, Lessees or Contractors—Scheduled Person Or Organization endorsement CG 20101001; or (b) Additional Insured—Owners, Lessees or Contrac(mrs—Comp|eted Operations endorsement[G 2O371O01; then the phrase"caused, in whole or in part, by"in paragraph 2.a. above is replaced by"arising out of'. c. If the written contract, written agreement, or certificate of insurance requires you to provide additional insured coverage to that person or organization by the use of: (1) Additional Insured—Owners. Lessees ur Contractors—Scheduled Person Or Organization endorsement C(S2O1VD7O4nrCG2Ol0O4i3; w/ (2) Additional Insured—Owners, Lessees or Contractors—Completed Operations endorsement CG 20 370704orCG20370413; or (3) Both those endorsements with either of those edition dates; or NW Either mr both of the following: (a) Additional Insured—Owners, Lessees or Contractors—Scheduled Person Or Organization endorsement CG201O without an edition date specified: or (b) Additional Insured—Owners, Lessees or Contractors—Completed Operations endorsement CG 2Q37 without an edition date specified: then paragraph Z.a.above applies. d. Premises, as respects paragraph 2.a.(1) above, include common or public areas about such premises if so required in the written contract mr written agreement. e. Additional insured status provided under paragraphs 2.a.(1)(b)or 2.a.(1)(c)above does not extend beyond the end ofa premises lease or rental agreement, [ The limits of insurance that apply to the additional insured are the least of those specified inthe: (1) Written contract: (2) Written agreement: (3) Certificate of insurance: or (4) Declarations of this policy. The limits of insurance are inclusive of and not in addition to the limits of insurance shown in the Declarations. includes copyrighted material ofInsurance Services Office, Inc, Page 2uf4 CG7D481015 Poicy#GL2OQ29410G Effective Dates: 11/2/2020'11/2/2021 g, Theinsuramcepmvidedioiheaddi|imma| insureddoesno|applyto ''bodilyimury^. ^prupertydamage''.or .,personal and advertising injury"arising out of an architect's,engineer's, or surveyor's rendering of,or failure to vender, any professional aan/krs, including but not limited to: (1) The preparing,approving, or failing,o prepare nrapprove: (a) Maps; (b) Drawings; *10pnions; (d) Reports; (e) Suweys; (f)Change orders: (g) Design specUicadons� and C8 Supervisory, inspection, or engineering services. h. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4.Other Insurance is deleted and replaced with the following: 4. Other|osurance, Coverage provided by this endorsement is excess over any other valid and collectible insurance available tm the additional insured whether: a. Primary: b.Excess; C.Contingent; or d. On any other basis: but if the written contract, written agreement,or certificate of insurance requires primary and non- contributory coverage,this insurance will be primary and non-contributory relative to other insurance available to the additional insured which covers that person or organization as a Named Insured,and we will not share with that other insurance, i If the written contract,written agreement, or certificate of insurance as outlined above requires additional insured status by use cf CG2D1O1185.then the coverage provided under this [G7D48endorsement does not apply except for paragraph 2.h. Other Insurance. Additional insured status is limited Uothat provided by[G2U1O || 85 shown below and paragraph 2.h.Other Insurance shown above. ADDITIONAL INSURED-OWNERS,LESSEES OR CONTRACTORS(FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART, SCHEDULE Name of Person or Organization: Blanket Where Required by Written Contract,Agreement,or Certificate of Insurance that the terms of CG 20 10 11 85 apply (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section 11) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of"your work"for that insured by or for you. CG 20 10 11 85 Copyright, Insurance Services Office, Inc- 1984 includes copyrighted material cd insurance Services Office, Inc, CG 70 48 10 15 Pages 3pf4 Poicy#GL2OB2941OG Effective Dates: 11/2/2020'11/3/2021 j. The insurance provided by this endorsement does not apply to any premises or work for which the person or organization is specifically listed as an additional insured on another endorsement attached to this policy, includes copyrighted material of Insurance Services Office, Inc. Page 4mf4 CGJO481n15 DATE(MM/DD/YYYY) A�" EVIDENCE OF PROPERTY INSURANCE 3/11/2021 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW.THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST. AGENCY PHONE COMPANY A/C No Ext:407-647-1616 Bowen, Miclette&Britt of Florida, LLC Certain Underwriters at Lloyds 30 rch St 1020 N.Orlando Avenue Suite#200 Londdonon EC3M 3AD FAX A//C No):407-628-1635 ADDRESS:mrushing@bmbinc.com CODE: SUB CODE: AGENCY CUSTOMER ID#: INSURED LOAN NUMBER POLICY NUMBER Pedro Falcon Electrical Contractors Inc Commissioners CSN0006572 &Monroe County Board of County Commissioners 31160 Avenue C EFFECTIVE DATE EXPIRATION DATE Big Pine Key, FL 33043-4516 CONTINUED UNTIL 06/01/2019 05/01/2021 El TERM INATEDIFCHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION/D ES C RI PT I O N Builders Risk for Commercial Structure-Marathon Library Project. New Construction of a two-story,masonry non-combustible, 14,000 sq.ft.library and adult education center. 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION PERILS INSURED I I BASIC BROAD SPECIAL COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE All Risk except as excluded in policy. 7,016,385 25,000 Named Windstorm deductible subject to a$100,000 minimum 5%of TIV All Other Wind/Hail deductible 25,000 Flood deductible-subject to a$100,000 minimum 3%of TIV Earthquake 50,000 Replacement Cost Valuation Approved Risk Management 3-11-2021 REMARKS(including Special Conditions Project:Monroe County Library and Adult Education Center, Marathon Branch 3490 Overseas Highway, Marathon, FL 33050 Certificate Holder is included as Loss Payee with respect to the property described herein. 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. ADDITIONAL INTEREST NAMEANDADDRESS )( ADDITIONAL INSURED H LENDER'S LOSS PAYABLE X LOSS PAYEE MORTGAGEE LOAN# Monroe County Board of County Commissioners 1100 Simonton Street Suite 2-216 AUTHORIZED REPRESENTATIVE Key West, FL 33040 ACORD 27(2016103) @ 1993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 75/18/2020 (MM/DD/YYYY) A�" EVIDENCE OF PROPERTY INSURANCE THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW.THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST. AGENCY PHONE COMPANY A/C No Ext:407-647-1616 Bowen, Miclette&Britt of Florida, LLC Certain Underwriters at Lloyds St 1020 N. Orlando Avenue 30 rch Suite#200 Londdonon EC3M 3AD Maitland, FL 32751 A/c No):407-628-1635 A"Ess:mrushing@bmbinc.com CODE: SUB CODE: AGENCY CUSTOMER ID#: INSURED LOAN NUMBER POLICY NUMBER Pedro Falcon Electrical Contractors Inc Commissioners CSN0006572 &Monroe County Board of County Commissioners 31160 Avenue C EFFECTIVE DATE EXPIRATION DATE Big Pine Key, FL 33043-4516 CONTINUED UNTIL 06/01/2019 12/01/2020 El TERM INATEDIFCHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION/DESCRIPTION Builders Risk for Commercial Structure-Marathon Library Project. New Construction of a two-story,masonry non-combustible, 14,000 sq.ft.library and adult education center. 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION PERILS INSURED I I BASIC BROAD SPECIAL COVERAGEIPERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE All Risk except as excluded in policy. 7,016,385 25,000 Named Windstorm deductible subject to a$100,000 minimum 5%of TIV All Other Wind/Hail deductible 25,000 Flood deductible-subject to a$100,000 minimum 3%of TIV Earthquake 50,000 Replacement Cost Valuation APPROVED RISK MANAGEMENT 06-24-2020 REMARKS(including Special Conditions Project: Marathon Library Project-3490 Overseas Highway, Marathon, FL 33050 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. ADDITIONAL INTEREST NAME AND ADDRESS )( ADDITIONAL INSURED H LENDER'S LOSS PAYABLE X LOSS PAYEE MORTGAGEE LOAN# Monroe County Board of County Commissioners 1100 Simonton Street Suite 2-216 AUTHORIZED REPRESENTATIVE Key West, FL 33040 ACORD 27(2016/03) ©1993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD r Na x if. 4s emu SEP092019 AR o DATE(MM/DD/YYYY) EVIDENCE OF PROPERTY INS _ -------------�--� 7/22/2019 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW.THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST. AGENCY PHONE COMPANY INC.No,Exti:407-647-1616 Bowen,Miclette&Britt of Florida,LLC Certain Underwriters at Lloyds hurch St 1020 N.Orlando Avenue Lo Suite#200 Landdonon EC3M 3AD Maitland,FL 32751 Maitland,FL 32751 (aC,No):407-628-1635 ADDRESS:mrushing@bmbinc.com CODE: I SUB CODE: AGENCY CUSTOMER ID#: INSURED LOAN NUMBER POLICY NUMBER Pedro Falcon Electrical Contractors Inc Commissioners CSN0006572 31160 Avenue C Big Pine Key,FL 33043-4516 EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 06/01/2019 06/01/2020 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION/DESCRIPTION Builders Risk for Commercial Structure-Marathon Library Project.New Construction of a two-story,masonry non-combustible, 14,000 sq.ft.library and adult education center. 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION PERILS INSURED BASIC BROAD SPECIAL COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE All Risk except as excluded in policy. 7,016,385 25,000 Named Windstorm deductible subject to a$100,000 minimum 5%of TIV All Other Wind/Hail deductible 25,000 Flood deductible-subject to a$100,000 minimum 3%of TIV Earthquake 50,000 Replacement Cost Valuation REMARKS(Including Special Conditions) Project:Marathon Library Project-3490 Overseas Highway,Marathon,FL 33050 Y ISK` NAGEPAENT BY DA WAIVER W YES..,..... 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. ADDITIONAL INTEREST • NAME AND ADDRESS X ADDITIONAL INSURED LENDER'S LOSS PAYABLE X LOSS PAYEE MORTGAGEE LOAN# Monroe County Board of County Commissioners 1100 Simonton Street Suite 2-216 AUTHORIZED REPRESENTATIVE/ Key West,FL 33040 C���k' ACORD 27(2016/03) ©1993-2015 ACORD CORPORATION. All rights reserved. The ACCORD name and logo are registered marks of ACORD MIDD A�� ® CERTIFICATE OF LIABILITY INSURANCE DATE 4(M 019 Y) 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: Lois Behr Bowen, Miclette&Britt of Florida, LLC PHONE FAX 1020 N. Orlando Avenue, Suite 200 IA/C,No,Ext):(407)647-1616 (NC,No):(407)628-1635 , Maitland FL 32751 E-MAIL certificates@bmbinc.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Amerisure Insurance Company 19488 INSURED PEDROFALCO INSURER B:Amerisure Mutual Insurance Company 23396 Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C INSURER C: Big Pine Key FL 33043-4516 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:99043830 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 ADDLTYPE OF INSURANCE INSO SUER • POLICY NUMBER ' (MM/DDY/YYYY) (POLICY M/IDDIYYYY) LIMITS LIR INSp MD A X COMMERCIAL GENERAL LIABILITY Y Y GL20929410401 11/2/2018 11/22019 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR . Y Al IC T PREMISES(Ea occurrence) $100,000 J ((�/f1 MED EXP(Any one person) $5,000 �Y � (��'"/ PERSONAL 8 ADV INJURY $1,000,000 7 GEN'L AGGREGATE LIMIT APPLIES PER: DATE ' f 1 / GENERAL AGGREGATE $2,000,000 POLICY X JEI LOC WAIVESNh YES PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y CA20929390401 11/2/2018 11/2/2019 COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ B X UMBRELLALU)B X OCCUR Y Y CU20929420402 11/2/2018 11/2/2019 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED RETENTION$ $ A WORKERS COMPENSATION Y WC209452604 11/2/2018 1122019 X PER OTH- AND EMPLOYERS'LWBILITY Y/N STATUTE _ _ER_____ ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) The following policy provisions and/or endorsements form part of the policies of insurance represented by this certificate of insurance. The terms contained in the policies and/or endorsements supersede the representations made herein. Electronic copies of the policy provisions and/or endorsements listed below are available by emailing: certificates@bmbinc.com When required by written contract,those parties listed in said contract,including the Certificate Holder,are added as additional insureds with respect to the General Liability including ongoing and completed operations,Auto Liability,and Umbrella Liability as afforded by the policy and/or endorsements. When required by written contract,waiver of Subrogation is granted with respect to the General Liability,Auto Liability,Workers Compensation,and Umbrella See Attached... 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 Board of County Commissioners 1100 Simonton Street, Room 2-213 AUTHORIZED REPRESENTATIVE Key West FL 33040 eefairdf0,0„,_ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01.) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE AGENCY CUSTOMER ID: PEDROFALCO LOC#: ACCPRE1 ADDITIONAL REMARKS SCHEDULE Page 1 of AGENCY NAMED INSURED Bowen,Miclette&Britt of Florida,LLC Pedro Falcon Electrical Contractors,Inc. 31160 Avenue C POLICY NUMBER Big Pine Key FL 33043-4516 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Liability to those parties listed in said contract,including the Certificate Holder. The General Liability and Umbrella Liability certified herein are primary and non-contributory to other insurance available,but only to the extent required by written contract. RE: Marathon Library and Adult Education Center at 3490 Overseas Highway,Marathon,FL 33050 ( ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT — FORM A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy Number Agency Number Policy Effective Date GL20929410401 08,45507 11/212018 Policy Expiration Date Date Account Number 11212019 11228245 Named Insured Agency Issuing Company PEDRO FALCON ELECTRICAL BOHEt4 MICLE_T E & BRITT OF ANERISURE INSURANCE CONTRACTORS INC FLCR:DA, LLC COMPANY 1. a. SECTION iI-WHO IS AN INSURED is amended to add as an additional insured any person or organization: (1) Whom you are-required to add as an additional insured on this policy under a written contract or written agreement relating to your business;or (2) Who is named as an additional insured under this policy on a certificate of insurance. b. The written contract,written agreement.or certificate of insurance must: (1) Require additional insured status for a time period during the term of this policy;and (2) Se executed prior to the"bodily injury'."property damage", or"personal and advertising injury" leading to a claim under this policy. c. If, however (1) "Your work"began under a letter of intent or work order;and (2) The letter of intent or work order led to a written contract or written agreement.within 30 days of beginning such work;and (3) Your customer's customary contracts require persons or organizations to be named as additional insureds; we will provide additional insured status as specified in this endorsement. 2. The insurance provided under this endorsement is limited as follows: a. That person or organization is an additional insured only with respect to liability caused, in whole or in part.by: . (1) Premises you: (a)Own; (b)Rent: (c)Lease:or (d)Occupy: (2) Ongoing operations performed by you or on your behalf. Ongoing operations does not apply to "bodily injury"or"property damage"occurring after: includes copyrighted material of Insurance Services Office, Inc. CG-70 48 1015 Pages 1 of 4 POLICY uGL20929410401 EFFECTIVE DATES: 1 i/212018-1112/2019 • (a) All work to be performed by you or on your behalf for the additional insured(s)at the site of the covered operations is complete,including related materials,parts or equipment(other than service,maintenance or repairs):or (b) That portion of'your work"out of which the injury or damage arises is put to its intended use by any person or organization other than another contractor working for a principal as part of the same project. (3) Completed operations coverage.but only (a) The written contract,written agreement,or certificate of insurance requires completed operations coverage or`your work"coverage;and (b) This coverage pad provides coverage for"bodily injury"or-property damage included within the"products-completed operations hazard'_ However.the insurance afforded to such additional insured only applies to the extent permitted by law. b. If the written contract.written agreement.or certificate of insurance: (1)• Requires"arising out of language;or (2) Requires you to provide additional insured coverage to that person or organization by the use of either or both.of the following: (a) Additional Insured—Owners, Lessees or Contractors—Scheduled Person Or Organization endorsement CG 2010.10 01:or (b) Additional Insured—Owners;Lessees or Contractors-Completed Operations endorsement CG 20 37 10 01; then the phrase"caused.in whole or in part.by'in paragraph 2.a.above is replaced by."arising out of'. c. If the written contract,written agreement,or certificate of insurance requires you to provide additional insured coveraeeto that person or organication,by the use of: (1) Additional Insured—Owners, Lessees or Contractors—Scheduled Person Or Organization endorsement CG 20 10 07 04 or CG 20 10 04 13;or (2) Additional Insured—Owners.Lessees or Contractors—Completed Operations endorsement CG 20 370704orCG20370413;or (3) Both those endorsements with either of those edition dates;or (4) Either or both of the following: (a) Additional Insured—Owners, Lessees or Contractors—Scheduled Person Or Organization endorsement CG 20 10 without an edition date specified:or (b) Additional Insured—Owners, Lessees or Contractors—Completed Operations endorsement CG 20 37 without an edition date specified: then paragraph 2.a.above applies. d. Premises,as respects paragraph 2.a.(1)above,include common or public areas about such premises if so required in the written contract or written agreement. e. Additional insured status provided under paragraphs 2.a.(1)(b)or 2.a.(1)(c)above does not extend beyond the end of a premises lease or rental agreement. f. The limits of insurance that apply to the additional insured are the least of those specified in the; (1) Written contract; (2) Written agreement: (3) Certificate of insurance:or (4) Declarations of this policy. The limits of insurance are inclusive of and not in addition to the limits of insurance shown ie the Declarations. Includes copyrighted material of Insurance Services Office. Inc. Page 2 of 4 CG 70 4010 15 POLICY#GL20929410401 EFFECTIVE DATES: 1 1/2120 1 8.1112/2019 g. The insurance provided to the additional insured does riot apoly,to"bodily injury"."property damage".or "personal and advertising,injury.arising out of an architect's,engineers,or surveyor's rendering of,or • failure to render,any professional services,including but not limited to; (1) The preparing,approving,or failing to prepare or approve: (a) Maps: (b)Drawings; (c)Opinions: (d) Reports; (e)Surveys; (f)Change orders: (g)Design specifications;and (2) Supervisory,inspection,or engineering services. h. SECTION IV—COMMERCIAL GENERAL.LIABILITY CONDITIONS, paragraph 4.Other Insurance is deleted and replaced with the following: 4. Other Insurance. Coverage provided by this endorsement is excess over any other valid and collectible insurance available to the additional insured whether: a.Primary; b.Excess; c.Contingent;or d,On any other basis; but if the written contract,written agreement.or certificate of insurance requires primary and non- contributory coverage,this insurance will be primary and non-contributory relative to other insurance available to the additional insured which covers that person or organization as a Named Insured,and we will not share with that other insurance, I. If the written contract,written agreement,or certificate of insurance as outlined above requires additional insured status by use of CG 2010 11 85,then the coverage provided under this CG 70 48 endorsement does not apply except for paragraph 2.h.Other.insurance. Additional insured status is limited to that provided by CG 20 10 11 85 shown below and paragraph 2:h,Other Insurance shown above. ADDITIONAL INSURED-OWNERS,LESSEES OR CONTRACTORS(FORM B) This endorsement modifies insurance.provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Blanket Where Required by Written Contract.Agreement,or Certificate of Insurance that the terns of CG 20 1011 85 apply (If no entry appears above,information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED_(Section II)is amended to include as an insured the person or organization shown in the Schedule,but only with respect to liability arising out of"your wort:"for that insured by or for you. CG 2010 11 85 Copyright, Insurance Services Office.Inc., 1984 Includes copyrighted material of Insurance Services Office,Inc.. CG 70 481015 Pages 3 of 4 POLICY.#GL20929410401. EFFECTIVE DATES: 111212018-111212019 j. The insurance provided by this endorsement does not apply to any premises or work for which the person or organization is specifically listed asan'additional insured on another endorsement attached to this policy, Includes copyrighted material_of Insurance Services Office, Inc. Page 4of4 CG70461015