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Certificates of Insurance DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 11/30/2023 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: Klein Agency,LLC ACNE. Ext: (410)832-7600 a/c,No): (410)832-1849 P.O.Box 219 E-MAIL certs@kleinagencyllc.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Timonium MD 21094 INSURERA: XL Specialty Insurance 37885 INSURED INSURER B KCI Technologies,Inc. INSURER C: 936 Ridgebrook Road INSURER D: INSURER E: Sparks MD 21152 INSURER F: COVERAGES CERTIFICATE NUMBER: 23-24 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO TED CLAIMS-MADE OCCUR -PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO kp , BODILY INJURY(Per person) $ OWNED SCHEDULED .i 1r1�"4 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS PROPERTY � HIRED NON-OWNED „,,.„ perm cden DAMAGE $ AUTOS ONLY AUTOS ONLY 7 9. 24 $ UMBRELLA LIAB .I OCCUR "^^" """""�" EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE �' "' AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability A DPR5021170 12/15/2023 12/15/2024 Per Claim $10,000,000 Aggregate $15,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Continuing Surveying Services Agreement with Monroe County. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St.,Rm.2-216 AUTHORIZED REPRESENTATIVE ?� Key West FL 33040-0000 �" @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACCOR" CERTIFICATE OF LIABILITY INSURANCE 4/22/2024 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: James Watson Lyons Insurance Agency Inc PHONE FAX 501 Carr Road, Suite 301 A/C No Ext: 302-472-2909 A/C,No:302-658-1253 Wilmington DE 19809 ADDE-MRESS: lyons@lyonsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: National Union Fire Insurance Company of Pittsburg 19445 INSURED KCITECH-01 INSURERB: Great American Insurance Co. 16691 KCI Technologies, Inc. INSURERC: New Hampshire Insurance Company 23841 936 Ridgebrook Road Sparks MD 21152 INSURERD:Zurich American Insurance Co 16535 INSURERS: Twin City Fire Insurance Company 29459 INSURERF: Evanston Insurance Company 35378 COVERAGES CERTIFICATE NUMBER:250813743 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 MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY Y Y 522-24-13 4/1/2024 4/1/2025 EACH OCCURRENCE $2,000,000 CLAIMS-MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $500,000 } APP7 T MED EXP(Any one person) $25,000 '„„z, PERSONAL&ADV INJURY $2,000,000 7 GEN'L AGGREGATE LIMIT APPLIES PER: DA 924 """" GENERAL AGGREGATE $4,000,000 .9. POLICY� PE � LOC '' `-�, �'� PRODUCTS-COMP/OP AGG $4,000,000 OTHER: Contractual Liab. $2,000,000 A AUTOMOBILE LIABILITY Y Y 448-95-82 4/1/2024 4/1/2025 COMBINED SINGLE LIMIT $2,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Hired Physical Dam. $ B X UMBRELLALIAB X OCCUR Y Y TUU 0-20-29-25-13 4/1/2024 4/1/2025 EACH OCCURRENCE $15,000,000 EXCESS LAB CLAIMS-MADE AGGREGATE $15,000,000 DED X RETENTION$1 n nnn $ C WORKERS COMPENSATION Y WC 0 12-01-6190 4/1/2024 4/1/2025 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICE R/M EMBER EXCLUDED? FN] 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 D Contractor Equip.-Leased/rented Y CPP 4613089-13 1/1/2024 1/1/2025 Leased/Rented Equip 500,000 E Crime-Third Party Y 44 KB 0260907-23 1/1/2024 1/1/2025 Per Occurrence 1,000,000 F Ocean Marine Y 9CD6319-8 3/8/2024 3/8/2025 Protection/Indemnity 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The Additional Insured(s)below referenced are included as Additional Insured under General&Automobile Liability,for ongoing and completed operations, where required by written contract.Waiver of Subrogation is granted under General,Automobile Liability&Workers'Compensation,where required by written contract&allowable by state law.This insurance is primary and non-contributory to any other insurance. Umbrella Liability is Following Form with the Underlying. If coverage is cancelled by the company,notice of cancellation will be provided at least 30 days in advance,subject to state-specific statutes. Project:On Call Professional Engineering Services Monroe County shall be listed as an Additional Insured under General&Automobile Liability,on a Primary/Non-Contributory basis where required by written contract.Wavier of Subrogation is granted under General&Automobile Liability,&Workers Compensation,where required by written contract&allowable by state law. Umbrella is Following Form with the Underlying. If coverage is cancelled by the company, notice of cancellation will be provided at least 30 days in advance,subject to state specific statutes. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West FL 33040 AUTHORIZED REPRESENTATIVE USA @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD KCITECH-01 MATSON �►co�ro,,, CERTIFICATE OF LIABILITY INSURANCE DAT/30/2D/YYYY) 023 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 James Watson,AINS NAME: Lyons Insurance Agency,Inc. PHONE FAX 501 Carr Road,Suite 301 (A/C,No,Ext): (302)472-2909 (A/C,No): ML Wilmington,DE 19809 ADDRESS:jwatson@lyonsinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:National Union Fire Insurance Company of Pittsburgh,PA 19445 INSURED INSURER B:Great American Insurance Co. 16691 KCI Technologies,Inc. INSURERC:New Hampshire Insurance Company 23841 5835 Blue Lagoon Drive,Suite 303 INSURER D 7 Miami,FL 33126 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 MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR 522-24-13 4/1/2023 4/1/2024 DAMAGE TO RENTED 500 000 X X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 25,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY�X JECT � LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000 Ea accident $ X ANY AUTO X X 448-95-82 4/1/2023 4/1/2024 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 15,000,000 EXCESS LIAB CLAIMS-MADE X X TUU 0-20-29-25-12 4/1/2023 4/1/2024 AGGREGATE $ 15,000,000 DED X RETENTION$ 10,000 $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY X STATUTE ER WC 012-01-6190 4/1/2023 4/1/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project:On Call Professional Engineering Services Monroe County shall be listed as an Additional Insured under General&Automobile Liability,on a Primary/Non-Contributory basis where required by written contract.Wavier of Subrogation is granted under General&Automobile Liability,&Workers Compensation,where required by written contract&allowable by state law. Umbrella is Following Form with the Underlying.If coverage is cancelled by the company,nntlra of rnnralinfinn will hP nrnuir1Pr1 nt lanct A,n rinvc in advance,subject to state specific statutes. j? ' a � CERTIFICATE HOLDER CANCELLATION 3 23 SHOULD ANY OF THE WAMM - ' Monroe CountyBOCC THE EXPIRATION I ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West,FL 33040 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 12/20/2023 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: Klein Agency,LLC ACNE. Ext: (410)832-7600 a/c,No): (410)832-1849 P.O.Box 219 E-MAIL certs@kleinagencyllc.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Timonium MD 21094 INSURERA: XL Specialty Insurance 37885 INSURED INSURER B KCI Technologies,Inc. INSURER C: 936 Ridgebrook Road INSURER D: INSURER E: Sparks MD 21152 INSURER F: COVERAGES CERTIFICATE NUMBER: 23-24 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO TED CLAIMS-MADE OCCUR -PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ �++Y� 9�^ Ea accident ANYAUTO y )�6K II BODILY INJURY(Per person) $ � OWNED SCHEDULED AUTOS ONLY AUTOS IP BODILY INJURY(Per accide nt) $ *� _,., HIRED NON-OWNED PROPERTY PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY 12.20.23 Per accident $ UMBRELLA LIAB OCCUR WAMMr �, EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability A DPR5021170 12/15/2023 12/15/2024 Per Claim $10,000,000 Aggregate $15,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Continuing Contract for On Call Professional Engineering Services. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE ?� Key West FL 33040-0000 �" @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD KCITECH-01 MATSON �►co�ro,,, CERTIFICATE OF LIABILITY INSURANCE DAT/30/2D/YYYY) 023 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 James Watson,AINS NAME: Lyons Insurance Agency,Inc. PHONE FAX 501 Carr Road,Suite 301 (A/C,No,Ext): (302)472-2909 (A/C,No): ML Wilmington,DE 19809 ADDRESS:jwatson@lyonsinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:National Union Fire Insurance Company of Pittsburgh,PA 19445 INSURED INSURER B:Great American Insurance Co. 16691 KCI Technologies,Inc. INSURERC:New Hampshire Insurance Company 23841 5835 Blue Lagoon Drive,Suite 303 INSURER D 7 Miami,FL 33126 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 MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR 522-24-13 4/1/2023 4/1/2024 DAMAGE TO RENTED 500 000 X X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 25,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY�X JECT � LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000 Ea accident $ X ANY AUTO X X 448-95-82 4/1/2023 4/1/2024 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 15,000,000 EXCESS LIAB CLAIMS-MADE X X TUU 0-20-29-25-12 4/1/2023 4/1/2024 AGGREGATE $ 15,000,000 DED X RETENTION$ 10,000 $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY X STATUTE ER WC 012-01-6190 4/1/2023 4/1/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project:On Call Professional Engineering Services Monroe County shall be listed as an Additional Insured under General&Automobile Liability,on a Primary/Non-Contributory basis where required by written contract.Wavier of Subrogation is granted under General&Automobile Liability,&Workers Compensation,where required by written contract&allowable by state law. Umbrella is Following Form with the Underlying.If coverage is cancelled by the company,nntlra of rnnralinfinn will hP nrnuir1Pr1 nt lanct A,n rinvc in advance,subject to state specific statutes. j? ' a � CERTIFICATE HOLDER CANCELLATION 3 23 SHOULD ANY OF THE WAMM - ' Monroe CountyBOCC THE EXPIRATION I ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West,FL 33040 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KCITECH-01 AMORRISON ACORO"° CERTIFICATE OF LIABILITY INSURANCE DATE(M/202YYY) 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 Maureen Martin,AAI NAME: Lyons Insurance Agency,Inc. PHONE FAX 501 Carr Road,Suite 301 (A/C,No,Ext): (302)472-2914 (A/C,No): Wilmington,DE 19809 ADDRIESS:mmartin@lyonsinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:National Union Fire Insurance Company of Pittsburgh,PA 19445 INSURED INSURER B:Great American Insurance Co. 16691 KCI Technologies,Inc. INSURERC:New Hampshire Insurance Company 23841 5835 Blue Lagoon Drive,Suite 303 INSURER D 7 Miami,FL 33126 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 MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR GL 522-24-13 4/1/2022 4/1/2023 DAMAGE TO RENTED 500,000 X X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 25,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT1:1 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000 Ea accident $ X ANY AUTO X X CA 448-95-82 4/1/2022 4/1/2023 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE X X T00020292511 4/1/2022 4/1/2023 AGGREGATE $ 10,000,000 DED X RETENTION$ 10,000 $ C WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY X STATUTE ER WC 012-01-6190 4/1/2022 4/1/2023 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000'OOO If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project:On Call Professional Engineering Services Monroe County shall be listed as an Additional Insured under General&Automobile Liability,on a Primary/Non-Contributory basis where required by written contract.Wavier of Subrogation is granted under General&Automobile Liability,&Workers Compensation,where required by written contract&allowable by state law. Umbrella is Following Form with the Underlying.If coverage is cancelled by the company,notice of cancellation will be provided at least 30 days in advance,subject to state specific statutes. CERTIFICATE HOLDER CANCELLATION l 3 GL AL. 11 1 _ DATA SHOULD ANY OF THE A THE EXPIRATION DF WAIM Monroe County BOCC ACCORDANCE WITH TF 1100 Simonton Street Key West,FL 33040 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Client#: 42475 KCITEC DATE(MM/DD/YYYY) ACORDT. CERTIFICATE OF LIABILITY INSURANCE 1 12/05/2022 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Letha E. Lombardi NAME: CBIZ Insurance Services, Inc. PHONE 443 259-3237 FAX A/C,No,Ext: (A/C,No): 44 Baltimore Street E-MAIL certreqest@cbiz.com ADDRESS: q G Cumberland, MD 21502 INSURER(S)AFFORDING COVERAGE NAIC# 301 777-1500 INSURER A:XL Specialty Insurance Co. 37885 INSURED INSURER B: KCI Technologies, Inc. INSURER C 6500 N.Andrews Ave. Fort Lauderdale, FL 33972 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 CONTRACTOR 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 INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISESOEa occurDrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- PRODUCTS-COMP/OP AGG $ POLICY PRO-JECT LOC OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED I PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY t Per accident UMBRELLA LIAB CLAIMS-MADE � "'"' 1 1 23 ��.....,,,,, EACH OCCURRENCE $ OCCUR EXCESS LIAB AGGREGATE $ DED RETENTION$ M 'I $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional DPR5006107 12/15/2022 12/15/2023 $10,000,000 each claim Liability $15,000,000 aggregate $500,000 deductible DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Continuing Contract for On Call Professional Engineering Services. CERTIFICATE HOLDER CANCELLATION Monroe County BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S3336527/M3333119 OPSD KCITECH-01 RVANDEGRIFT ACORO` CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDrrYYY) `-� 3/28/2019 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 Maureen Martin,AA! NAME: Lyons Insurance Agency,Inc. PHONE FAX 501 Carr Road,Suite 301 (A/c,No,Ext):(302)472-2914 (A/C,No): Wilmington,DE 19809 E-MAIL mmartin@Iyonsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:National Union Fire Insurance Company of Pittsburgh,PA 19445 INSURED INSURER B:Great American Insurance Co. 16691 KCI Technologies,Inc. INSURER C:New Hampshire Insurance Company 23841 6500 North Andrews Avenue INSURER D: Fort Lauderdale,FL 33309 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. ILTR TYPE OF INSURANCE R AINSD WVD POLICY NUMBER IMM/ODY�1 IMMIDDIIYYY XYPYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 5222413 4/1/2019 4/1/2020 DAMAGE TO RENTED 500,000 X X PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 25,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X jECT LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 _(_Ea accident) X ANY AUTO X X 4489582 4/1/2019 4/1/2020 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ AUTOS ONLY NON-OWNED (Peer accident DAMAGE X Camp.Ded.$250. x Coll. Ded.$500 $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 25,000,000 EXCESS LIAB CLAIMS-MADE X X TUU0202925-08 4/1/2019 4/1/2020 AGGREGATE $ 25,000,000 DED X RETENTIONS 10,000 $ C WORKERS COMPENSATION x AND EMPLOYERS'LIABILITY STATUTE EERH ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N x WC012016190 4/1/2019 4/1/2020 1,000,000 OFFICER/MEMBER EXCLUDED? N N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE.$ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Monroe County shall be listed as an Additional Insured under General&Automobile Liabilit ,on a Primary/Non-Contributory basis where required by written contract.Wavier of Subrogation is granted under General&Automobile Liabili ,& orke s om ensation,where required by written contract&allowable by state law. Umbrella is Following Form with the Underlying.If cove , lice of cancellation will be provided at least 30 days in advance,subject to state specific statutes. BY DA WAIVER N/ YES— CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe CountyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West,FL 33040 - - AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KEITAND-01 NCHANDUVI ,a�c_o�Ro CERTIFICATE OF LIABILITY INSURANCE DATE ) 10112017(MMIDDIYYY o3rovzal7 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 endorsemen s). PRODUCER C NTACT Ames $ Gough PHONE FAX 8300 Greensboro Drive (AIC, No, Ext): (703) 827.2277 (Alc, No):(703) 827-2279 _ Suite 980 i E-MAfL admin a amesgough.com ADDRESS _ McLean, VA 22102 INSURER(S) AFFORDING COVERAGE NAIC N �19445 INSURER A: National Union Fire Insurance Compan INSURED I INSURER B : St_ Paul Fire and Marine Insurance Company 124767 Keith and Schnars, P.A. i INSURER C : National Union Fire insurance Company of Pittsburgh, PA19445 6500 North Andrews Avenue INsuRER D :Continental Casualty Company (CNA) A, XV 20443 Ft. Lauderdale, FL 33309-2132 i INSURER F COVERAGES CFRTIFICATF NLIMRFR: octnclAKf wtulaco. 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 R ; TYPE OF INSURANCE )ADDLISUBRi POLICY NUMBER ----- POLICY EFF POLICY EXP YY YYY LIMITS — A X I COMMERCIAL GENERAL LIABILITY LAIMS-MADE CCX �, OCCUR I--.—p— 5180214 EACH OCCURRENCE 03/01/2017 03/01/2018 DAMAGE TO RENTED $ 1,000,000 300,00{) 1 � 10,000 _ MEDEXP(Mvon onepers) PERSONAL & ARV INJURY...__-.- 110001000 GEN'L AGGREGATE LIMIT APPLIES PER:'. Xl POUCY �X JET X LOG $ 2,000,000 ;GENERAL AGGREGATE PRODUCTS _COMP/OP AGG $ 2'000'000 . g _ OTHER: • AUTOMOBILE LIABILITY X ANYAUTO _ 12961640 OWNED HEDULED SC AUTOS ONLY AUTOS I COMBINED SINGLE LIMIT i _AEacadentl 10310112017 03/01/201 B ! BODILY INJURY (Per person) I BODILY INJURY Per accident 1 ,QQQ QQQ $ $ $ HIRED NON-pWNEO �— AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident, $ B X UMBRELLA LIAB I OCCUR EXCESS LIAB i CLAIMS -MADE I II''' UP-15T76430-17-NF ! :EACH OCCURRENCE 03/01/2017 03/01/2018':., AGGREGATE S 5,000,DOO 5,000,000i DED , X 1 RETENTION$ 10,000; $ C AND EMPLOYERS' COMPENSATION I - Y 1 N :ANY PROPRIETORIPARTNERIEXECUTIVE N j N f A OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yyBS, daacribe untler 6ESCRIPTION OF OPERATIONS below 012015939 X PERT T ORH- 03101/2017 03I01/2018 E.L. EACH ACCIDENT E.L DISEASE -EA EMPLOYE '', E.L. DISEASE -POLICY LfMfT ' $ 1,000,000 $ 1,000,000 1,000,000 p IProfessiona{ jAEHOO6091227 03/01/2017 03/01/2018 JPer Claim 2,000,000 D �Lllbillty AEH006091227 03/01/201, 03/01/2018 Aggregate i' 4,000,0001 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additlonal Remarks Schedule, may be attached If more space is required) RE: k&s#18147.XX RFQ-NON-68-0-2013/EC - ON CALL PROFESSIONAL ENGINEERING SERVICES. CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED WITH THE EXCEPTION OF WORKERS COMPENSATION 8 PROFESSIONAL IIABILiTY. �VE EMW DAT WAI R MONROE COUNTY 1100 SIMONTON STREET KEY WEST, FL 33040 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 AC:UKU L�b/03) ©1988-2015 ACORD CORPORATION. All rights reserved. C. C_ The ACORD name and logo are registered marks of ACORD 4 KFITAmn-n1 NCHANDUVI CERTIFICATE OF LIABILITY INSURANCE E (MM/D D/YYYY) 0DATE 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 Ames 8� Gough Ame Greensboro Drive Suite 980 CONTACT NAME: PHONE (Arc, No, Ext): (703) 827-2277 (Arc, No):(703) 827-2279 all oRlEss: admin@amesgough.com INSURERS AFFORDING COVERAGE NAIC # McLean, VA 22102 INSURER A: National Union Fire Insurance Company 19445 INSURED INSURER B:St. Paul Fire and Marine Insurance Company 24767 INSURER C: National Union Fire Insurance Company of Pittsburgh, PA 19445 Keith and Schnars, P.A. INSURER D:Conti nentalCasualty Company CNA) A XV 20443 6500 North Andrews Avenue Ft. Lauderdale, FL 33309-2132 INSURERE: - INSURER F : lrnvCOA/rCe r`1=0TICIr`ATC nil inaRGR• R1=VICI0KI NIIMRFR- THIS IS TOCERTIFYTHAT 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 LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE [X] OCCUR 5180214 03/01/2018 03/01/2019 DAMAGE TO RENTED PREMISES Ea occu rence $ 300,000 Contractual Liab. X MED EXP An one person)$ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY Fx_1 JECT F—xl LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 21000,000 $ OTHER: A AUTOMOBILE LIABILITY Ee a d.n SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ X ANY AUTO 2961640 03/01/2018 03/01/2019 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY NON-OWNED ONLY PRPER a. _Z DAMAGE $ $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS -MADE ZUP-15T76430-18-NF 03/01/2018 03/01/2019 AGGREGATE $ 5,000,000 DED I X I RETENTION$ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 012015939 03/01/2018 03/01/2019 X STATUTE OERH E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 $ E.L. DISEASE - POLICY LIMIT 1,000,000 $ If yes, descrbeuntler DESCRIPTION OF OPERATIONS below D Professional AEH006091227 03/01/2018 03/01/2019 Per Claim 2,000,000 D Liability AEH006091227 03/01/2018 03/01/2019 Aggregate 4,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional arks Schedule, may be attached if more space is required) RE: CERTIFICATE HOLDER IS included as additional i red �cA I ral iability Auto Liability, and Umbrella Liability when required by written contract. AP V B Y� BY WAIVER N/A YE6 Monroe County 1100 Simonton Street RM 2-216 Key West, FL 33040 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 ACORD 25 (2016 03) , GG• ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Amendment Of Limits Of Insurance And Other Insurance Clause For Described Persons Or Organizations 1. The following replaces section IV. Definitions J. Insured, Paragraphs 2. and 5., but only with respect to any person or organization listed in the Schedule below: Any person or organization that is listed in the Schedule below is an Insured but only: a. with respect to liability for Bodily Injury or Property Damage caused, in whole or in part, by your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of Your Work to which the written contract requiring insurance applies for such Insured; and b. if such person or organization is included as an Insured under any Scheduled Underlying Insurance or Scheduled Retained Limit. 2. The following is added to section VII. Conditions L. Other Insurance: L. Other Insurance Nor will we apply this provision to any person or organization listed in the Schedule below if: 1. such person or organization qualifies as an Insured under section IV. Definitions J. Insured 2. or 5. of this agreement; 2. you have agreed in a written contract or agreement with such person or organization that this policy will apply before any Other Insurance; and 3. the Scheduled Underlying Insurance or Scheduled Retained Limit applies to such person or organization on a primary and noncontributory basis. If these conditions are met, then this policy will apply to such person or organization before any Other Insurance, but only to the extent that the minimum limits of liability required by such written contract or agreement exceed the applicable limits of such Scheduled Underlying Insurance or Scheduled Retained Limit, subject to the Limits of Insurance stated in Item 3. of the Declarations of this policy. 3. The following is added to section III. Limits of Insurance B.: However, with respect to any person or organization listed below in the Schedule, the most we will pay for all damages covered under Insuring Agreement I. Coverage shall be the lesser of the following to the extent they exceed the applicable limits of the Scheduled Underlying Insurance or Scheduled Retained Limit: 1. the minimum limits of insurance required in the contract or agreement between you and such person or organization; or 2. the limits of insurance stated in Item 3. of the Declarations. Schedule of Described Persons or Organizations ANY PERSON OR ORGANIZATION FOR WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT OR AGREEMENT THAT THIS POLICY SHALL APPLY TO THEM BEFORE ANY OTHER INSURANCE. Schedule of Designated Locations ONLY THOSE LOCATIONS DESIGNATED IN THE WRITTEN CONTRACT OR AGREEMENT REFERENCED DIRECTLY ABOVE. All other terms of your policy remain the same. SU334 Ed. 7-11 0 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 POLICY NUMBER: GL5180214, COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. PER THE CONTRACT OR AGREEMENT, Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section li - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and Included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured Is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insu- rance shown in the Declarations; whichever is less. 2. If coverage provided to the additional_ This endorsement shall not increase the appli- insured is required by a contract or agree- ment, the insurance afforded to such addi cable Limits of Insurance shown in the Decla- tional Insured will not be broader than that rations. CG 20 37 04 13 0 Insurance Services Office, Inc„ 2012 Page 1 of 1 9 ENDORSEMENT This endorsement, effective 12:01 A.M. 03/01/2018 forms a part of policy No.: CA 296-16-40 issued to KEITH & SCHNARS, P.A. by NATIONAL UNION F 1 RE INSURANCE COMPANY OF P I TTSBURGH , PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following. - BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR ORGANIZATIONS LIABILITY ARISING OUT OF THE USE OF A COVERED AUTO. I. SECTION 1I - LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add: A. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. 87950 (10/05) Adthorized Representative or Countersignature (in States Where Applicable Page 1 of 1 ------ 4 KEITAND-01 NCHANDUVI ACORN DATE (MWDDNYYY) �� CERTIFICATE OF LIABILITY INSURANCE 02123/2018 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). CQNTACT PRODUCER IN Ames & Gough 8300 Greensboro Drive A/CC, No, Exty (703) 827-2277 jAAixc, No1:(703) 827-2279 Suite 980 { : admini@amesgough.com McLean, VA 22102 IY0110 01 Aarnonur_ MVPQAr:P sate e INSURED Keith and Schnars, P.A. 6500 North Andrews Avenue Ft. Lauderdale, FL 33309-2132 St. Paul Fire and Marine Insurance Company_ National Union Fire Insurance Company of Pittsburgh, PA Continental Casualhf Company_(CNA)LAzXV 11■■can. OCVIQInLi A1111111101=0- . THIS IS TOCERTIFYTHAT 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 ADDLINSD.,SUB WVDPOLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRA X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE b 1,000,000 CLAIMS -MADE X OCCUR Contractual Liab• 5180214 03101/2018' 03/01/2018 ETORENTED _ — $10,000 PR 1 a occurrence) _ ; b PREMISES 000 MED EXP A one person)$ _ _ 0' - PERSONAL &ADVINJURY E 1,000,000 X GENERAL AGGREGATE $ 2,000,000 -PRODUCTS =COMPIOPAGG E 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY FX jF& a LOC OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident_ 1,000,000 i X ANY AUTO 2961640 03/01/2018 03/01/2019 BODILY INJURY Per erew i BODILY INJURY Peraoddent BODILY OWNED SCHEDULED AUTOS ONLY AUTOS p AUTOS ONLY AUTO ONLY $ E POPER Yrs AGE E B X UMBRELLA LIAR X OCCUR EXCESS LIAS CLAIMS -MADE P-,iM6430-18-NF 0310112018 03101/2019 EACH OCCURRENCE E S,000,OOO $ 5,000,000 AGGREGATE DED X I RETENTIONS 10,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN pFFICER/MEMBER EXCLUDED? �_� 'Mandatoryin NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 012015939 03/01/2018 03/01/2019 TH- X PER OEIR T T E ER 1,000,000 $ __ 1,000,000 E _ 1,000,000 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE E.L. DISEASE -POLICY LIMIT D (Professional IAEHOO6091227 03101/20181 03/01/2019 lPer Claim 1,000,000 D Liability AEH006091227 03/01/2018 1 03/01/2019 ,Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: Continuing Contract for On Call Professional Engineering Services Monroe County is included as additional insured with respects to General Liability and Auto Liability when required by written contract. APPR B K GEMENT BY DATE V /'A\IrCI 1 ATIAW SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County tY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West, FL 33040 AUTHORIZED TIV E �REPRESENTATIVE IPy�,oERP�RESENTA ACORD 25 (2016103) W 19t$t3-ZU15 AGUKU GUKI'UKA I IUN. Ali rlgn[s reserves. The ACORD name and logo are registered marks of ACORD r ,....,......"140 KCITECH-01 RVANDEGRIFT ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 46...----- 3/20/2019 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 Maureen Martin,AA! NAME: Lyons Insurance Agency,Inc. PHONE FAX 501 Carr Road,Suite 301 (A/C,No,Ext):(302)472-2914 (A/C,No): Wilmington,DE 19809 ADDRESS:mmartin@lyonsinsurance.com • INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:National Union Fire Insurance Company of Pittsburgh,PA 19445 INSURED i - wsuRERB:Great American Insurance Co. 16691 KCI Technologies,Inc. . ( IJ IA /s / {� INSURER c:New Hampshire Insurance Company 23841 6500 North Andrews Avenue U�r"` LINSURER D: Fort Lauderdale,FL 33309 _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. INSRL TYPE OF INSURANCE ADDLS SUBRW POLICY NUMBER IMMIDD/YCY YYYI (MMIDDY�1 LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X 5222413 4/1/2018 4/1/2019 R EMISEUEa occu nce) $ 500,000 MED EXP(Any one person) S_ 25,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIESPER: GENERAL AGGREGATE $ 2,000,000 POLICY X %Ref LOC PRODUCTS-COMP/OP AGG ,$ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) _ S X ANY AUTO X 4489582 4/1/2018 4/1/2019 BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) S X Comp Ded.$250 X Collision Ded$500 S B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 25,000,000 EXCESS LIAB CLAIMS-MADE X TUU0202925-07 4/1/2018 4/1/2019 AGGREGATE $ 25,000,000 DED X I RETENTION$ 10,000 $ , C WORKERS COMPENSATION x PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER _ Y/N WC012016190 4/1/2018 4/1/2019 1,000,000 ANY OFFICER/MEMBER EXCLUDED?ECUTIVE N N/A E.L.EACH ACCIDENT S (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under A� ROlJ�D ISK h Nr �El,r_ ; 1,000,000 DESCRIPTION OF OPERATIONS below E E.L.DISEASE-POLICY LIMIT $ DY ( 1 DATA ��AA''``�pp 'v''/I 4_ 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,AdWfolfa7 lnhilika iC yrEB a attached if more space is required) Auto Policy includes CA 99 48(Pollution Liability-Broadened Coverage for covered autos-Business auto and motor carrier coverage forms) Workers Compensation Policy includes Employer's Liability Stop Gap Coverage Project Name: Continuing Contract for On Call Professional Services Additional Insured under General&Automobile Liability,on a Primary/Non-Contributory basis where required by written contract.Wavier of Subrogation is granted under General&Automobile Liability,&Workers Compensation,where required by written contract&allowable by state law. Umbrella is Following SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe CountyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West,FL 33040 AUTHORIZED REPRESENTATIVE 3:7-7./----V__, ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD r I L �1 AGENCY CUSTOMER ID:KCITECH-01 RVANDEGRIFT /".'", LOC#: 1 ACOREY ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED L ons Insurance A KCI Technologies,Inc. enc Inc. Y 9 Y� 6500 North Andrews Avenue POLICY NUMBER Fort Lauderdale,FL 33309 SEE PAGE 1 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/LocationsNehicles: Form with the Underlying.If coverage is cancelled by the company,notice of cancellation will be provided at least 30 days in advance,subject to state specific statutes. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD