COI Expires 12/11/2019 •e' DATE(MMIDD/YYYY)
A R`D• CERTIFICATE OF LIABILITY INSURANCE
8/15/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER Phone: (813)251-4900 CONTACT Professional Insurance Center Inc
Fax (813)253-2676 NAME:
Professional Insurance Center,Inc. UUHCNNo.Extl: FAX
No):
E-MAIL
2003 West Kennedy Blvd ADDRESS:
Tampa,Florida 33606 INSURER(S)AFFORDING COVERAGE NAIC#_
INSURER A: Amalgamated Casualty Insurance Company 13293
INSURED ---- -— - - - INSURER B:
KEYHOPPER TRANSPORTATION,INC.. INSURER C:
9400 OVERSEAS HIGHWAY#103 INSURER D:
MARATHON,FL 33050 -
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:499 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. -
IN SR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP • -'-
INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYYI LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
I DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $
MED EXP(Any one person) $
PERSONAL&ADV INJURY $ •
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
HPOLICY JECOT LOC PRODUCTS-COMP/OP AGG $
OTHER: $
AUTOMOBILELIABIUTY CAP-18-0103881-03 12/11/2018 12/11/2019 CCOMeBIINEDtSINGLE LIMIT $ 300,000
A
ANY AUTO BODILY INJURY(Per person) $
OWNED �/ SCHEDULED AUTOS ONLY AUTOS I N BODILY INJURY(Per accident) $
_
-0 HIRED NONWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
$
UMBRELLA LIAB _ OCCUR . EACH OCCURRENCE $
EXCESS UAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY-, Y/N _ STATUTE ER
ANYPROPRIETOR/PARTNER/EJECUTIVE ❑ N/A - - EL EACH ACCIDENT $
OFFICER/MEMBEREXCLUDED7
(Mandatory in NH) EL DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY MIT $
I LIMIT --
•
•
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
— —CERTIFICATE-HOLDER-IS-AN ADDITIONAL-INSURED - — - - --
2015 - FORD - TRANSIT - NM0GE9F77F1182174
2017 - NISSAN - SENTRA - 3N1AB7AP2HL663610 APPR t NAGEMRNI
2018 - DODGE - GRAND CARAVAN - 2 C4RDGBG6JR2 016 96 BY
2016 - HYUNDAI - SONATA - 5NPE2 4AF 7GH3 173 76 • DATE 1
CI
WAIVER N/A ,..z
CERTIFICATE HOLDER C• .CELLATION
Holder's Nature of Interest:Additional Insured
SHO LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
MONROE COUNTY BOARD OF COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACC.,RDANCE WITH THE POLICY PROVISIONS.
COMMISSIONERS
1100 SIMONTON ST AUTH.- .REPRESEN
KEY WEST,FL 33040
1
1988 2015 CORD CO PORATION. Ali rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks ACORD