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COI Expires 04/15/2020 ATE A D® CERTIFICATE OF LIABILITY INSURANCE D 9/26/20191 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: Frank H. Furman, Inc. IAIC Nn o.Eat): (954)943-5050 (AAic No): (954)942-6310 1314 East Atlantic Blvd. E-MAILESS: 1'jenn @furmaninsurance.com ADDR P. O. Box 1927 INSURER(S)AFFORDING COVERAGE NAIC# Pompano Beach FL 33061 INSURER A:Berkley Assurance Co 39462 INSURED INSURERB:National Fire Ins Of Hartford 20478 Bob Hilson & Company, Inc. INsuRERc:National Fire Ins Co of Pitts 19445 _ 401 NW 14th Ave INSURERD: INSURER E: Homestead FL 33030 INSURERF: COVERAGES CERTIFICATE NUMBER:Oct 19 GL Auto XS 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 NSO W NSR SUBR D POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDD/YYYY) (MM/DDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 A CLAIMS-MADE X OCCUR DAMAGE PREMISES(Ea occurrence) $ 100,000 X Contractual X VUMD0000471 10/1/2019 10/1/2020 _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 X PRO-JECT LOC _PRODUCTS-COMP/OPAGG S 2,000,000 X OTHER: $5K Ded Per Occ PD Only Policy Aggregatge S 5,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED AUTOS AUTOS X 2069003905 4/15/2019 4/15/2020 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accident) S PIP $ 10,000 UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 1,000,000 C X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED X RETENTION$ zero EBU016361090 10/1/2019 10/1/2020 S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA /�J{�'s'�'(`,''+,'�� (Mandatory in NH) APP NED B RIS 1 Q�,+AGEMEN - E.L.DISEASE-EA EMPLOYEE S If yes,describe under Y �� "^" DESCRIPTION OF OPERATIONS below ''V (f, E.L.DISEASE-POLICY LIMIT $ A.WAIVER W/AA )( YV s DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may b attached if more space is required) Project: BID-PFM-352-13-2007-PUR/CV, Roof Repair - Spottswood Building. Monroe County Board of County Commissioners is included as Additional Insured with respect to General Liability and Automobile Liability where required by written contract per policy terms and conditions for work performed by the Named Insured. CERTIFICATE HOLDER CANCELLATION slavik-maria@monroecounty-fl. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Maria Slavik 1100 Simonton Street #268 AUTHORIZED REPRESENTATIVE Key West, FL 33040 40A.6429 429,$4y.---- Dirk DeJong/MR ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)