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Certificates of Insurance AC � CERTIFICATE OF LIABILITY INSURANCE °0A3/02/20 z") 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 1-800-247-7756 CONTACT NAME: Zach Stltz Holmes Murphy & Assoc - WDM PHONE FAX A/C No Ext: 300-247-7756 A/C,No PO sox 9207 ADDRESS: ZStitz@holmesmurphy.com INSURER(S)AFFORDING COVERAGE NAIC# Des Moines, IA 50306-9207 INSURERA: ZURICH AMER INS CO 16535 INSURED INSURER B: General Asphalt Co., LLC INSURER C 4850 NW 72nd Avenue INSURERD: INSURER E Miami, FL 33166 INSURERF: COVERAGES CERTIFICATE NUMBER: 63970994 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 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ OCCUR DAMAGE TO S( RENTED CLAIMS-MADE PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: y j? k GENERALAGGREGATE $ POLICY PE� LOC * p """ PRODUCTS-COMP/OP AGG $ OTHER: '- $ AUTOMOBILE LIABILITY 5 . 24 I.. � . 2022 COMBINED SINGLE LIMIT $ __, ,,, Ea accident ANY AUTO I BODILY INJURY(Per person) $ T'OWNED SCHEDULED M tkx y"- ' AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ PER A WORKERS COMPENSATION WC375713504 11/01/21 11/01/22 % STATUTE OE TRH- AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y 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 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Project GAKAP159, Project Rehabilitate Taxiway A Monroe County BOCC. Waiver of subrogation in favor of Monroe County BOCC and all contractors and subcontractors as required by written contract per policy terms and conditions. CERTIFICATE HOLDER CANCELLATION Monroe County BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN KEY WEST,FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Z,. 14 2 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD zstitzwdsm 63970994 GENEASP-01 SSIMEON �►co�zo CERTIFICATE OF LIABILITY INSURANCE DAT2/3/2 D/YYYY) 022 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: Collinsworth,Alter,Fowler&French, LLC PHONE 305 822-7800 FAX 305 362-2443 15050 NW 79th Court (A/C,No,Ext): ( ) (A/C,No):( ) Suite 200 ADDRESS: Miami Lakes,FL 33016 INSURER S AFFORDING COVERAGE NAIC# INSURER A:Travelers Indemnity Company 25658 INSURED INSURER B:Great American Insurance 16691 General Asphalt Co., LLC INSURER C:Phoenix Insurance Co 25623 4850 NW 72 Ave INSURER D: Miami,FL 33166 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 j OCCUR VTC2KCO2N2542311ND22 1/1/2022 2/1/2023 DAMAGE TO RENTED 300,000 PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY ] JECT1:1 LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000 Ea accident $ X ANY AUTO VTC2KCAP2N2541511ND22 1/1/2022 2/1/2023 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X 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 T00025052410 1/1/2022 2/1/2023 AGGREGATE $ 10,000,000 DED RETENTION$ $ 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 $ C Leased/Rented QT6607S952638TIL22 1/1/2022 2/1/2023 w/$5000. Ded 500,000 C Schedule Eqpt Blkt QT6607S952638TIL22 1/1/2022 2/1/2023 w/$5000. Ded 11,147,018 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project:Rehabilitate Taxiway A Project No.GA Al63.Certificate holder and The Monroe County BOCC,its employees and officials are added as additional insured as required by written contract for the general liability and automobile policies.Waiver of subrogation is included for general liability. XCU Included. T S TE�5 2 4 • 2 , �T . CERTIFICATE HOLDER CANCELLATION ,, " w MONROE COUNTY BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West, FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD GENEASP-01 T ARR1 . aa. R CERTIFICATE OF LIABILITY INSURANCE D1223ATE 100/20 �✓ 12/23/2020 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 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 ri hts to the certificate holder in lieu of such endorsements. PRODUCER 3-CN CT Teresa Garrido Collinsworth,Alter,Fowler&French,LLC PH' oNE mmmm ^W Ax mm 8000 Governors Square Blvd {ac,No.EXelp305822-7800__ lac,No�:�305 362-2443 Suite 301 E'M9449l: tgarrido�caffllc.com � Miami Lakes,FL 33016 INSURED INsuREas:Phoenix Insurance Co 25623 General Asphalt Company Inc. NsuReR c:Great American Insurance,,,,, _ 16691 P O Box 522306 Miami,FL 33166 lNsuRER D ^.INSURER E: l 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' ......._._�.._._....�..__ ADOL'SUBR ' POLK:Y EFFVPOLICY EXP �� TYPE OF INSURANCE INSD VI POLICY NUMBER IMMIDOryyY`/) nuimiPDlyyyyl LIMBS A X COMMERCIAL GENERAL LIABILITY EACH_QCCURRE19CE $ 2,000,000 CLAIMS-MADE X OCCUR X ' X DTC08063M466COF21 1/1/2021 1 11112022 DAMAGE ro RENreO PREM15E,5(Ea $-1-11111 gpp Ogp X 55000.PD Dad MED EXP{Any one perron} $_ 81000 Approved Risk Manogement i;000,000 PERSONALS ADV INJURYS_ _ _GEN'L AGGREGATE LIMIT APPLIES PER: .C--. GENERAL AGGREGATE i$ ._4,000,006 POLICY i X I JECT _a LOC 1-26-2021 PROD UCTS-_.COMPlOP_AG $ 4,000,000 OTHER: S B AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT 21000,000 (Ea accident)i `_ X .ANY AUTO X er� '8109N5860252126G 111/2021 j 111/2022 BODILY INJURY P erson) �$ OWNED SCHEDULED - ._„ ;AUTOS ONLY 'AUTOS I BODILY INJURY peeracadenl-}�$ X X;NON•OWN pp PROPERTY DAMAGE _....,AUTOS ONLY .�AUTOS ON�Y Zf?eCa acid $ ........_-._.- _...., .. .... �$ C XUMBRELLA LIAB X OCCUR 10,000,000 � _.EACH OCCURRENCE EXCESS une CLAIMS-MADE T00025052409 111/2021 1/1/2022 10,000,000 AGGREGATE ...r....._._. ....... ..... _..$.. ...._._.. , _._.,.. ..... DED RETENTION$ I s$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y _ -.. �IALS/T.f.—i.-_— .E6.—. ;ANY PROPRIIETgOER/PARTNER/EXECUTIVE YIN v J E.L.EACH ACCIDENT $, (plFandatoryl in NX)EXCLUDED? ._ N/A C 1 #'.._ ......... .....'... ._�...._...W.M...._._.......__. yy 1 E.L.DISEASE-EA EMPLOYE -$ DESCRIPTI Ncnbe under (. E.L.DISEASE-POLICY LIMIT $ ON OF OPERATIONS below B Leased/Rented QT630-M397964TIL21 111/2021 1/1/2022 w/$5000.Dad 500,000 B iSchedule Equip Bikt I !QT6308M397964TIL21 111/2021 1/112022 w/$5000.Dad 11,147,018 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached if mom space is required) State of Florida Contractors License Number:CGC1522723 Monroe County License p:ENG 11286D Monroe County BOCC,Its employees and officials are included as additional insured with respect to general liability and auto liability on a primary and non-contributory basis when required by written contract. Waiver of subrogation applies in favor of the additional insured with respect to general liability when required by written contract. ......_.... CERTIFICATE HOLDER CANCELLATION _ MONROE COUNTY BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE INSURANCE COMPLIANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 100085-FX ACCORDANCE WITH THE POLICY PROVISIONS. DULUTH,GA 30096 AUTHORIZED REPRESENTATIVE -4w— _ _ _ _ ACORD 25(2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:81 DD549B-72B2-4F30-AD60-D9032BD39BEE AC CERTIFICATE OF LIABILITY INSURANCE 10/16/2020) 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 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 1-800-247-7756 CONTACT NAME: SARAH TAITZ,CLCS Holmes Murphy & Assoc - WDM PHONE FAX (A/C. /C No Ext: 1-515-223-6813 A/C,No): 1-515-221-7198 E-MAIL PO Box 9207 ADDRESS: STRITZ@HOLMEMURPHY.COM INSURER(S)AFFORDING COVERAGE NAIC# Des Moines, IA 50306-9207 INSURERA: ZURICH AMER INS CO 16535 INSURED INSURER B: General Asphalt Company, Inc. INSURER C 4850 NW 72nd Avenue INSURER D7 INSURER E: Miami, FL 33166 INSURERF: COVERAGES CERTIFICATE NUMBER: 60518056 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 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES DAMAGE TO PREMISES Ea occurrence) ccurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY D PE O LOC ISK PRODUCTS-COMP/OP AGG $ x OTHER: - - - $ ..G AUTOMOBILE LIABILITY By �� - - COMBINED SINGLE LIMIT $ -- - -- Ea accident ANY AUTO - 1 0/2 77/2.Q 2 __ -_. ,e,...,--�,,,, BODILY INJURY(Per person) $ OWNED SCHEDULED DA AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ WAMP HIRED NON-OWNED - �'" PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC3757135 11/01/20 11/01/21 % STATUTE OERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YH 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 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) Project GAKAP159, Project Rehabilitate Taxiway A Monroe County BOCC. Waiver of subrogation in favor of Monroe County BOCC and all contractors and subcontractors as required by written contract per policy terms and conditions. CERTIFICATE HOLDER CANCELLATION Monroe County BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN KEY WEST, FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE USA AVk �i� Ce` ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD stritzwdsm 60518056 �1 GENEASP-01 SSIMEON ACORD" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) `-� 12/18/2019 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 1dAME: Collinsworth,Alter,Fowler 8,French,LLC PHONE 305 822-7800 FAx 305 362-2443 8000 Governors Square BlvdIL (A/c,No,Ext):( ) lac,No):( ) Suite 301 ADE DRESS: Miami Lakes,FL 33016 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Charter Oak Fire Ins Co 25615 INSURED INSURER B:Phoenix Insurance Co 25623 General Asphalt Company Inc. INSURER C:Great American Insurance 16691 P 0 Box 522306 INSURER D: Miami,FL 33166 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 IMMIDD/YYYYI IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR C08063M46619 1/1/2020 1/1/2021 DAMACETORENTED 300,000 X X PREMISES(Ea occunence) $ X $5000.PD Ded 5,000 pppppp � MED EXP(Anyone person) $ 1 ( � �.C.R�;I1ACEMENT PERSONAL 8 ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: BY \(�f( , GENERAL AGGREGATE $ 4,000,000 POLICY X JEtaT LOC '(1 �^ 9 PRODUCTS-COMP/OPAGG $ DM 4,000,000 OTHER: r� $ B AUTOMOBILE LIABILITY WAIVER N/IAY YES_ COMBINED SINGLE LIMIT_ 2,000,000 (Ea acddent) $ X ANY AUTO X 8109N58602519 1/1/2020 1/1/2021 BODILY INJURY(Per person) $ OWNED SCHEDULED I AUTOS ONLY AUTOS pBODILY INJURYp (Per accident) $ X AUTOS ONLY X NON-OWNEDUUO L (Per acddenq AGE $ $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 9,000,000 EXCESS LIAB CLAIMS-MADE TUU025052408 1/1/2020 1/1/2021 AGGREGATE $ 9,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N _ STATUTE ER ANY ICERIMEMBER EXCLUDED?ECUTIVE N/A E.L.EACH ACCIDENT $ (Mandatory in NH) 1E.L.DISEASE-EA EMPLOYEE$ If yes,describe under DESCRIPTION OF OPERATIONS below J i I E.L.DISEASE-POLICY LIMIT $ B Leased/Rented QT6308M397964 1/1/2020 1/1/2021 w/$5000.Ded 500,000 B Schedule Equip Blkt QT6308M397964 1/1/2020 1/1/2021 w/$5000.Ded 12,097,865 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project:Rehabilitate Taxiway A Project No.GAKAP159 Monroe County BOCC,Its employees and officials are included as additional insured with respect to general liability and auto liablity on a primary and non-contributory basis when required by written contract. Waiver of subrogation applies in favor of the additional insured with respect to general liability when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe CountyBOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West,FL 33040 AUTHORIZED REPRESENTATIVE I ..4tai ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A`cPR E)� CERTIFICATE OF LIABILITY INSURANCE 12/20/20 9 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 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 1-800-247-7756 CONTACT NAME: Holmes Murphy & Assoc - WDM PHONE FAX (NC,No,Ext): (NC,No): _ E-MAIL PO Box 9207 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Des Moines, IA 50306-9207 INSURER A: ZURICH AMER INS CO 16535 INSURED INSURER B: General Asphalt Company, Inc. INSURER C: 4850 NW 72nd Avenue INSURERD: INSURER E: Miami, FL 33166 INSURERF: COVERAGES CERTIFICATE NUMBER:58053780 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS {MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 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 $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: 1.T BY RISK t AG ME$.IT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ BY (Ea accident) ANY AUTO J BODILY INJURY(Per person) $ OWNED I SCHEDULED DATE r AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED WAIVES N/A YES PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A X WORKERS COMPENSATION WC3757135 11/01/19 11/01/20 _ STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) EL 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 GAKAP159, Project Rehabilitate Taxiway A Monroe County BOCC. Waiver of subrogation in favor of Monroe County BOCC and all contractors and subcontractors as required by written contract per policy terms and conditions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West, FL 33040 USA ,� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD chellmanwdsm 58053780