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COI Expires 01/01/2021 A�O® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/23/2019 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 Eryn Zak NAME: ry -Lassiter-Ware Insurance of Tampa Bay PA/HONE Extt: (800)845-8437 FAX X,No): (888)883-8680 1300 N.Westshore Blvd E-MAIL E nZ lassiterware.com ADDRESS: ry Suite 110 INSURER(S)AFFORDING COVERAGE NAIC S Tampa FL 33607 INSORERA: National Fire Insurance Company of Hartford 20478 INSURED INSURER B: Transportation Insurance Company 20494 Air Mechanical&Service Corp. INSURER C: Continental Insurance Company 35289 2700 Ave of the Americas INSURER D: Builders Mutual Insurance Company 10844 INSURER E: Scottsdale Insurance Company 41297 Englewood • - FL 34244 ' INSURER F: . • COVERAGES CERTIFICATE NUMBER: 20-21 Master 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. I , LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICYEFF POLICY EXP (MMM/IDDD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ DAMAGE TO RENTED 100,000 CLAIMS-MADE in OCCUR PREMISES(Ea occurrence) $ X CONTRACTUAL LIABILITY MED EXP(Any one person) $ 5,000 A X XCU INCLUDED N 6079391995 01/01/2020 01/01/2021 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY n PRO- I I LOC PRODUCTS-COMP/OPAGG $ 2,000,000 $ JECT I ES OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED N 6079392015 01/01/2020 01/01/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) PIP-BASIC $ 10,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAB CLAIMS-MADE 6079392032 01/01/2020 01/01/2021 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 �/ $ WORKERS COMPENSATION /� STATUTE EORH AND EMPLOYERS'LIABILITY YIN 1,000,000 D ANY PROPRIETOR/PARTNER/EXECUTIVE NIA WCP1068136 01/01/2020 01/01/2021 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , CONTRACTORS POLLUTION CLAIM LIMIT $2,000,000 E CONTRACTORS PROFESSIONAL VRS0004279 01/01/2020 01/01/2021 GENERALAGGREGATE $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RE:Marathon Government Center HVAC Monroe County Board of County Commissioners,its employees and officials are named as Additional Insureds with respect to General Liability,Automobile Liability and Umbrella Liability when required by written contract. BY F I✓ AG):(s+Il IVl WAVER (/ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Gato Bldg,Room 2-213 AUTHORIZED REPRESENTATIVE Key West FL 33040 -16 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00053185 � l LOC#: ACC)RD ADDITIONAL REMARKS SCHEDULE Page of • AGENCY NAMED INSURED Lassiter-Ware Insurance of Tampa Bay Air Mechanical-Englewood POLICY NUMBER • 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:Notes Air Mechanical&Service Corp. Certificate Notes for Policy Term 1/1/2020 to 1/1/2021 General Liability: 1.BlanketAdditional Insureds when required by written contract including Ongoing Operations and Products&Completed Operations per Form#CNA75079 (10/16). 2.Blanket Waiver of Subrogation when required by written contract per Form#CNA74705(01/15). 3.Primary&Non-Contributory when required by written contract per Form#CNA74705(01/15). 4.General Aggregate Limit Applies Per Project per Form#CNA74705(01/15). Automobile Liability: 1.Blanket Additional Insureds when required by written contract per Form#CNA63359(04/12).2.Blanket Waiver of Subrogation when required by written contract per Form#CNA63359(04/12). 3.Automobile is a statutory coverage mandated by State Law. As such,coverage is primary and non-contributory. Workers'Compensation: 1.Blanket Waiver of Subrogation when required by written contract per Form#WC000313. 2.Worker's.Compensation is a statutory coverage mandated by State Law. As such,coverage is primary and non-contributory. Umbrella: 1.General Liability,Automobile and Employers Liability are listed in the underlying schedule on the Umbrella policy. . 2.Follow form to the underlying,Additional Insured by written contract,Primary&Non-Contributory wording,and Waiver of Subrogation. General Information: 1.The General Liability policy contains no specific residential exclusions 2.The certificate notes shown above reference the following policies: 6079391995,6079392015,WCP1068136 and 60079392032 ALL COVERAGE IS SUBJECT TO THE POLICY TERMS,CONDITIONS AND EXCLUSIONS. • ACORD 101(2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD